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TITLE Bibliography on and Health. INSTITUTION Public Health Service (DHEW), Rockville, Md. National Clearinghouse for Smoking and Health. PUB DATE 71 NOTE 344p. AVAILABLE FROMSuperintendent of Documents, U. S. Government Printing Office, Washington, D. C. 20402

EDRS PRICE MF-S0.65 HC- $13.16 DESCRIPTORS Bibliographic Coupling; *Bibliographies; Booklists; Disease Control; Disease Rate; Diseases; Health; *Health Education; Indexing; Information Retrieval; *Literature Reviews; *Smoking; *

ABSTRACT This Bibliography includes all of the items added to the Technical Information Center of the National Clearinghouse for Smoking and Health from January through December 1971. The publication is broken down into eleven major categories. These are: (1) chemistry, pharmacology and toxicology; (2) mortality and morbidity;(3) neoplastic diseases;(4) non-neoplastic respiratory diseases; (5) cardiovascular diseases; (6) other diseases and conditions;(7) behavioral and educational research;(8) tobacco economics;(9) bills and legislation; and (10) general references. Also included in this bibliography are a cumulative author and organizational index and a cumulative subject index. U00 1971

NATIONAL CLEARINGHOUSE FOR SMOKING AND HEALTH

BIBLIOGRAPHY on SMOKING AND HEALTH

U.S. DEPARTMENT OF HEALTII. EDUCATION & WELFARE OFFICE OF EDUCATION THIS DOCUMENT HAS BEEN REPRO- DUCED EXACTLY AS RECEIVED FROM THE PERSON OR ORGANIZATION ORIG INATING IT. POINTS OF VIEW OR OPIN IONS STATED DO NOT NECESSARILY REPRESENT OFFICIAL OFFICE OF EDU- CATION POSITION OR POLICY.

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Public Health Service Health Services and Mental Health Administration FILMED FROM BEST AVAILABLE COPY 1 PREFACE

This Bibliography includes all of the items added to theTechnical Information Center of the National Clearinghouse for Smoking and Health fromJanuary through December 1971. Earlier volumes still available for purchase throughthe Superintendent of Docu- ments, Government Printing Office, include thevolumes for 1968, 1969 (Parts I and II), and 1970. These may be ordered by requesting fromthe Government Printing Office, Public Health Service Publication No. 1124, BibliographySeries No. 45, plus the year desired.

Information on the availability of articles listed in thisBibliography may be obtained by writing or calling the Technical Information Center at theClearinghouse.

Technical Information Center National Clearinghouse for Smoking and Health 5401 Westbard Avenue Bethesda, Maryland 20016 301-496-7941

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For ado by the Superintendent of Documents, U.& Government Printing Mee, Washington, D.C. 20102 CONTENTS

CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY 1,33, 64,96,129,148, 179,208

MORTALITY AND MORBIDITY 7,41, 76,103,134,156,183,213

NEOPLASTIC DISEASES 9,43, 76,104,135,156, 184,213

NON-NEOPLASTIC RESPIRATORY DISEASES 13,47, 79,108,137,159, 188, 218

CARDIOVASCULAR DISEASES 19, 52,84,113,140,163, 193, 225

OTHER DISEASES AND CONDITIONS 25, 55, 88,119,142,169, 199, 229

BEHAVIORAL AND EDUCATIONAL RESEARCH 27,57,91,124,145,171,201,232

TOBACCO ECONOMICS 30,61,93,236

BILLS AND LEGISLATION 31,61,93,126,205

SMOKING CESSATION METHODS 31,62,94,126,177,205,236

GENERAL 31,63,95, 127,146,178,206,238

CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX 240

CUMULATIVE SUBJECT INDEX 301 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

71-0001. Anastasov, A., Mokhnachev, LG. Sherstyanykh, .]Mitteilangen sus dem Gebeite der Lehenz. N. A. Izsledmie na Sustava na Alkaloidite v Tyutyu- mittehengtersuchung mod lbwiene 60(5):379-388. 1969, neviya Dim a Pomoshta na Gazovata Khromatografiya. German. [investigation of the Alkaloid Composition in Tobacco Smoke by Gas Chromatography.] Bulgarskl Tyutyun The acrolein and hydrocyanic acid content of 13(5):24-26, 1968, Bulgarian. smoke has been studied. The measurement of acrolein was carried out directly by chromatography while hydro- Gas chromatography was used to determine the com- cyanic acid in the gas and particulate phases was deter- position of all basic constituents present in cigarette mined by a colorimetric method. The hydrocyanic acid smoke, such as pyridine, alpha-picolinc.and berapicoline, content retained in the butt was also measured. In the gas with special attention given to the true alkaloids (nico- phase of the without filters were found between tine, nomicotine, , metanicotine, etc.). The 90 and 230 micrograms of acrolein per cigarette. de- results are tabulated. A crepe filter reduced the pending on the kind of tobacco. The quantity of hydro- content of the smoke by about 20 percent and the con- cyanic acid found in main-stream smoke (gas and particu- tent of the other alkaloids from 20 to 57 percent. As far late phases) was between 150 and 350 micrograms per as the toxicity of nicotine and other alkaloids is con- cigarette. It was further established that the two com- cerned, such a filter on a cellulose base definitely renders pounds are appreciably reduced by the utilization of smoking less hazardous. filters containing the adsorbent materials.

71-0002. Anastasov, A., Pisklov, V. P., Mokhnachev, I. G. 71-0005. Banyai, A. L. Ominous Mesalliance: Inhalation lzsledvane na Puafinovite Vuglevodorodi v Glavnata of Carbon Monoxide From Motor Vehicles and Ciga- Struya na Tyutyuneviya Dim s Pomoshtta na Gazovata rettes. Chest 58(5):532, November 1970. Kluomatopafiya. [investigation of the Paraffin Hydro- carbons in Main-Stream Tobacco Smoke by Gas Chrome- Animal and human experiments hav'e shown that t opap hy .]Bulgarski Tyutyun13(11 ): 27-32,1968, carbon monoxide can lead to increased pulmonary artery Bulgarian. pressure,increasedheartrate andsystolicpressure. decreased metabolism, some myocardial fiber degenera- The peaks in the chromatogram disclosed that paraffin tion, hemorrhaging and necrosis of the myocardium, hydrocarbons containing 20 to 33 carbons, both straight increased blood viscosity, atheromatous changes. ECG and branched chain, were present in the smoke. Cellulose changes, inhibition of brain bioclectric activity, impair- filters increased the average values from 2.37 to 2.64 mg ment of cognitive and psychomotor areas of the brain and of higher hydrocarbons per gram tobacco. This indicates inhibition of alveolar macrophage function. Carboxy- that filters by their decomposition may cause a relative hemoglobin levels reach 4 to 6 percent in moderate increase of approximately 10 percent in higher hydro- smokers and up to 12 percent in heavy smokers. Carbon carbons. It was speculated, however, that the increase monoxide concentrations from motor vehicle exhausts, might be due not to filter decomposition but to hydro- especially during peak traffic hours, often exceed the carbons adsorbed inthe filters and later released as maximum allowable levels. smoking continued. 71-0006. Baribaud, L., Yacoub, M., Faure. J., Malinas, Y., 71-0003. Arsenyan, E.Kolichestveni lzmeneniya na Cau, G. L'Oxycubonemie de rEnfant Ne de Mere Alkaloidite pal Razlichni na Fermentatsiya na Orientalski Fumeuse. [Carboxyhemoglobinemia in the Child Born to Tyutyuni. [Quantitative Changes in the Alkaloid Content a Mother Who .]Afedechse Legale et Dommage of Oriental Tobacco With Different Curing Pro- Comore! 3(3):272-274. July-August-September, 1970. cesses.]Bulgarski Tyutyun 13(11):22-26, 1968, Bul- French. garian. While the average rate of carbon monoxide in non- The Bulgarian , aware of the health smoking women is 2.11 cm3/1000 cm3 of blood. and is hazards of smoking and its consequences on the industry's 352 for their children, this rate increases in smoking economic survival, has tested several curing methods in an mothers. Women who smoked from 11 to 20 cigarettes a attempt to lower the nicotine content of Bulgarian-grown day showed 11.67 cm3 of carbon monoxide per 1000 tobacco, These methods, including short, high-tempera- cm3 of blood, and their babies 15.13 cm3 of carbon ture curing, multi-step curing, and curing with various monoxide in the blood. This indicates that children born pauses, affect the enzyme activity and microorganisms to smoking mothers show an almost chronic intoxication present in the tobacco. The best results were obtained from carbon monoxide, which is present in tobacco with the short, high-temperature cure, w.dch reduced the smoke at 3.2 percent. Spontaneous abortions occurred in alkaloid content by almost 10 percent. 11 out of 27 smoking mothers, as compared to 7 out of 50 nonsmoking mothers. 710004. Artho, A., Koch, R. Ueber den Gehalt des Cigarettenrauches an Acrolein and Cyanwassentoff. 71-0007. Bastos, W. P., Ramos, A. 0. Isoaminile as In- [Acrolein and Hydrocyanic Acid Content in Cigarette hibitor of Musearinic and Nicotinic Ganglionic Re- ceptors. Pharmacology 4(1):39. 44,1970.

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The tanglioplegic action of isoaminile was observed in 71-0011. Clia, B., Lemanccau, B. Etude par Resonance dogs and cats. The drug antagonizes Zioth muscarinic and Magnetique Nucleaire d'Isomeres Cancerogenes et non nicotinic ganglionic receptors in the superior cervical Cancerogenes (Dibenzacridines etDibenzanthracenes). ganglion of the cat, the adrenal responses to splanchnic (Study by Nuclear Magnetic Resonance of Carcinogenic nerve stimulation, and the hypertensive action of nico- and Non-Carcinogenic Isomers (Dibenzacridines and tine, and McN-A-343 (4-(m-chlorphenyl- Dibenzanthracenes).JComptes Rendus Herbdomadaires carbumoiloxy)2-butynyltrimethylammonium chloride). des Seances de lAcademie des Sciences: D: Sciences (Auth. Abs. Mod.) Naturelles271(9):788.790, August 31, 1970, French.

To add to the knowledge of carcinogenic elements in 71-0008. Bianchi, C., Beani, L., Creme, C. Effects of tobacco smoke, nuclear magnetic resonance studies were Metocloprimide on Isolated Guinea-Pig Colon. 2) Inter- made of molecules of three dibenzacridine isomers, and of ference With Ganglionic Stimulant Drugs.European two dibenzanthracenes. Interpretationof thesebio- Journal of PharmacologyI 2(3):332-34I ,November chemical studies on the effects of solvents is very com- 1970. plex, although an attempt was made to separate normal from abnormal effects of carcinogens. Possibleeffects of metoclopramide on intramural nervous structures of isolated guinea-pig distal colon were investigated to ascertain if stimulation produced by the 71-0012. Collins, P. F., Sarji, N. M., Lawrence, W. W., drug on thegastrointestinalperistalsis depended on Williams, .1. F. An Automated Method for the Determina- actions °the( than the demonstrated peripheral sensitiza- tion of Total Aldehydes in Gas Phase of Cigarette tionto acetylcholine. Nerve-mediated responses were Smoke.Tobacco171(26):83-87, December 25, 1970. obtained with nicotine and 5- hydroxytryptamine, which stimulated not only cholinergic neurons, but also non- A method for the determination of total aldehydes in cholinergic nervous structures in the presence of post- the gas phase of cigarette smoke is described which is ganglionic cholinergic and adrenergic blockade. Metoclo- practical to use in the analysis of large numbers of ciga- pramide enhanced the cholinergic responses to nicotine, rettes. The method provides a measure of the total but blocked the others. Conversely, the drug completely aldehydes in the gas phase of cigarette smoke, and the prevented the effects of 5- hydroxytryptamine. Since: (1) results obtained agree well with the sum of acetaldehyde, the stimulatory effect of nicotine on non-adrenergic, propionaldehyde and acrolein found by gas chroma- non-cholinergic structures was abolished during 5- tography. The method has been applied to various types hydroxylryptamine tachyphylaxis; (2) 5-hydroxytrypta- of cigarettes with the relative standard deviation per port mine maintainedits own effectsduring nicotine of 5 cigarettes ranging from 6 to 14 percent. (Auth. Abs. tachyphylaxis; (3) metoclopramide antagonized 5- Mod.) hydroxylryptamine, it is suggested that the drug blocks try pia minergicreceptors,necessaryforactivating unknown nervous elements involved in the control of 71-0013. Dempster, W. J. Smoking and Frusemide gastrointestinal tone and motility. (Auth. Abs.) Diuresis. (Letter)Lancet2(7674):661, September 26, 1970.

71-0009. Bolt, A.J.N., Clarke, R. E. Cholesterol Glucoside An intravenous injection of frusemide can abolish the in Tobacco.Phytochemistry9(4):819-822, April 1970. antidiuretic effect of an injection of posterior pituitary extract, such as I nfundln, and thus avoid subjecting exper- The sterol and sterolin fractions of flue-cured tobacco imental smokers to nausea and more accurately control have been investigated. It has been confirmed that the the amount of antidiuretic hormone stimulation a given major components in the sterol fractionare stigmasterol, quantity of frusemide can inactivate. beta-sitosterol, caninclerol and cholesterol and these compounds are present as their glucosides in the sterolin fraction. Cholesterol glucoside has not previously been 71-0014. Drachev, T. Vliyanie na Vlazhnostta i Tempera- reported in tobacco, nor in any other plant. (Auth. Abs.) tunas Vurkhu Nyakoi Khimicheski Sustavki na Tyutyun Virzhiniya pri Fermentatsiyata. (Effect of Moisture and Temperature on the Change of Some Chemical Com- 71-0010. Bush, L. P., Sims, J. L., Atkinson, W. 0. Volatile ponents in the Virginia Tobacco Type During Fermenta- Nitrogenous Bases and Aliphatic Secondary Amines of tion.)Bulgarski Tyutyun13(5)27-32, 1968, Bulgarian. Burley Tobacco.Canadian Journal of Plant Science 50(3):289-294, May 1970. Soluble carbohydrate, protein, nicotine, and ash con- tent of 10 brands of cigarettes, with a moisture content of Volatile nitrogenous bases and dimethylamine, 12.1 and 14.7 percent, were determined at 40, 50 and methylethylamine, and diethylamine with N-methyl-n- 60°C. There was no observable difference if the fermenta- propylamine were determined on two strains of burley tions were carried out at 40 or 50°C. A temperature in- tobacco isogenic for . Concentrations of the crease to 60°C resulted in an insignificant drop in nicotine nitrogenous bases and the secondary aliphatic amines, content. which are positively correlated with total nitrogenlevels, were lower in leaves from the lower stalk positions. I Aut h. Abs.) 71-0015. Duncan, M. E., Brookes, P. The Relation of Metabolism to Macromolecular Binding of the Carcinogen Benzo(a)pyrene, by Mouse Embryo CellsinCul-

2 5 CHEMISTRY. PHARMACOLOGY AND TOXICOLOGY

Lure. International Journal of Cancer 6(3):496-505, 7 1-0018. Georgiev,S. Vliyanieto na Nabivkata na November 15, 1970. Tsigarite Vurkhu Khimicheskiya Sustav na Tyutyuneviya Dim. [Influence of the Density of Cigarettes on the The metabolism of tritiated benzo(a)pyrene (B(a)P) Chemical Composition of the Smoke.]Bulgarski by primary mouse embryo cells in culture was studied. At Tyulyun 13(8/9):53-59, 1968, Bulgarian. concentrations of B(a)P in the medium below about 2-3 millimicromoles/ml, metabolism was exponential with Cigarettes were selected so that the weights of the time, but at higher concentrations a period of rapid individual cigarettes in the various batches would not metabolism was followed by a progressive decline. The fluctuate by more than ±10 mg. Air was aspirated through extent of binding of the hydrocarbon to DNA, RNA and the cigarettes at a rate of 17.5 ml /sec. The dry con- protein was studied under the above conditions. It was densate, chloroform-soluble matter, nicotine, and phenols found that at low doses of hydrocarbon the binding to were determined. A denser packing did not significantly macromolecules was proportional to the overall meta- alter the values. It was hoped that the greater density and bolism, with the result that the binding index. Le. the resulting greater draw effort would induce a certain amount of hydrocarbon bound divided by the amount amount of irritation (and cut down on the smoke and metabolized, was constant. At higher dose levels, overall nicotine content) but this did not materialize. A denser metabolism didincreasewithdose whereas macro- cigarette with a longer butt, however, would offer some molecular binding reached a plateau value. This resulted protectionforthe smoker since more toxic material in a fall in the "binding index" below the constant value would remain in the unsmoked portion of the cigarette. found at low doses of B(a)P. As a consequence of these results and those of other workers, a model scheme is proposed for the enzymic metabolism of B(a)P which 71-0019. Grunwald. C., Davis, D. L., Bush, L. P. Choles- accords with the known facts of metabolism and macro- terol in Cigarette Smoke Condensate. Journal of Agri- molecular binding. (Auth. Abs.) cultural and Food Chemistry 19(1):138-139, January- February 1971. 71.0016. Gambhir, S. S., Das, P. K. Effects of Acetyl- Cholesterol, the prinicipal animal sterol, was found in and on the Blood Vessels of the cigarette smoke condensate both in free and bound form. Frog. Quarterly Journal of Experimental and Cognate The cholesterol identification was based on gas-liquid Medical Sciences 55(4):313-319, October 1970. chromatographyandmass spectrometry. This sterol accounted for 8.6 percent of the total sterol content in The effects of a few cholinergic agents, especially cigarette smoke condensate, of which about 52 percent acetylcholine and carbachol, were studied on the perfused was in the free form and 48 percent in the bound form. In systemic blood vessels of the frog. Nicotine, adrenaline, cigarette tobacco, cholesterol accounted for 10 percent of isoprenaline, papaverine and barium chloride were used as the total sterols, of which 48 percent was in the free form controls. Acetylcholine (ACh) and carbachol (CCh) were and 52 percent in bound form. The transfer of free and found to be potent vasoconstrictors, confirming the bound cholesterol from cigarette tobacco to trapped con- report of Rahman (1963) with ACh. The vasoconstrictor densate was about 13 percent while the total sterol trans- action of choline and pilocarpine was much weaker. The fer was 15 percent. (Auth. Abs.) ACh action was only partially inhibited by , but the actions of ACh as well as CCh remained un- affected by tolazoline, gallamine and d-tubocurarine. 71-0020. Guerin, M., Chouroulinkov, I., Lazar, P. Action Atropine nearly completely blocked the vasoconstrictor Inhibitrice des Carcinogenes Chimiques sur les Mitoses responses of ACh and CCh though the skeletal muscle Dans les Cultures de Cellules Pulmonaires de Rat. I. Etude spasms caused by these choline esters remained un- du 3,4 Benzopyrene. [Inhibiting Action of Chemical affected. The results indicate that the nicotinic activity of Carcinogens on the Mitosis in the Cultures of Pulmonary ACh and CCh did not play any major role in the vasocon- Cells of Rats. I. Study of 3,4-Benzopyrene.] Comptes strictor actions in frogs. Decrease in perfusion rate was Rendus des Seances de la Societe de Biologic et de scs also not due to spasms of skeletal or non-vascular smooth Filiales 164(2):234-238, September 25, 1970, French. muscle. It appeared that the action is chiefly mediated through atropine sensitive receptors. (Auth. Abs.) Dosage with 3,4-benzopyrene results in almost com- plete inhibition of the mitotic coefficient. Where inhibi- tion is not complete, it is sharply depressed in comparison 71-0017. Garofalo, P. Avvelenamenti Accidentali Acuti with control cultures. The decrease in the mitotic co- Domiciliari da Vegetal'. [Acute Accidental Poisoning at efficient is shown as a function of the dosage of 3,4- Home From Vegetables.]Minerva Pediatrica benzopyrene and is highly significant. The inhibition is 22(30):1545-1553, July 28, 1970, Italian. believed due, not to the general toxicity of benzopyrene, but rather to its specific action on the mitotic cycle of the In a general discussion of the various methods and cell. causes of accidental poisoning in the home, particularly harmful to children, cigarettes are mentioned as one category. Two cases are described in which cigarette butts 71-0021. Haebisch, H. The Cigarette as a Source of Car- were accidentally ingested. In such cases nicotine, al- bon Monoxide.Translated from Arch iv fur Toxikologic though known as an extremely dangerous poison, was not 26(3):251-267, August 26, 1970. the principal cause. Rather, the noxious material which accumulated in the cigarette butt was the culprit which Complete English Translation of 70.1277. irritated the gastric mucous membranes due to the action of the tarry components.

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71-0022. Hama, J., Ritli, I. Huai Gyartmanyu Op- The responses of pigeon duodenal villi to intravenous rettak Kemiai Vizsgalata Kulonos Tekintettel as Utobbi injection or local application of "autonomic drugs" were Evekben Mojelent uj Gyartmanyokra. [Chemical In- studied and compared with those reported in dogs by vestigation on Domestic Cigarettes, Especially the Newest other workers. Clieline esters, anticholinestermes, nor- Products of the Past Year.]Dohanyipar 17(2):72.74, adrenaline, adrenaline and nicotine all stimulated villous March-April 1970, Hungarian. movement in the pigeon. Similar responses to these drugs have been reported in the dog. The effects of these drugs The chemical properties of Hungarian cigarettes, a on villous activity could be inhibited by pretreatment of total of 82 separate products under 18 brand names, com- the bird withsuitableantagonists, although hexa- mercially available in the first half of 1969, are tabulated. methonium was ineffective in preventing the effects of Generally valid and standard methods were used in the nicotine. Some of the antagonists also stimulated the villi. testing. The Hungarian cigarettes were compared with Isoprenaline causedinhibition of villous movements. foreign products. which could be prevented by pretreatment of the bird with propranolol. It appears that in pigeons the villi have both a-adrenoceptors, stimulation of which increases 71-0023. Harke, H.-P. The Problem of "Passive Smok- villous activity, and P-adrenoceptors, stimulation of which ing". Translated from Munchener Medizinische Wochen depresses villous movements. (Auth. Abs.) schrift I 12(51):2328-2334, December 18, 1970.

The concentrations of carbon monoxide (CO) and 7 1-0026. Lengyel,I.Hazel Dohanyaink Kemiai nicotine were measured in ventilated and unventilated Osszetetele. (Chemical Components of Domestic To- rooms under abnormal smoking conditions (42 cigarettes baccos.) Dohanyipar17(2):78-80, March-April 1970, smoked within 16 to 18 minutes) and normal smoking Hungarian. conditions (II cigarettes smoked within 5 hours). An average of 0.50 mg nicotine/m3 and 48 ppm CO were A brief descriptionis given of the chemical com- measured under the abnormal conditions and 0.04 to 0.09 ponents (from the literature) which are of significance for mg nicotine/m3 and 10 ppm CO under normal conditions. the quality of the most important commercial varieties of The maximum allowable working place concentration tobacco. Published results of chemical analyses of the values established for nicotine and CO (0.5 mg/cm3 and domestic varieties (Havesi, Burley, Kerti, Szabolcsi) are 50 ppm) were exceeded in the smoking of cigars (9 cigars also given. There are references to the possibilities, with smoked within 30 to 35 minutes resulting in a maximum whose help, development of the chemical components of of 1.04 mg nicotine/m3 and 60 ppm CO), were about the tobacco can be influenced qualitatively. equal under the abnormal conditions and were signifi- cantly below under the normal smoking conditions. In another'study, carboxyhemoglobin and urine nicotine and 71.0027. Leuner, H. Die toxische Ekstase.(Toxic values of subjects before and after smokingor Ecstasy.]Biblio theca Psychiatricaet Neurologica in ventilated and unventilated rooms 134 :73-114, 1968, German. were determined. The differences in these measured values between smokers and nonsmokers and between States of ecstasy induced by using various toxic sub- ventilated and unventilated rooms were significant. There stances arc discussedindetail. The so-called "magic were no significant differences between the values at dif- plants" were originally used exclusively in connection ferent ventilations. with health treatments apparently because they were believed to possess supernatural powers. Active principles of the "magic plants" arc chemical substances, many of 71-0024. Hess, H. On "Passive Smoking." Translated which have now been identified. Administered to humans, from Literatur- Eildienst "Roche" 37(7):49 -52, 1969. they frequently cause severe changes in the psychic area, usually more marked than by administration of the plants Tobacco smoke passively inhaled by the nonsmoker is themselves. The substances arc called by various names predominantly side-stream smoke and in smoke-filled today: ha Bucinogens,psychotics, psychotomimetics, rooms, where nicotine concentrations may reach from 3.0 phantastics, psychotoxins, psychedelicsubstances, or to 5.2 mg/m3 of air, the nonsmoker inhales the equivalent even mysticomimetics. The substances differ in the of one cigarette hourly. The quantity of carbon monoxide method of application:oral intake of plants or of formed in the combustion of 1 g of tobacco can fluctuate extracts; percutaneous; use assalves,especiallyas from 20 to 1000 cm3, depending on the moisture content "witches ointments" in the middle ages; and inhalation of of the tobacco, the packing density, and thespeed of the smoke of burned substances, or in modern applica- smoking. The carboxyhemoglobin level in theblood of tion, intramuscular or intravenous injection. According to nonsmokers may reach 3 percent, while in smokersit can an old arrangement, the ecstasy states were distinguished rise to 10 or even 15 percent. Nicotine, carbonmonoxide as ecstasy through use of magic plants, smoke ecstasy, and other possibly pathogenic constituentsof tobacco alcoholic ecstasy, and nicotine ecstasy. , smoke can so pollute the room air thateven passive in- consumption and use of hashish arc discussed halation can result in the development ofobliterating briefly. vascular diseases.

71-0028. Molchnachev, I. G., Pisklov, V. P., Anastasov, A. 71-0025. Hooper, P. A., Schneider, R. The Effects of Spektrofotometridmo Opredelyane na Benzo(a)pirena v "Autonomic Drugs" on Vinous Movement in theSmall Kondenzata na Tyutyuneviya Dim. ISpectrophotomettic Intestine of the Pigeon. British Journal of Pharmacology Determination of Benzo(a)pyrene in Tobacco Smoke 40(3):426-436, November 1970. Condensate.]Bulgarski Tyutyun 13(8/9):26.30, 1968, Bulgarian.

4 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

A method was developed making use of extraction 71-0032. Ogg, C. L., Schultz. E. (Jr.). Collaborative with nitromethane and adsorption on a column of silica Study of the DeterminationofTar and Nicotine in Ciga- gel, for removing materials showing absorption peaks rette Smoke.Journal of the Association of Analytical similar to benzo(a)pyrene which could be determined Chemists53(4):659.672, July 1970. spectrophotometrically. Paraffinic hydrocarbons could be determined simultaneously by the same method. A crepe Ten laboratories participated in a 2-phase collaborative filter permits a reduction of the benzo(a)pyrene content study of a method for tar and nicotine in cigarette smoke. by about 10 percent but this is not sufficient to overcome In one phase, 200 monitor cigarettes were smoked, while the carcinogenic action of this compound. in the second phase, 60 cigarettes from each of 5 pairs of samples were smoked over a period of 2 weeks according to a random port X sample design. A total of over 9000 71-0029. Montesano, R., Magee, P. N. Metabolism of measurements was reported for weight, number of puffs, Dimethylnitrosamine by Human LiverSlicesin total particulate matter, water, nicotine, and tar. Statisti- Vitro.Nature228(5267 ):173.174, October 10,1970. cal analysis of the results showed the significant variables to be within- and among-laboratory differences and a An attempt was made to get indirect evidence of laboratory X material interaction. Agreement between man's susceptibility to the carcinogenic action of nitrosa- laboratories was good for cigarettes delivering less than 20 mines by studying the metabolism of dimcthylnitrosa- mg tar and1 mg nicotine, but poor for samples with mine by human liver slicesin vitro.Results showed that higher tar and nicotine deliveries. Further study of the human liver can metabolize dimethylnitrosamine at a rate method is recommended to improve its performance with comparable with rat !Aver and the similar levels of nucleic cigarettes having high tar and nicotine deliveries. (Auth. acid methylation in the two species suggot that man may Abs.) be about as sensitive as the rat to the carcinogenic action of this compound. 71-0033. Peirone, S.. Guarona, P. Azione Della Nicotine su CeUule Coltivatehi Vitro.[Action of Nicotine on Cells 71.0030, Neu ra th, G. Stielcstoffverbindungendes CulturedIn Vitro.!Bolletino Della Societa Italian di Tabakrauches.[Nitrogen Compounds in Tobacco Biologia Sperimrntale45(17):1146-1148, September 15, Smoke.]Beitraege zur Tabakforschung5(3):115-133, 1969, Italian. December 1969, German. Chicken embryo hearts were studied throughin vitro Knowledge of tobacco smoke composition grows culture in order to study the effect of nicotine on the rapidly by application of modern analytical methods. cells. The cells showed stress within a few minutes of Hitherto, 181 nitrogen compounds are known comparable initiating the experiment, and stress increased with time, to 50 in1959, comprising 24 aliphatic amines, 19 being most accentuated in the cell cytoplasm. Notable aromatic amines, 7 nonaromatic N-heterocyclic com- changes were seen in the chondrioma almost immediately pounds, 26 pyridinebases, 6 other aromaticsix- upon contact, but not all the mitochondria were affected membered N-heterocyclic compounds, 2 pyrroles, 15 at the same time or to the same extent. However, the other aromatic five-membered N-heterocyclic compounds, nucleus of the cell, within this experimental time limit, 12 pyrazine.s, 16 tobacco alkaloids and compounds with showed no remarkable alteration. All changes noted were two nitrogsn rings, 15 amino acids, 16 nitrites, 6 nitro- reversible to a time limit up to three hours. After repealed alkanes, some derivatives of nitrous acid, inorganic cyano washings, the cells recovered a normal aspect within six or compounds, nitrogen oxides, ammonia, and elemental seven hours. The disappearance of vacuoles was rapid and nitrogen. The balance of all the nitrogen compounds in took place within one hour; reconstitution of the mito- j. tobacco smoke condensate gives a hint at the occurrence chondria was in the form of filaments. of unknown neutral N-compounds. (Auth. Abs.)

71-0034. Philippin, C., Gilgen, A., Grandjean, E. Etude 71-0031. Obi, Y., Muramatsu, M., Shimada,'1.,Sakurai, Toxicologique et Physiologique de rAcroleine Chez la H. Netsubunkai Kara Mita Tabs Ito no Hir.shitsu. V. K Souris. (Toxicological and Physiological Investigation on Atai Kosei Gasu Seibun to Kokitsumi Tokusei to no Acrolein Inhalationinthe Mouse.]Internationales Sokan no Tokeiteki Kento. [Evaluation of Tobacco Archiv fur Arbeitsmedizin26(4):281.305, November 17, Quality From Pyrolytic Aspects. V. Statistical Study of 1970, French. Correlation Between Gaseous Constituents of Cigarette smoke From Which the K Value Was Computed and Acute and chronic effects of the inhalation of acrolein Organoleptic Properties of Tobacco Smoke.]Nippon vapors were investigated in mice. The acute exposure Senbai Kosha Chuo Kenkyusho Kenkyu Hokoku lasted six hours. In the chronic exposures, each concentra- 111:125-128,1969, Japanese. tion was given six hours daily for two weeks. The effects on swimming performance, body weight and lethality The statistical investigation of correlation between were studied, and histological analysis of the lungs was gaseous constitutents of cigarette smoke of K value and carried out. Chronic exposure to 25 ppm of acrolein organoleptic properties of tobacco smoke showed that the produced a significant slowing of swimming speed. Acute K value is reasonable as quality coefficient for the evalua- LDso was found at a concentration of 66 ppm and tion of aroma and taste of cigarette smoke of flue cured chronic LDso at a relatively wide dose range between 25 tobacco. (Auth. Abs.) and 50 ppm. Repeated exposures to acrolein revealed no signs of a development of tolerance or sensitization. In

tJ CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

the chronic exposures, body weight was significantly increased the flow rate, protein content and induction of reduced with concentrations of 6 ppm or more. Histologi- amylase in rabbit parotid gland saliva on electric stimula- cal analysis of the lungs revealed ateleetasis, inflammatory tion of the auriculotemporal nerve. At doses of300 responses with edema and, in two of 15 cases, dilatations micrograms/kg, the stimulating action of nicotineon of alveoles and bronchioles were seen. (Auth. Abs.) protein content and amylase activitywas not inhibited by phenoxybenzamine (8 mg/kg, administered 30 minutes previously), bretylium (10 mg/kg, 45 minutes previously) 71.0035, Scasscllati Sforzolini, G., Savino, A. Evaluation or by chronic denervation. (2 mg/kg, 3 of a Rapid Index of Ambient Contamination by Cigarette minutes previously), propranolol (0.3 mg/kg, 4 minutes Smoke, in Relation to the Compositinn of the Gas Phases previously) and adrenalectomy inhibited the action of of the Smoke. Translated from Rivista Italian d7giene nicotine on protein content and amylase activity. January-April 1968. Pro- pranolol, chronic denervation and adrenalectomy did not inhibit the stimulating action of nicotineon the flow rate. Complete English Translation of A-11372. Itwas inhibited by hexamethonium, bretylium and phenoxybenzam inc. 71-0036. Scassellati Sforzolini, G., Saldi, G. Furth./ Re- search on the Polycyelic Hydrocarbons of Cigarette 71-0040. Yacoub, M., Faure, J., Mallion, J.-M., Cau, G. La Smoke. Comparison of the Inhaled Smoked and That Taken From the Ambient Atmosphere. Translated From Thiocyanaturie du Fumeur. [Thiocyanaturia of the . Smoker.]bledecine Legateet Dommage Corporal Bollettino Della Societa Italian de Biologic, Sperimentale 37:769-771,1961. 3(3):266-270, July-August-September 1970, French. The metabolism and urinarymetabolites of thio- Complete English Translation of A-05447. cyanates in smokers are discussed. The toxicology of eyanogenic components of tobacco smoke and the presence of cyanohydrie acid in smoke are reviewed. 71.0037. Somasundaran, P. Change in Gas Volume During Urinalyses were made of 253 men, of whom 165were Puffing of a Lit Cigarette. Tobacco171(25):15-20, smokers, and of 47 women, 22 of whom were smokers. December 18,1970. Thiocyanatcs in the urine of nonsmokerswas 4.5 mg/I and values rose as a function of age. In thecase of A knowledge of the change of gas volume during smokers, thiocyanates in the urine rose to 14.5 mg/1. puffing is important for the analysis of the burning pro- Various factors influenced the statistics in thecase of cess of cigarettes and is required in the correlation of smokers, such as number of cigarettes smoked, inhaling reverse smoking experiments (in which a positive pressure the smoke, age and occupation. Results is used to force air through a cigarette) with conventional prove that cyanides enter the organism through tobacco smoke. ones in which smoke is sucked from it. A sensitive and rapidly responding piessure transducer-oscilloscopecom- bination was used to measure the rate at which airwas 71-0041. Yacoub, M., Faure, J., Mallion, Cau, J. entering the cigarette while smoke was sucked fortwo Peut-on Determiner 1'Origine Tabagique de l'Oxycar- seconds at a constant rate of 16.57 cc/second. The bonisme Chronique? [Can the Tobacco Origin of Chronic volume change was an increase averaging 23 percent of Carbon Monoxide Poisoning Be Determined?] Medecine the volume of entering air. During the first fraction ofa Legate et Dommage Corporal 3(3):262-265, July-August- second, there was a small decrease in the volume change September 1970, French. followed by a steady increase. After completion ofa two- second puff, the cigarette continued to producegasses for To study carbon monoxide poisoning in relation to about one third of a second, making the total volume nicotine from tobacco smoke, research was doneon 300 change about 19 percent. If the supply of air to the glow subjects, both smokers and nonsmokers of bothsexes, cone is reduced prior to the puff, the volume increase is and of varying age and occupations. The number of ciga- reduced. Literature reports that the volume change iszero rettes smoked per day, the rate of carbon monoxide in might be due to such choking of the cigarette fora few the blood, and the amount of thiocyanatcs in the urine seconds prior to the puff. (Auth, Abs.) were determined. Carbon monoxide in the blood of 113 nonsmokers was 3.05 m1/1; thiocyanates excretedwere 4.50 mg/1. Subjects smoking and inhaling smoke of 20 71-0038. Srch, M. The Significance of Carbon Monoxide cigarettes showed 18.8 m1/I of carbon monoxide in the in Cigarette Smoke in Passenger Car Interiors. Translated blood and excreted 19.4 mg/I of thiocyanatcs. Those From Deutsche Zeitschrift fur die Gesamte Gerichtliche smoking 20 cigarettes but not inhaling the smoke showed Medizin 60(3):80-89,1967. carbon monoxide in the blood at the rate of 12.1 m1/1, and excreted 16.3 mg/I of thiocyanates. Accordingto the Complete English Translation of D-07279, amount of thiocyanates excreted, it is'possible to estimate the number of cigarettes smoked daily. 71-0039. Tamari, Y. Jlicasen Daeki Amylase Bumpitsu ni Taisuru Nicotine Sayo ni Mute. [Effect of Nicotine on 71-0042, Yazudzhiyan, E., Zhelazkov, D.,Anastosov, A., Amylase Secretion by the Parotid Gland.]Folia Spasova, V. latimiko-Tekhnologicheska Kharakteristika Pharmacologica Japonica 65(5):454-465, September 20, na Tsigarite, Proizvezhdani v Stranite of SIV. Suobsh- 1969, Japanese. tenie. Tsigari, Proizvezhdani v SSSR, GDR i Polsha. [Chemical and Technological Characteristics of Cigarettes Nicotine (100 -1000 micrograms/kg intravenous) Produced in tht Countries of the SIV. Report. Cigarettes

6 9 MORTALITY AND MORBIDITY

Produced in the USSR, German Democratic Republic and and the German Democratic Republic. In addition to Poland.]Bulgarski Tyutyun13(8/9):47.52, 1968, Bul- length, mouthpiece width, weight and granulometric mea- garian. surements, data are included on nicotine, tar, protein, sugar and paraffin content, internal resistanceduring Various physical and chemical values are tabulated for aspiration and pure ash after combustion. several brands of cigarettes produced in the USSR, Poland

See also71-0129

MORTALITY AND MORBIDITY

710043. Coronary Drug Project Research Group. The years of Life.]Boletim do histituto Portugues de Coronary Drug Project.Initial Findings Leading to Oncologia de Francisco Gentil37(8):6-9, August 1970, Modifications of Its Research Protocol.Journal of the Portuguese. American Medical Association214(7):1304-1313, November 16, 1970. After age 30, cancer of the lungs grows in importance as a cause of death, and research reveals that themajority The Coronary Drug Project is a national collaborative of people affected are tobacco smokers. There has been study to evaluate long-term effects of I) conjugated estro- no effective method yet evolved to dissuadeyouth from gens, 2.5 mg/day (ESG1); 2) conjugated estrogens,5.0 taking up smoking, since advertising of cigarettes is so mg/day (ESG2); 3)clofibrate,1.8 g/day; 4) dextro- much more prevalentthan anti-smoking campaigns. thyroxine, 6.0 mg/day (DT4); and 5) niacin, 3.0 g/day Although nonsmokers throughout the world are the compared with placebo for men aged 30 to 64 who have 'or,ception, physicians in Great Britain and the United recovered from myocardial infarction (Ml). From 1965 to fi1,1tes who smoke are in the minority. The cigarette is 1969 8341 men were recruited and randomly assigned to tes;..insible for about 10 percent of the yearly deaths in the six groups. The ESG2 group experienced an excess En4land. Lost time from work, disability, and premature number of events of nonfatal MI, pulmonary embolism jeath are all caused by the cigarette. and thrombophlebitis, compared with the placebo group. No overall trend towards a beneficial effect in reducing mortality was evident to outweigh these apparent adverse 71-0046. Goldsmith, J. R. The New Airborne Disease. effects. Thirty-two percent of the 1119 men of the ESG2 Community Air Pollution.California Medicine group were smokers. The drug regimen was discontinued 113 (5): 13-20, November 1970. for all patients in this group. The ESG1 group did not show the apparent excess risk identified with the ESG2 Photochemical air pollution of the California type group and is therefore continuing with the medication. A involves newly defined atmospheric reactions, is due small subgroup of the DT4 group, those with frequent mostly to motor vehicle exhaust, is oxidizing, and pro- ectopic beats of ventricular origin on the resting ECG duces ozone, plant damage, impairment of visibility and taken at baseline, experienced a higher mortality than 78 eye and respiratory symptoms. Aggravation of asthma, similar patients receiving placebo. Their medication was impairment of lung function among persons with chronic discontinued. No similar adverse effects were noted respiratory disease and a possible causal role, along with among other patients on this medication and they are cigarette smoking in emphysema and chronic bronchitis, continuing to receive the drug. are some of the effects of photochemical pollution. More subtle effects of pollution include impairment of oxygen transport by the blood due to carbon monoxide and inter- 71-0044. Deleizhe, A., Reginster-Haneuse, G. Incidences ference with porphyrin metabolism due to lead. Carbon Medico-Sociales de l'infarchts du Myocarde. (Medico- monoxide exposures may affect survival of patients who Social Incidence of Myocardial Infarct.]Archives Beiges are in hospitals because of myocardialinfarction. During de Medecine Sociale, Hygiene, Medecine du Travail et periods of carbon monoxide pollution cigarette smokers Medecine Legate28(4):267-280, Apti11970, French. are likely to have higher carboxyhemoglobinlevels than during non-polluted periods. Smokers also tend to have Medical and social factors influencing myocardial in- higher blood laid levels than nonsmokers because of the farct were eudied in 181 hospitalized patients and in SO persisting residual effects of lead arsenate sprays used out-patients. Forty-two patients were smokers, and of this years ago where cigarette are now grown. While number 32 smoked more than one pack of cigarettes a many uncertainties in pollution-health relations need to day. On medical advice, 37 of these heart patients be resolved, a large number of people in California have abstained entirely from using tobacco, and the others cut health impairment due to airborne disease of this new their consumption of tobacco by half. The frequency of type. (Ruth. Abs. Mod.) heart attacks is much greater in men than in women and might possibly suggest that more men than women smoke. 71-0047. Beddow, A. J. The Future and Lung Can- cer.Health (London)7(2):23-25, Summer, 1970. '

71.0045. Godber, G. 0 Preco do Maco de Cigarros: Chico In the early 1940's, the incidence of lung cancer began Anal de Vida. (The Price of a Pack of Cigarettes: Five to increase rapidly in males and coincided with the change

7 10 MORTALITY AND MORBIDITY

in smoking habits from cigars and pipes to cigarettes. tionally independent from the mean age of incidence Although smoking in men is still increasing, in women it is curve. However, the added information included in the increasing even more rapidly: If the present trend con- index of incidence consists of the mean age of incidence tinues, they could reach the male mortality level in the curve. The correlation between smoking and lung cancer next 20 years. The most important cause of lung cancer was somewhat higher when lung cancer was measured by appears to be light Virginia-type tobacco, perhaps because the proposed index of incidence than when measured by itis so habitually inhaled. In Central American and t heage-adjustedincidencerate,adjusted by direct Portugal heavy cigarette smoking does not lead to high method. The model is applied to support the hypothesis lung cancer mortality rates. In these areas, a dark brown that breast cancer consists of two components of the dis- cigarette is smoked, the leaf being prepared in amanner ease, but available statistical methods are not accurate similar to that of cigar tobacco. Recent World health enough to estimate the indices of incidence of each com- Organization studies of buccal carcinoma in relation to ponent. The proposed index is limited and more work is local tobacco chewing leave no doubt that a carcinogen is needed to obtain reliable estimates of cancer incidence for present in tobacco. All the evidence points to the fact epidemiologic purposes. (Auth. Abs. Mod.) that smokers of over 20 cigarettes per day have between 20 to 30 times as great a chance of dying from lung cancer as does the nonsmokers, and the exsmolcer re- 71-0049. liuttner.I., Buttner, II.Die Motivation des covers much lost ground, but never quite reverts to the Gesundheitsverhaltens. TeilI.(Motivationin Health position of the nonsmoker. Recently, a substantial in- Behavior. Part LIZeitschrift fur Aerztliche Fortbildung crease was found in the DNA content of the bronchial 64(9):471477, May 1, 1970.German. mucous membrane of smokers, and this increase slowly reverted to normal after smoking was stopped. Air pollu- Since the Nineteenth Century, health education has tion may play a part in the etiology of lungcancer, but it become the truly scientific principle of preventive medi- not considered an important one. Tobacco consumption cine. Individuals have had to develop the corresponding continues to rise because of the failure of propaganda and drives and urges to remain healthy and be socially accept- education to convince people of the hazards of smoking, able. They have had to learn to compensate for a reduced government apathy and the national revenue derived from physical activity since labor-saving devices arc on the in- the sale of tobacco products. The result is thatmore crease. With a decreased physical activity, certain diseases, school children are becoming smokers, andas the latent as for example, disorders of the respiratory tract, become period for lung cancer is from IS to 20years, these may more prevalent. One can overcome this high incidence of be lung cancer cases by their thirties. disease only by moans of proper nutrition, a comprehen- sive program of physical training, and complete absten- tion from smoking. Abstention, in itself, is not a panacea. 71.0048. Hakama, M. Age-Adjustment of IncidenceRates Other factors such as a higher education. limitation in in Cancer Epidemiology.Ac:a Pathologica et Micro- family size, and a healthy family life, also contribute to biologica Scandinavica(Section A, Supplement the maintenance of health. 21 3):I-47, 1970.

The problem of comparing disease frequency in dif- 71-0050. Jaques, W. E. Comparison of the Incidence and ferent areas and in different populationgroups is con- Site of Malignancies in Taipei, Taiwan and Little Rock, sidered. The most preferable comparisonsare made by Arkansas.Journal of the Arkansas Medical Society incidence rates of the disease. The rates have been 67(4): I 35-137, September 1970. adjusted to eliminate the confounding effects ofconcom- mitant variables, the most common of which isage. A Four hundred fifty consecutive post mortems on adult parametric method for the problem of age adjustment is males were reviewed from Taipei, Taiwan, and Little proposed and the biological basis of this procedurein the Rock, Arkansas. The Taiwanese group showed a 46.6 per- case of cancer is outlined. It is proposed that the Gaussian cent incidence of malignancies while the Little Rock curve approximates the incidence curve for which theage group accounted for only a 29.5 percent incidence. Pri- specific incidence rates are discrete estimates. Information mary liver cell carcinoma, squamous cell carcinoma of the included in the specific rates cannot be replacedby a esophagus, bronchiogenic carcinoma, iuukcmia and single index. The proposal that the probability of occur- lymphoma, adenocarcinoma of the pancreas andnaso- rence of a tumor by age has a normal distribution leads to pharyngeal carcinoma were the most frequent neoplasms three indices, maximum value, mean and standarddevia- encounteredin the Taiwanese group. Leukemia and tion of the incidence curve, which specifycancer in- ly mphomas, bronchiogenic carcinoma. adenocarcinoma of cidence by age. The three indicesmay be used as age- the pancreas and colon werethemost common adjusted indices of incidence and forsome forms of malignancies in Little Rock. Environmental factors are cancer a further reduction of adjusted indices is attained. discussed as representing the differences in incidence and The results are applied to four different primary sites of primary site of the neoplasms in the two groups. Particu- cancer. The model, Gaussian curve, adequately fits the age lar attention is paid to the role of infectious hepatitis and specific incidence rates of the four primary sites.The its sequelac in the causation of hepatomas. The high in- single index of incidence for stomachcancer is noninfor- cidence of nasopharyngeal, esophageal and gastric mative and misleading and the three estimates ofpara- malignancies in the Taiwacese group is suggested to repre- meters of the incidence curve are preferable in epidemio- sent contact of the mucosae with carcinogens produced in logic comparisons. In lung cancer, the method is directly the preparation of foods. The slightly lower incidence of applicable to the purposes of adjustment. This is even lung cancer in Taiwan may be attribotable to the less truer in regard to nervous system tumors. The proposed frequent smoking of cigarettes. (Auth. Abs. Mod.) index of incidence is a function of the maximum value and standard deviation of incidence curve, and func- s,,

8 11 NEOPLASTIC DISEASES

Negro males 71-0051. Schoenberg, B. S., Balla:, J. C. (II1), Fraumeni, nonwhite statistics for 1950.66 showed that and females, together with Chinese andJapanese males, J. F. (Jr.). Certain Mortality Patterns of EsophagealCan- contributed to the excess in mortality. However,only cerinthe United States,1930-67. Journal of the time. To National Cancer Institute 46( 1 ) : 63-73 , January 1971. Negroes had a steady increase in mortality over study factors implicatedinthe origin of esophageal cancer,mortalityrates by States for 1950-66 were Cancer of the esophagus shows substantial racial, each State: the geographic, and temporal variation within the United compared with the following variable for percentage of population living in urban areas, percapita States. In a cohort analysis of mortality during193067, cigarette sales, and per capita alcohol sales.Mortality the nonwhite population experienced steadily and rapidly showed significant geographic correlationswith each of increasing rates, while those of the white population with cigarette remained relatively stable. The rising nonwhitemortality these three variables, but the associations and alcohol consumption seemed to resultfrom some occurred at all ages and all areas of the country and was environment. females. Death rates other, still unidentified, hazard in the urban more pronounced among males than suggest in the Northeast were consistently higher than in other The striking racial variations in esophageal cancer Negroes have been increasingly exposed,and are sus- regions of the country, with the geographic differential Abs.) being more prominent among nonwhites (threefold) than ceptible, to these carcinogenic influences. (Auth. among whites (twofold).Detailedanalysis of the

See also 71-0055, 71-0059, 71-0073, 71-0124,71-0174, 71-0182

NEOPLASTIC DISEASES

New England Journal of Medicine 714052. Campbell, A.H., Guilfoyle, P. Pulmonary Tract. Tuberculosis, lsoniazid and Cancer. British Journalof 284(3):129-134:January 21,1971. Diseases of the Chest 64(3):141-149, July 1970. Interviews were conducted with 470 patients with transitional or squamous-cell carcinoma of the lower A group of 3064 tuberculous ex-servicemenexperi- enced a significant excess mortality from all cancer (92 urinarytract, more than 90 percent of whom had a observed, 68 expected) during a 6-year period of observa- bladder tumor. An age-stratified and sex-stratified but tion. This was due to an increased mortality from lung otherwise random sample of 500 persons drawn from the cancer (33 observed, 16 expected) and carcinomaof the population of the entire study area was also interviewed upper respiratory and digestive tracts (12 observed, 5 as a control. Among men, cigarette smokershave a re- expected). A control group of ex-servicemen showed no lative risk of bladder cancer of 1.89 as compared with increase of mortality from lung cancer, but did have a nonsmokers, and about 39 percent of the cases are related significant increase of mortality from carcinoma of the to smoking. This amounts to 16.4 cases per year per upper respiratory and digestive tracts. The administration 100,000 men 20 years of age and over. Among women 20 of isoniazid was not found to increase the lung cancer years of age and over, the comparable figures arc 2.00, 29 mortality of the tuberculouspatients. The excess percent and 3.9 cases per year per 100,000. For both mortality from lung cancer of the tuberculous group sexes risk is increased among those who smoked heavily could not be attributed to a greater consumption of to- and those who inhaled. None of the excess risk of bladder bacco. Tuberculosis may have been a causal factor, cancer associated with cigarette smoking is explained by increasing the lung cancer rate above that usually caused any indirect association with occupational experience. No by the smoking habits of the group. The excess mortality significant risk is associated with pipe or cigar smoking. from carcinoma of the upper respiratory and digestive The data also suggest that incidence rates will increase tracts in both the tuberculous group and the controls during the next decade or so especially among women. were unexplained, but could have been related to excess (Auth. Abs.) alcohol consumptioninboth groups. Lung cancer mortality was greatest among the heavier smokers and least among the non-smokers. (Auth. Abs.) 714055. D'Alfonso, G. La Cantterizzazione del Cancro Primitivo del Polmone. (Nola Epidemiologica.) [Nature of Primary Lung Cancer, (Epidemiological Note.)]Archirio 714053. Chakravorty, R. C. Smoking and Cancer of the di Tisiologia e Delle Malattie Dell'Apparato Respiratorio Lung.Journal of the Indian Medical Association 24( 10) : 756-787. October 1969, Italian, 55(8):282-283, October 16 , 1970. In an epidemiologic and statistical description of A number of studies are reviewed which link cigarette malignant neoplasms, tobacco use is mentioned as one of smoking to human lung cancer in terms of increased lung the exogenous factors of pulmonary oncogenesis. Statis- cancer risk in smokers, type of lung cancer cell in tics are presented on lung cancer related to cigarette smo smokers, respiratory epithelial changes in smokers, and kingin 16countries duringthe three-yearperiod, the carcinogenicity of various chemical constituents and 1963-65.13-n United States ranks third in mortality from physical characteristics of tobacco smoke. lung cancel,vithEngland and Wales, and Finland showing higher rates. A net decrease in lung cancer is illustrated from mortality data on physicians in England 71.0054. Cole, P., Monson, R. R., Haning, H., Frieda, G. and Wales who gave up smoking, as compared to H. Smoking and Cancer of the Lower Urinary mortality rates of the general male population. A drop in

9 NEOPLASTIC DISEASES

mortality from lung cancer, as a function of time, is Experiences With 1121 Cases (1946-1969).]Zeitschnft shown to be on the order of 20 percent for those who fur Laryngologie, Rhinologie, Otologie and Ike Oren. gave up smoking. zgebiete 49(7):432-443, July 1970. German.

The epidemiology, pathogenesis. sexdistribution 71-0056. Doll, R. Cancer and Aging; The Epidemiological changes in different age groups and radiation therapy ina Evidence. Bulletin of the International Union Against series of 1125 laryngeal and hypopharyngeal carcinomas Cancer 8(2):15.16, August 1970. recorded between 1946 and 1969 are discussed. Acon- nection between these carcinomas and cigarette smoking Epidemiology has recently focused on the study of the is probable. relationship between aging and cancer. A 17-year study of bronchial carcinoma in 34,000 male doctors and their smoking habits showed that in both cigarette smokers and 71-0059. Koszarowski, T., Gadomska, H., Karewicz, Z. nonsmokers the incidence of the disease increases in Deena Epidemiologiczna Zachorowan i Zgonow na Raka proportion to the power of age, but it increasesmore Pluca u Mieszkancow M.st. Warszawy w Latach rapidly in cigarette smokers (power of 7.5) than innon- 1963-1967. (Epidemiological Evaluation of the Incidence smokers (power of 4). However, the relationship between and Mortality Due to Pulmonary Carcinoma in the Popu- incidence and duration of exposure is thesame for both lation of the City of Warsaw in the Years groups. Taking a look at the effect of different doses, of 1963-1967.]Polskle A rchlwum Medycyny Wewnetrznej changing the dose, and of stopping exposure, it was found 45(3):451-459, September 1970, Polish. that prolonged and continuous exposure toan agent such as cigarette smoke leads to an incidence of cancer that is In the last 50 years a striking rise was observed in the proportional to a power of the duratiori ofexposure. For incidence and mortality due to pulmonary carcinoma in this agent, the incidence at a given age is proportionalto various countries. In Poland the highest indices of in- the daily dose. When exposure stops, the risk fallsslightly cidence and mortality due to pulmonary carcinoma and then rises parallel to that in nonsmokers; itfollows appeared in large cities. In Warsaw the incidence of that the effect of exposure must be to a large extent pulmonary carcinoma rose sixfold in the time period irreversible. Most epithelial cancers reveal a pattern similar 1956-1967. From 1959 pulmonary carcinomawas the to that for bronchial carcinoma in cigarette smokers. most frequent malignant neoplasm in men, before gastric Analagous results from other studies suggest thatage per carcinoma. In the years 1963-1967 pulmonary carcinoma se is not likely to be a factor, but that the progressive accounted, of all reported neoplasms on the average, for increase in incidence with age that is characteristic of 21.8 percent in men and for 4.4 percent inwomen. The many common tumors is the result of continuous and incidence of this neoplasm accounted in prolonged exposure to a carcinogenic agent. men for 77.1 percent and in women for 22.9 percent of all pulmonary neoplasms, on the average (sex ratio = 3.9). Deaths dueto pulmonary carcinoma constituted the greatest number of 71-0057. Doll, R.Incidencedu Cancer en Fonction de deaths due to all carcinomas, accounting, on theaverage, l'Age: Elements Epidemiologiques. [Incidence ofCancer as a Function of Age: Epidemiological Elements.] Made for 26.7 percent of all deaths due to neoplasms inmen. Deaths due to pulmonary neoplasms were more frequent eine et Hygiene 28(924):1110-1112, July15, 1970, French. in men than in women. In the overall number of deaths due to pulmonary neoplasms men accounted for 79.1per- cent of cases and women for 20.9 percent of cases,on the Epidemiological considerations in cancer incidenceare average (sex ratio = 4.4). The rise in the number of prefaced by general remarks new on statistical methods and cases and deaths due to pulmonary carcinoma is ascribed mathematical validity. The incidence of bronchialcar- to various factors, cigarette smoking being the prime cinomas in smokers is evaluated in the light ofresearch factor. (Auth. Abs. Mod.) done in Great Britain, Canada, and the UnitedStates. From data furnished by 34,000 residentBritish physi- cians, details were obtained on pulmonary cancer entered 71-0060. Langvad, E., Zachariah, J., Pindborg, J. on death certificates. Results were analyzed in view of J. Lactate Dehydrogenase Isoenzyme Patterns in Leuko- five variables: the way tobaccowas smoked (pipe, cigar, plalcia, Submucous Fibrosis and Carcinoma of theOral cigarette); daily amount smoked; duration ofsmoking habit; age smoking started; and Mucosa in South Indians. Acta Pathologica et Micro- age tobaccohabit biologic(' Scandinavia 78(5, Section A):509- 515,1970. stopped. From research in the United States,it was deter- mined that the incidence of bronchialcancer in non- smokers was only 6 out of 5,000 The lactate dehydrogenase isoenzyme pattern of over a 16-year period. A biopsies from Indian oral leukoplakia, submucous fibrosis mathematical formula is presented to showthat pro- longed exposure to a carcinogen such and carcinoma of the oral mucosa as wellas that of oral as cigarette smoke mucous membrane biopsies from clinically normal Indian produces an incidence of cancer proportionalto a power of the exposure time. persons has been studied. The LDFli v/LDHil isoenzyme ratios found for leukoplakias, carcinomas and control . biopsies did not differ significantly. Themean isoenzyme ratio of Indian control biopsies was significantly 71-0058. Heermann, H., Rayes, A. above R. Zur Epidemiologie, that reported for Danish control biopsies. Submucous Pathogenese, Geschlechtsverteilung, Strahlentherapieund Statist ik des Larynx- und fibrosis was accompanied by a significant depression of Hypopharynx-Icarzhioms. the isoenzyme ratio. No clear correlation between LDH Erfahrungen an 1121 Fallen (1946-1969). [Epidemiology, isoenzyme pattern and epithelial thickness was found. Pathogenesis, Sex Distribution, Radiation Therapyand Smoking and Statistics of Laryngeal and Hypopharyngeal Carcinomas. :-awing habits, which may be correlated with prevalen. And localization of oral leukoplakias and

10 NEOPLASTIC DISEASES

Revista Cubana de Medicind carcinomas, didnotsignificantlyinfluencetheiso- Study of 453 Cases.] enzymatic structure. Although final conclusions cannot 8(6):561 -567, December 31, 1969, Spanish. be drawn, the high isoenzyme ratio of the Indian control material may represent an early precancerous condition, Obstructive pulmonary emphysema isa frequent unrelated to smoking and chewing, preceding the histo- pathology among patients admittedtothe Internal considerably more frequent pathologicalmanifestdtions of precancerous lesions. Medicine Service, andis (Auth. Abs.) among cigarette smokers than among nonsmokers. The highest incidence of this disease was observed in patients who had been smoking for more than 30 years. In this 71-0061. Mancuso, T. F. Relation of Duration of Employ- study, all cases of pulmonary cancer occurred among ment and Prior Respiratory Illness to Respiratory Cancer smokers. Among Beryllium Workers, aviromental Research 3(3):25I-275, July 19,1970. 71.0065, ScassellatiSforzolini, G., Modolo, M. A. A prospective study was conducted of whitc males (Editors). II Fumo e In Salute, Guide Pratiche per l'Educa- employed in 1937-1948 in the two major companies zione Sanitaria, [Smoking and Health. Practical Guide for extracting beryllium and followed to 1967. The study Health Education,] Perugia, Italy, Centro Sperimentale showed a relationship of duration of employment with per l'Educazione Sanitariadell'Universita di Perugia, specific causes of death. Workers who were employed for 1968, 32 pp., Italian. one to five quarters (of a year) had a higher lung cancer rate than those employed for six quarters or more. A Public health interest based on statistical and epidemi- subcohort of beryllium workers with prior chemical ologicalstudies,isdirectedtoward morbidity and respiratory illness, observed for the same period of time, mortality due to tobacco smoking. Biological effects, revealed that six of the eight lung cancer patients (one to chemical composition of the components of smoke from fivequarters) hadpriorrespiratoryillnessinthe tobacco products, and socio-psychological factors are con- 1940-1948 cohorts, and five of the six lung cancers in age sidered in relation to education dissuading people from 35.44 (as of 1940) in these cohorts. There was a much smoking. Tables show the highest mortality from lung higher rate per 100,000 for lung cancer among the sub- cancer in cities of over 50,000 population. As expected, cohort of cases with prior respiratory illness than among both lung cancer and heart disease are highest in the the total cohort. The data indicates that prior chemical population sector smoking more than 40 cigarettes a day. respiratory illness influences the subsequent development Other tables show the mortality from all causes, lung of lung cancer among beryllium workers. (Auth. Abs.) cancer, and heart disease. Compared with nonsmokers, smokers of over 20 cigarettes a day show a ratio of 110 to 12 deaths. Appended are descriptions of experiments 71.0062. McEwen, 1., Finlayson, A., Mair, A., Gibson, showing the oxygen taken from the air by cigarette A.A.M. Mesothelioma in Scotland. British Medical Jour- smoke, and an indication of the chemical components in nal 4(5735):575.578, December 5, 1970. . tobacco smoke. In a retrospective study of the incidence of mes- othelioma in Scotland for 1950.1967, 80 cases were 71-0066. Schmahl, D. Experimentelle Untersuchungen traced from pathological reports and biopsy material of zur Atiologie des Bronchialcarcinoms. [Experimental malignant tumors invading the pleura and peritoneum. Research on the Etiology of Bronchial Carcinomas.)In- These cases were matched with two sets of controls. ternist 11(9):300-302, September 1970, German. Detailed histories of residence, occupation and degree of exposure to asbestos confirmed that the incidence of Fluorescent measurement of exhaled cigarette smoke mesothelioma in Scotland is similar to that in other parts indicates that more than nine-tenths of fluorescent of Britain. A comparison of five categories of smoking tobacco smoke componentsis retained in the lungs. habits among mesothelioma cases and controls showed a Active and passive smoking experiments were made with significant difference at the 1 percent level. (Auth. Abs. laboratory animals and various results from literature are Mod.) reviewed. Further research is needed in the area of more harmful effects from filter or filterless cigarettes. Mice and rats injected subcutaneously with tobacco condensa- 71-0063, Ochsner, A. Relacion Entre el Habito de Fumar tion products developed local carcinomas. Experimental y el Cancer de Pulmon. [Relation Between the Habit of results from smoking machines with laboratory animals Smoking and Lung Cancer.]Prensa Medico Argentina correlated satisfactorily with harmful effects of tobacco 57(25):1241 -1 243, August 21,1970, Spanish. in humans, especially in the area of carcinoma develop. ment and respiratory difficulties. The arsenic component A brief review is made of a few of the laboratory, of tobacco smoke certainly leads to carcinoma develop- prospective and retrospective studies conducted in the U. ment, but consideration must also be given to the S. and Great Britain which have provided evidence of the accumulation effect also from the arsenic common to relationship between lung cancer and cigarette smoking. many .

71.0064, Rodriguez Rivera, L., Achon Polhamus, M., 71.0067, Shabad, L. M. Review of Attempts to Induce Rodriguez Silva, H., De la Paz, E., Pita de la Vega, H., Lung Cancerin Experimental Animals By Tobacco Durand Ochamendi, R., Sollet Guilarte, R. Habito de Smoke, Cancer 27(1):51-54, January 1971. Fumar y Diagnostico al Alta. Estudlo de 453 Cams. [Analysis of the Smoking Habit in Discharged Patients. Chemical-analytical and biological studies performed

11 14 NEOPLASTIC DISEASES

in the U.S.S.R. in recent years in thearea of tobacco and air pollution deleterious effect of carcinogenic tobacco smokeare carcini.tgenesisare reviewed. Studies reviewed. Tobacco smoke condensate was shown to be attempting to induce lung mcer in laboratory animals carcinogenic and sarcomagenic to animal tissues, especial- are emphasized. Although there is still a lack of experi- ly in the respiratory tract. Since humans and animals mental data on animal moeels clarifying the relationship of lung cancer to cigaret.e smoking. these studies t:''Ter anatomically, no conclusion can be drawnto the do effect that a given agent may cause thesame type of indicate that cigarette smcke can induce lungcancer in animals. tumors in different species. Both retrospective and on- going epidemiological studies indicate that tobacco smoke is a causal factor in cancer of the lungs and larynx. Studies using smoking machines with various animal 71-0068. Shear, M. South African Dental News.Dental species clearly attest to the carcinogenic effect of tobacco Magazine 87(3):130.132, June-July 1970. smoke. A brief survey is made of some of the evidence im- plicating smoking as a major health hazard andwas used to persuade the Dental Association of South Africa to 71-0071. Vagoni, G. 11 Cancro del Polmone e l'Inquina- adopt a resolution condemning the use of tobacco inany mento Atmosferico da Industrializzazione. [Lung Cancer form. and Air Pollution Due to Industrialization.]Gazzetta Internazionale di Medicine e Chiturgia 75(15):1160-1172, August 15, 1970. Italian. 71-0069. Soustin, V. P. K Gistokhimicheskoy Kharakter- istike Epiteliya Istinnykh Golosovykh Svyazokpri In- A statistical survey of the variations in the incidence dividual'nomRazvitii Cheloveka. of lung cancer in different countries and in various regions [The Histochemical of Italy, has been made. The more, important factors Characteristics of the Epithelium of True Vocal Cordsin the Individual Development of Man.]Vestnik Ow- which can have a bearing on the real increase in the Rino-Laringologii 31:33-36, May-June 1969, Russian. incidence of this malady are discussed. Smoking,as a risk factor in certain types of lung cancer cannot be denied, The author investigated 198 true vocal cords ofman but the author also emphasizes the role of air pollutionas from the time of their origination to theage of 70 years. a carcinogenic factor. (Auth. Abs. Mod.) Subject to consideration was theage, sex and tobacco smoking in deceased persons. In the sections theauthor determined glycogen and neutral mucopolysaccharides 71-0072. Wynder, E. L. Etiological Aspects of Squamous after the Hochkiss-Shabadash method, acidmucopoly- Cancers of the Head and Neck. Journal of the American saccharides after Heil's technique, RNA afterBrachet's, Medical Association 215(3):452-453, January 18, 1971. and keratin after Shubich's. Enzymatic andchemical controls (amylase, hyaluronidase, ribonuclease,acetyla- A very close association has been established between don) were carried out. Thetrue vocal cords start to tobacco usage in any form and squamous cell cancer of develop on the 6th-7th week of embryogenesis.At this the head and neck in nearly all sites. Cancer of the vocal period they are covered by multilayer nonciliaryepithel- cord, however, is predominantly related to cigarette ium. Soon after origination opposite vocalcords grow smoking. While there is no evidence that alcohol iscar- together, while on the 8th-9th week ofintrauterine life cinogenic, it is suggested that alcohol either aids in the they separate. In 216-4 monthson the cords appear multi- absorption of tobacco carcinogens, irritates tissues,or layer epithelium. Its cells synthesizeat first glycogen and most likely, because of nutritional deficiencies related to then mucopolysaccharides. Withage the thickness of heavy alcohol intake, makes squamous cellsmore sus- epithelium on the cords increases. It reachesthe maximal ceptible to conversion into cancer cells. The etiological thickness of 180 microns ata mature period of life. At roles of syphilis and nutritional deficiences insquamous this time the epithelium is characterized bya high content cell cancers of the head and neck are discussed. Arecent of RNA, glycogen and mucopolysaccharides.There is a study showed that the heavier a patient smokes before distinct delineation of the layer into protectiveand developing oral and upper respiratory tractcancers, the reproductive zones. In a number ofcases after 40 years in more likely he is to develop a second primary tumor; that the epithelium of the man's cord therewas established continued smoking after the first primary tumor hasa keratin synthesis. The epitheliumon the male cord is significant association with theoccurrence of a second thicker than on the female. The epithelialthickness on primarytumor; that continued drinking afterinitial the smoker's cord reaches 300-350microns, which is diagnosis has no significant effect on the development of double that of nonsmokers. Suchan epithelium as a rule a second primary tumor; that discontinuance of smoking counties. The epithelium of the medialand upper sur- and drinking after the first primary cancer doesnot en- faces, as well as edges of the cord,are characterized by a sure that the patient will not develop a second primary specific structure and histochemistri.(Auth. Abs. Mod.) cancer; and that radiation therapy for the first primary tumor appears to be associated with the development ofa second primary tumor. 71-0070. Tannenbaum, A. Relatorio dosTrabalhos Sobre Macao de Cancerigeneos com Especial Referenciaao Fumo do Talmo. [Report of Studieson the Inhalation of 71-0073. Zenk, H. Das berufsbedingte Kehlkopflcarzinom Carcinogens With Special Reference to Tobacco in gutachterlicher Sicht. [Occupational Laryngeal Car- Smoke.] Boletim do htstituto Portugues de Oncologia cinoma From the Viewpoint of Expert de Francisco Cereal 37(7):1-7, July 1970, Portuguese. Testimony.]Zeitschrift fur Latyngologie. Rhinologie, Otologie and Ihre Grenzgebiete 49(2):100-108, February Experiments on animals and humans to determine the 1970, German.

12 11.111,-

NON-NEOPLASTIC RESPIRATORY DISEASES

conditions. As the German changing chemical and physical There is a statutory obligation in the East occupational details generally available to the assessor Democratic Republic to observe and report on occupa- tend to be insufficient, industrial medicaldocuments tional carcinogenic factors causing cancer of therespira- correct 1967 four cases of usually need to be obtained. To facilitate the tory passages. Between 1957 and adjudication of individual cases it is desirable toestablish carcinoma of the larynx suspected of arisingfrom expo- a central register for reporting,working out, documenting sure to noxious substances at workhave been subjected to of the and evaluating of such cases. Theassociation between medico-legal scrutiny. It is surprising that in spite and we buen occupation and laryngeal cancer is still equivocal growing industrial expansion only one case has association, of occupa- shouldthereforeseekevidence of such recoginized as such. Medico-legal assessment irrespective of statistics, in the individual caseof employ- tional laryngeal cancer requires an exhaustivehistory. and a ment in suitable chemical worksand also pursue the histological reports, occupational health schedules occupational factor, as far as possible by postmortem detailed analysis of the work undertaken in the past.The well as examination. Irrespective of individuallyidentified car- toxic substances in question, their metabolites, as unified nicotine consumption are critically examined andthe cinogens, suspect cases should be reported under a latent period considered. The individual case, rather than heading of cancers of the air passages due to occupational his occupational group, must be assessed in thelight of causes. (Auth. Abs.)

See also 71-0045, 71-0047, 71-0048, 71-0050, 71-0051

NON-NEOPLASTIC RESPIRATORY DISEASES

71-0074. Addington, W. W., Carpenter, R. L.. McCoy, 3. 71-0076. Bopp, K. Ph. Pathogenese and Fruhdiagnostik der chronischenBronchitis.[Pathogenesis and Early F., Duncan, K. A., Megg, K. The Association of Cigarette Medizhiische K bulk Smoking With Respiratory Symptoms and Pulmonary Diagnosis of Chronic Bronchitis.] Function in a Group of High School Students. Journal 65(36):1598-1602, September 4, 1970, German. of the Oklahoma State Medical Association The chronic bronchitis syndrome has exogenous 63(11):525.529, November.1970. causes (infection, mechanical damage,irritating gases, Cigarette smoking has been suggested to be causally cigarette smoke, air pollution) and endogenous causes rare (hypogammaglobinemia and muco- related in the adult to chronic obstructive lung disease, which are viscidosis). The smoking habit alone can cause chronic but there is little data on the effects of cigarettesmoking bronchitis which is aggrevated if in combination with on teenagers. Five hundredfifty-seven out of 737 stu- dents of an Oklahoma City high school were surveyed for another causative agent of this syndrome. In workers who slight incidence respiratory symptoms and their pulmonary functions are continually exposed to gas, a measured. Despite the minimal and brief cigarette smok- of chronic bronchitis is normal, but in habitual smokers, and ing reported by most students, significant differences the bronchitis, once established. will be more severe were found between cigarette smokers andnonsmokers in difficultto cure. In housewives, not industrially em- ployed, the changes induced by chronic bronchitis will be the sample studied. Respiratory symptoms weresignifi- more severe if they are smokers. Whilesmoke from ciga- cantly more frequent in the students who reported that emitted from they smoked cigarettes than in those who did not. No rettes may be lesser in magnitude than that in pulmonary function were smokestacks, nevertheless, cigarette smoke, due to its significant differences offender observed between cigarette smokers and nonsmokers. The peculiar chemical composition, can be a worse data presented strongly suggest a prospective study of the with respect to the development of chronic bronchitis. relationship between cigarette smoking and chronic obstructive lung disease would need to begin with high school age subjects. (Auth. Abs.) 71-0077. Bride, D. Frequence de la Bronchite Cronique Chez la Femme. Role du Tabac. [Frequency ofChronic Bronchitis in Women. Role of Tabacco.]Revue de 71-0075. Albert, R. E., Alessandro, D., Lippmann, M., Tuberculose et de Pneumologie 33(6):794-797, 1969, Berger, .1. Long-Term Smoking in the Donkey. Archives French. of Environmental Health 22(1):12-19, January 1971. The increasing incidence of chronic bronchitis among Three donkeys smoked 30 cigarettes two to three women iscited, as based on a literature survey and tothe times per week for six to eight months. Two of the don- personal experience. This factisattributed keys showed severe impairment of clearance during the increasing number of women who take up smoking, since entire period of smoking but with rapid and virtually formerly the ratio of women to men smoking was one to complete recovery within a few weeks after the endof six. Generally, the frequency of production in exposure. The third donkey also showed severeimpair- smoking women is greater than in men who have never ment for several months but developed a tolerancefor smoked. It must be considered also that older women smoke, on the average, less than youngerwomen. It is cigarette smoke with a regression inthe level of impair- of age smoke less by the end of exposure. suspected that women over 50 years ment to almost normal levels than 15 cigarettes a day, while menin the same age group (Auth. Abs.) are moderately heavy smokers. NON-NEOPLASTIC RESPIRATORY DISEASES

71-0078. Br ysiewicz. K., Buluk, H.. Cesarz-Fronczyk, M., meters were described, and an attempt was made to Kordecka, .1., Lcszczynski, B., Lukjan, Z.,Sadokierska,14. examine each type, using the data on the 810 males and Wplyw Pracy w Warunkach Zapylenia na Czestosc the 1.390 females. It was concluded that there was insuf- Wystpowania Przewieklych Zapalen Oskrzeli u Pracowni- ficient evidence to justify using either of two polynomial kow Zaklodow Przemyslu Welnianego 1m. Sierzanaw model types. There appeared to be a certain amount of Bialymstoku. [The Effect of Occupational Dust Exposure bias in the linear model. Effort is needed to developa on the Prevalence of Chronic Bronchitis Among Workmen more refined model, taking into account both the error of Sierzan's Wool Industry at Bialystok.]Gnizllca i structure and a presumed focal age effect. A logarithmic Choroby Pluc 38(7):657 - 661,1970, Polish. model appeared to approach the former problem. The logarithmic equation type did have some mathematical The noxious effects of dust exposure on chronic bron- justification based upon data given in this study, but the chitis were studied in 1047 wool industry workers ata factory in Bialystok, Poland. Manifestations of chronic epidemiologic and biologic ramifications need to be explored. Further effort needs to be directed toward bronchitis were found in 114 workmen (10.9 percent), 27 developing equations with a more appropriate attention of whom also had advanced emphysema. In departments to age. The six ventilatory parameters were found to lack with dust concentrations over 10 ing/m3, 16.6 to 30.0 independence as shown by pritial correlation and pattern percent of the workers had chronic bronchitis, while in analyses. Moreover, combining the screening cutoffs departments with lower dust levels, bronchitis on was found two of these parameters, as the Breathmobile Project is in 5.4 to 6.6 percent of the workmen. Dust concentration now doing, does have some methodologic defects. There- and duration of work were the most hazardous factors in fore, a principal components analysis was initiatedon this relation to chronic bronchitis. The ratio of smokersto study group in an attempt to derive independent factors nonsmokers with chronic bronchitis was 3 to 2. An and overcome the methodologic examination of 97 workmen with chronic bronchitis shortcomings. With showed 45 percent with obstructive respiratory failure further study, we intend to evaluate it as a new tool for and 33 percent with ECG abnormalities. (Auth. Abs. both screening programs and epidemiologic investigations. Mod.) (Auth. Abs.)

71-0081. Dobrzynski, W., Kisielewicz, J., Kociecka, I. 71-0079. Cicrniak, E., Jelonkiewicz, J., Slodczyk, M., Analiza Kliniczno-Statystyczna Przewieklych Niczytow Cierniak, J., Pawlak, F. Przewlekle Zapstlenie Oskrzeli Oskrzeli u Pracownikow Portu i Stoczni w Szczecinie. Wsrod Pracownikow Zaldadow Wlokienniczych. [Chronic [Clinical and Statistical Analyses of Chronic Bronchitis in Bronchitis in Textile Industry Workmen.] Gnalica i Port and Shipyard Workers.] Medycyna Pracy Choroby Pluc 38(7):635-641, 1970, Polish. 21(3):294-306, 1970, Polish. In a survey of 596 textile workers (310 women and Clinical examinations were made of 250 port and ship- 286 men) ages 36 to 64, 493 had been exposedto dust. yard workers including 50 trimmers loading coal (Group Chronic bronchitis was diagnosed in 108 workers (simple I), 50 trimmers of products such as apatites, phosphorites, chronic bronchitis in 58 and bronchitis with manifesta- sulfur and cement (Group 11), 50 corn elevator workers tions of airways obstruction in 50). The incidencewas (GroupIll), 50ship welders (Group IV) and 50 higher among men (24.I percent) thanamong women stCycdores loading timber (Group V, control). An (12.5 percent), and was related to the higherprevalence anamnesis, chest X-rays, spirographic examinations and of smokers among the men. There was no difference pharmacological tests for latent bronchi contraction between rural and urban populations. The proportion states of were conducted. Chronk bronchitis was diagnosed in 140 cases of chronic bronchitis was 28 percent among smokers persons. 101 with simple chronic bronchitis and 39 with against 12 percent among nonsmokers, the difference chronic obstructive bronchitis. The main factor causing being statistically significant. Exposure to dusthad no chronic bronchitis was cigarette smoking. Most of the significant effect on the incidence of chronic bronchitis cases and mostly chronic obstructive bronchitis were (12 percent among those exposed to dust and 9percent found among smokers. All cases of chronic bronchitis among those not exposed). (Auth. Abs. Mod.) among the control group were also observed in smokers. Most cases of chronic bronchitis were found in workers exposed to dust. The incidence of bronchitis was 74per- 71-0080. Discher, D. P., Stelnborn, J. 1S/MFT:Lung cent in Group 11, 62 percent in Group IV, 60 percent in Screening by Meaningful Function TestingPart Group Ill and 48 percent in Group 1. Evidence of the II. American Journal of Public Health and the Nation's pathogenic effect of phosphorite, apatite,corn and Health 60(12):2361-2385, December 1970. welding dusts was seen in the significant percentage of nonsmokers with chronicbronchitis who had been Linear equations for ventilatory functionshave been exposed to these dusts. Latent bronchospasmatic states used by the Breathmobile Project, based upon those given were observedin in the published literature. This report is 137 workers. X-ray changes were an evaluation of observed in 172 persons and were the basis for diagnosing these equations obtained on 2,200 persons considered to pneumoconiosis in 30 ship welders. Both X-ray changes be "normal," each of whom had the six ventilatory mea- and chronic bronchitis were noted in 102 persons. Radio- surements, were asymptomatic, and hadnever smoked. logical changes, latent bronchospasm and bronchitiswere The six ventilatory parameters reportedupon were as fol- found in 89 workers and most often in ship welders, lows: the forced expiratory volume in the rust second, apatite trimmers and elevator workers. Among ship the forced expiratory vital capacity, the peak flow, the welders, chronic bronchitis occurred more often among maximal expiratory flow rate, the mid-maximal expira- younger men and men who had worked for shorter tm y flow rate, and the ratio of the rust two parameters. periods of time than in all the other groups. Four mathematical model types for ventilatorypara-

14 17 NON-NEOPLASTIC RESPIRATORY DISEASES

the pathological 71-0082. Dobrzynski, W., Ktsielewicz, J., Kociecka, I. on chest symptoms in comparison to Przewlekle Zapalenia Oskrzeli u Pracownikow Portowego effect of the dust produced by this firm. (Auth. Abs.) Elewatora Zbozowego. (Chronic Bronchitis Among the Workmen of a Harbor Grain Elevator.]Cruz licai Choroby Pluc 38(7):651.656, 1970, Polish. 71-0085. Fletcher. C. M. Cigarettes and Respiratory Dis- ease. Inhalation Therapy1401:45-50. August 1969. The following examinations were carried out in 152 A broad review is made of the evidencesupporting a workmen of a harbor grain elevator: past history accord- chronic ing to the Medical Research Council's questionnaire on causal relationship between cigarette smoking and respiratory symptoms, roentgenographic, physical and respiratory disease. particularly bronchitis andemphy- spirographic examinations, and pharmacologic tests. The sema. This evidence includesfindings of increased ±5 years; the mortality rates from respiratory disease amongsmokers. mean age of the examined workmen was 41 in the mean time of their employment was 10±6 years. Chronic and systematic development of certain symptoms bronchitis was diagnosed in 72 workers (47.3 percent) of syndrome of bronchitis and emphysema, includingcough. which 22 (14.5 percent) were cases with airways obstruc- profuse and often purulent sputum and increased airways obstruction, all of which have been found to be relatedto tion and 50 (32 percent) were cases of simple bronchitis. that: In 121 workers (79.5 percent) chest radio;-ram, changes cigarette smoking. Additional causal evidence shows were seen in the form of linear L shadows ,, increased Z (I)inidentical twins with different smoking habits. respiratory symptoms are more frequent andrespiratory markings. Manifestations of chronic bronchitis were of observed in 35 percent of the workmen employed for up fuhction is impaired in the heavier smoking member to 6 years, in 51 percent of those working up to 11 years each pair; (2) when smokers are matched inpairs with and in 74 percent of those working up to 16 years. nonsmokers in relation to a large number ofunconnected Chronic bronchitis was found in 57 percent of smokers personal factors which should control mostconsitutional and in 18.3 percent of nonsmokers. The study demon- differences,the smokersretaina *fifteen -fold excess strates that a many-year exposure to grain dust predis- mortality from emphysema; and (3) in animal experi- poses to frequent inflammatory processes of the upper ments, cigarette smoke has induced severebronchitis and respiratory tract and to chronic bronchitis with spastic caused destruction of the lung by emphysema.There is hyperreactivity of the bronchi. No distinct pneumo- some indication thatairpollution and chronic dust coniotic changes were observed. (Auth. Abs. Mod.) exposure can cause respiratory disease,but it seems that the adverse effects of these elements chieflyaffect ciga- rette smokers. 71-0083. Durda, M., Szafranski, W., Smiech-Najda, B., Kosciolko, L. Przewlekle NienVoiste Choroby Pluc u 71-0086. Greenberg. M., Milne, J. F., Watt, A.Survey of Pracownikow Zakladow Elektromaszynowych "EDA" w of Poniatowej. [Chronic Non-specific Lung Disease Among Workers Exposed to Dusts Containing Derivatives the Workmen of the Electro-Machine Works "EDA" at Bacillis Subtilis.British Medical Journal Poniatowa.]Cruz licei Choroby Pluc 38(7):623.634, 2(5710):629-633, June 13.1970. 1970, Polish. In a survey of 121 workers exposed to dusts con- proteolytic Data on age, sex, smoking habits, working conditions, taining derivatives of Bacillus subtilis, mainly enzymes, skin tests showed evidence ofsensitization in 48 and roentgenographic and spirographic findings were "atopic" analyzed on 745 workers at an electro-machine works. workers. Sensitization was higher among The examined persons were divided into two groups: 1) workers (showing one or more reactions to common aller- 703 without any pulmonary lesions, and 2) 42 con- gens) 16 out of 25 (64 percent)than among "non- valescents who had had pulmonary tuberculosis. Chre-rmc atopic" subjects32 out of 96 (33 percent). Of the 48 non-specific lung diseases were found in 33.8 percent of sensitized workers, 43 (90 percent) were sniokers com- pared with 58 (80 percent) out of 73 non-sensitized the subjects in Group 1 and in 59.5 percent of the persons 44 in Group 2. The prevalence was 40.9 percent in men and workers. Reduced ventilatory capacity was found in percent of sensitized workers compared with14 percent 17 percent in women. Cigarette smoking had a significant for by effect on the prevalence of chronic bronchitis, while dust of those not sensitized. but was not accounted exposure had a less detrimental effect. (Auth. Abs. Mod.) smoking habits. (Auth. Abs. Mod.)

71-0084. EI-Sewefy, A. Z., Awad, S., Abdel-Salam, M. S. 71-0087. Hawthorne. V. M., Gillis, C. R., Lorimer, A. R. Chest Symptomatology in an Egyptian Cement-Asbestos Multiphasic Screening Findings in Volunteers Examined Pipe Factory (A Field Survey). Journal of the Egyptian at the Chest and Heart Association HealthExhibition in Medical Association 53(1):84- 92,1970. Glasgow. Medical Officer 124(19):253.255, November 6,1970. This study was carried out in a plant for the manu- facture of asbestos-cement pipes and salt glazed clay Abnormalities detectedin 523 of 3600 persons pipes. Three hundred and forty-seven workers out of a volunteering and keeping their appointment for multi- total of 600 were asked standard questions from the phasic screening examination as part of a Chest andHeart M.R.C. short questionnaire on respiratory symptoms Health Exhibition in Glasgow, Scotland are described. The group examined differed fromsamples drawn from (1960), examined clinically and their chest X-rayed. The in that it con- results showed that there is a high incidence of respiratory industry routinely examined in this area, tained more examinees with angina, fewersmokers, more signs and symptoms due to the high dust concentration in preventive this plant. Smoking and aging have a very minimal effect with no remediable defects, fewer requiring

15 18 NON- NEOPLASTIC RESPIRATORYDISEASES

advice on smoking, and more requiring referral to the and nomograms were constructed for 4 standard ventila- family doctor or hospital with established early clinical tory measurements. Comparison were made with predic- abnormalities. These results suggest thata higher propor- tion formulas of other workers. There was progressive tion of the sample were more conscious of their health decline in ventilatory function with age; larger values in and were possibly attempting topursue a healthier mode of living. men were present at all ages. Wide variation was en- countered and was not attributable to age, sex, or height. This was most marked in the two forced expiratory flows, 71.0088. Jordeczka, which had low multiple correlations and large standard S., Hasa, S., Basa, B. Czestosc errors of estimate. The wide range of normal values Wystcpowania Przewleklej Nieswoistej ChorobyOskrze- seriously impairs the usefulness of spirometry in reliably lowo-Pluenej u Pracownikow Przemyslu Welnianego.[The detecting impairment of ventilatory function in asympto- Prevalence of Chronic Non-specificBronchopulmonary Disease in Wool Industry Workmen.) matic individuals. Other techniques are needed to detect Gruzlica i Choroby early impairment of pulmonary function. (Auth. Abs.) Pine3817):643. 650,1970, Polish.

Symptoms of chronic non-specificbronchopulmonary disease were found in 145 (18.1 percent) 11-0091. Naeye, R. L., Mahon, J. K., Dellinger,W. S. out of 800 wool Effects of Smoking on Lung Structure of Appalachian industry workers. In the agegroups under 40, chronic Coal Workers.Archives of EnvironmentalHealth non-specific bronchopulmonary diseasewas found in 32 22( 2):190 -193, February 1971. (5.8 percent) out of 548 persons examined,while in the age groups over 40, the disease was present in 113 (44.9 A quantitative, morphologic studywas undertaken of percent) out of 252 workers examined. Therewas a signi- ficant difference in the incidence of postmortem heart and lung structure on 144 Appalachian the disease between underground coal workers. Thirty-two had smokers and nonsmokers and also a lifetime between workmen history of nonsmoking. 24 smoked a pipe or cigars, and employed for more than 15 years andthose employed for less than 5 years. (Auth. Abs. Mod.) 88 smokcd cigarettes in various amounts.There was no influence of smoking on the primary coal dust maculeand its direct complications but the bituminous-coalminers who smoked had a 17 to 33 percent greater degree of 71-0089. Lourenco, R. V., Castellanos, cor D. Lung Tissue pulmonale, 9 to 25 percent more emphysema, and 56to Hysteresis in Pulmonary Tuberculosis.American Review of Respiratory Disease 68 percent more bronchiolar goblet cellsas evidence of 103( l ):49-56, January 1971. chronic bronchiolitis than nonsmoking bituminous-coal miners. No significant effect of smoking Lung hysteresis and compliance, on lung and heart and pulmonary and structure was found in anthracite miners. (Auth. Abs.) airway resistances were measuredin 16 patients (14 smokers, 2 nonsmokers) with pulmonarytuberculosis. l'or this purpose, tidal volume, air flow, transpulmonary 71-0092. Ned, L. C., Mandel, J. S., O'Connor, pressure measured with an esophageal catheter, M. L., and trans- Larson, M. A Household Survey of Chronic Methodologi- airway pressure obtained ina constant volume body plethysmograph were depicted simultaneously cal Problems and Results of Pilot Survey.Canadian Jour- on two nal of PublicHealth 61(5):407412, September-October cathode ray oscilloscopes. The resultswere correlated 1970. with the clinical symptoms andradiologic extent of the disease and were compared with dataobtained by the same methods in 11 normal subjects. Lung A household survey is to be conducted in the Ottawa tissue hystere- area to estimate the prevalence of chronic obstructive sis was significantly greater thannormal in patients with pulmonary disease and to relate this to smoking, habits,air pulmonary tuberculosis, and its valuewas related to the extent of the lesion present and pollution and other measurable variables in theenviron- to the severity of ment. Results of a pilot survey and its implications for dyspnea. Lung compliance, althoughsignificantly less than normal, was not as greatly modifying and carrying out plans for the mainsurvey are altered as hysteresis. Air- reported. way resistance was not different fromnormal. Abnormal- ly increased lung tissue hysteresiswith or without simu- ltaneous decrease in pulmonarycompliance might play a role in the symptoms of patients 71-0093. Spindletop Research, Inc. Synopsisof the Work with re: onal lung dis- Session Proceedings. September eases such as pulmonary tuberculosis.(Auth Abs. Mod.) 10-12,1969.Inter- national Conference on OW. SpindletopResearch, Inc., Lexington, Kentucky, 1969, 34pp. 34 pp. 71-0090. Morris, J. F., Koski,A., Johnson, L C. Spiro- metric Standards for HealthyNonsmoking Adults. A conference on coal workers' pneumoconiosiswas American Review of RespiratoryDisease 103(1):57-67, January 1971. held to consider present knowledge of themedical aspects of this disease to summarize points ofagreement con- Previous studies designed to establish cerning certain key questions, and toformulate recom- normal standards mendations for further research with regard to for ventilatory testing haveusually included substantial problems where no agreement could be reachedbecause of con- numbers of cigarettesmokers and hospital patients. flicting or inadequate data. Surveys haveshown that Forced expiratory flows and volumeswere measured in 988 healthy nonsmoking miners smoke as much as the nonmining population, but men and women who had rela- their smoking patterns differ somewhat because of work tively little exposure to any form ofair pollution. Nega- tive correlations were obtained with restrictions on smoking. Cigarette smoking has not been age and positive cor- shown to be related to coal workers' pneumonconiosis, relations with height. Prediction formulaswere derived but it is highly related to respiratory symptoms, including

16 19 NON-NEOPLASTIC RESPIRATORY DISEASES

fiir Arbeitsmedi:in , sputum, breathlessness on exertion, and to various tion.]In t erne Honchos Archie laboratory indices of ventilatory function. In a study 27(1/2) :49-72, October 30. 1970. German. where a relationship between duration of dust exposure Close relations. statistically still to be secured,have and pulmonary function was shown, division of the popu- and lation into smokers and nonsmokers showed that this been found between duration and severity of smoking frequency of cough and expectoration in 8.162 menand relationship was stronger for smokers. Thus, it is possible and women. that cigarette smoking potentiates the effects of dust on women examined. Strong smokers, men pulmonary function, although smoking by itself is more generallycomplained two to three times more often about cough and expectoration in the daytime or inthe important in the production of respiratory disease than of smoking exposure to coal mine dust. morning than non-smokers. The influence habits on frequency of cough or expectorationshowed to be as strong as that of age. Functional changesdeveloping by a 71-0094. Peuana, A., Scordamaglia, R. Control lo Dello in dependence on smoking habits are characterized slight reduction of the arterial oxygen-pressure and riseof Stato di Salute del Personale di un Ospedale Generale difference. The Provinciale. (Control of the State of Health of Personnel the alveoloarterial carbon-dioxide pressure findings suggest that severe smoking leads to an increased of a General Provincial Hospital.]Giornale di Igiene e 10(4):493-507, September-November inhomogenity of the ventilation-perfusion and ventila- Medicine Preventive tion-diffusion relationship in the lungs. Considering the 1969, Italian. frequency of obstructive bronchial diseases, severity and The state of health of 296 people from the staff of a duration of smoking do not seem to have the assumed General Provincial Hospital has been checked. Numerous iir.prmance. This results among other things from the fact cases of chronic affections of the respiratory system were that the generally less smoking women show just as often detected, which are thought to be due to smoking habit; obstructivebronchial diseasesasthe more strongly moreover, several cases of rheumatic valvular defects, 7 of smoking men. (Auth. Abs.) which are still asymptomatic and unknown to the subjects concerned, were ascertained. (A uth . Abs. Mod.) 71-0097. Sadoul, P., Laxenaire, M. C., Lambert, H. Tableau Fonctionnel de rEmphyseme Radiologiquement 71-0095. Pudelski, 3. Czestosc Zaburzen Wentylacyjnych Destructif. (Functional Picture of Radiologieally Destruc- Typu Obturacyjnego u Chorych na Swieza i Przewlekla tive Emphysema.]Journal Francais de Medecine et Gruzfice Pluc. (Prevalence of Airways Obstruction in Chimrgie Thomciques24(2):183.204, February-March Patients With Recent and Chronic Pulmonary Tuberculo- 1970. French. sis.]Gntzlicat Choroby Pluc38(7):595-604, 1970, Polish. The 32 cases had the following features: Clinically. bronchitic and radiological symptoms were preceded by Spirographic examinations, including vital capacity, dyspnea on exertion, there was distension of the lung one second forced expiratory volume (FEV ) and maxi- areas, retention of air in forced expiration,disappearance mal voluntary ventilation, were conducted in 830 patients of subscgmcntal vascular nets, which leads to further with recent infiltrative or infiltrative with cavity tuber- precisions on the real and radiologically certain concept culosis, and in 179 patients with chronic pulmonary of generalized emphysema. Twenty-two were heavy tuberculosis of over two year's duration. The ages of the smokers; only one was a nonsmoker. Three out of four patients ranged from 18 to 70. Ventilatory disturbances were underweight, by recognized standards. In25 percent in the form of airways obstruction (FEV' less than 70 of the cases, the MEVS/VC is over 70 percent. Total percent) were found in 263 percent of patients with capacity, as measured by dilution of helium is above the recent pulmonary tuberculosis (31 percent of men and 17 theoretical value for the CECA in one half of the number percent of women). Considerable airways obstruction of patients. The total capacity for helium is always below (FEVI under 50 percent) was found in 2.1 percent. The the total capacity as measured on the NB films. Ventila- incidence of airways obstruction increased with the age of tion energy Is about three times the normal energy. the patients. Dust exposure at work and smoking habits whereas basic ventilation compliance has not been signifi- had a significant effect on airways obstruction in the men. cantly above normal in 13 patients with emphysema. CO Airways obstruction was found in 59 percent of patients and CO2 ductance, AV/V, are notably lowered. Arterial with chronic tuberculosis and was not dependent on their blood gases. coefficient of take-in stable system, are less sex. In 16.2 percent of these patients, the airways ob- troubled than in severely breathless bronchitics. Hyper- struction was considerable (FEN,' less than 50 percent). eapnia is rare; hypoxhemia is discrete but grows with The incidence of airways obstruction increased with the exertion. Hematocrit is seldom higher. Average of cardiac age of the patients, but was frequently found in the 30 to output. is less than with bronchitics. Pulmonary artery 40 age group. The extent of pulmonary lesions or smok- blood pressure is very seldom high at rest. Evolution has ing habit had no effect on the incidence of airways ob- been watched for 12 months to 5 year: in 21 patients, for struction, while the duration of the illness had a definite some days to 12 months in the other 1 I. Twelve died. and effect in men. (Auth. Abs. Mod.) only three died of severe respiratory failure with hyper- capnia. In three instances, death was more or less directly related to treatment by corticoids. Five sudden deaths 71-0096. Reichel, G., Ulmer, W. T., lkonomides, S. Z were recorded. Auth. Abs. Mod.) Einflusse der Rauchergewohnheiten auf die HauflgIceat unspezifischer Atemwegserkranlcungen. III. Mitteilung. Screen for (Influence of Smoking Habits on the Incidence of Non- 71-0098. Sufrin, M. To Screen or Not to specific Respiratory D i s ea ses.111. Communka- COPD.Bulletin National Tuberculosis and Respiratory Disease Association56 (9): I 1-13. October 1970.

17 20 1

NONNEOPLASTIC RESPIRATORY DISEASES

Cigarettes, air pollution and in one form of emphy- is concluded that the smoking sema a genetic defect have been firmly linked to chronic habit does not impair pulmonary ventilation andmixing in asymptomatic obstructive pulmonary disease. The incidence isrising smokers in the third decade. (Auth. rapidly and as an element in its control, screening projects Abs.) of varying scope and aim have been undertaken.The dis- cussion explains why screening is useful for researchand 71 -0102. Tremonti, L. P.Tokyo - Yokohama as part of general health examinations and why it isnot Asthma. Annals of Allergy recommended for case finding alone or for educationof 28(12):590-595, December the general public. 1970. In 31 cases of Tokyo- Yokohama asthma, clinical features of chronic airway obstruction 71-0099. Teculescu, D., Stanescu, D., Gavrilescu, N. Com- and the association pliance Puhnonaire des Silicotiques with cigarette smoking have remainedunchanged from a Spirographie previous reports. Because of the Normale. [Pulmonary Compliance in PatientsWith Silico- association of asthma to sis and Normal Spirographic Values.] air pollution and the high incidenceof blood and sputum Internationales eosinophilia, a hypersensitivity Archie fur Arbeitsmedizin 26:250-262,1970,French. or allergic mechanism has been postulated as to the etiology ofTokyo-Yokohama asthma. (Auth. Abs.) In 30 patients with silicosis,some abnormalities of static lung volumes and mechanics ofbreathing were found despite normal spirographic performance.Although FEY! .0/VCwas within normal limits, 71-0103. Ulmer, W. T., Reichel, G. ZurEpidemiologie der several subjects had chronischen Bronchitis and deren hypennflation and an increase in differencebetween Zusammenhang mit der static and dynamic lung compliance. The Luftverschmutzung. [The Epidemiology ofChronic Bron- static lung com- chitis and Its Relationship to Air pliance showed a wife scatter; however,seven patients Pollution.] Deutsche (three from among the five patients with Medizinische Wochenschrift95(51):2549-2553, advanced silico- December 18, 1970, German. sis) had a compliance under the lowernormal limit, while a further four had "borderline" low values. Ininterpreting the physiologic abnormalities of the lung An epidemiological studyon the prevalence of chronic in patients with bronchitis in 8162 persons demonstrated silicosis, the influence of age and smokinghabits must be that ordinary taken into account, but itwas not thought that the con- chronic bronchitis (with cough andexpectoration) mar- sumption of tobacco, by itself, could kedly increases wIls increasingage. To a large extent it explain the dis- depends on smoking habits. Significant tensions found in these cases. (Auth.Abs. Mod.) differences were not found in the prevalence between urbanareas of the Ruhr, some of them with severe airpollution, a small 71-0100. Teculescu, D. B., Stanescu, town and a rural district. Obstruction bronchitisis much D. C. Pulmonary less common than simple bronchitis. Function in Workers With ChronicExposure to Cadmium The number of Oxide Fumes. Internationales Archlyfur Arbeitsmedizin patients requiring intensive treatment isstill rather high at 26(4):335-345, November 17,1970. 3 percent; the prevalence of allforms of respiratory tract obstructionrises from 3toover 14 percent with increasing age. Smoking is Detailed pulmonary function studieswere carried out forms of obstructivea causal factor in the severe on 11 workers (8 smokers, 1 ex-smokerand 2 non- bronchitis. But obstructive smokers) of middle age, who had bronchitis increasesinrelationship to agealsoin been exposed for 7 to nonsmokers. There was no correlation 11 years to moderate concentrationsof cadmium oxide. between general air Minor abnormalities of lung volumes, pollution and the prevalence ofrespiratory-tract ob- intrapulmonary struction. Simple bronchitis mixing and lung compliancewere found in a few cases; no occurs more frequently in airway obstruction was present.The lung diffusing men than women, but respiratory-tract obstructionhas capacity and the bloodgases were normal. The chest the same prevalence inthe two sexes. Whether air roentgenogram showed a normal vascular pollution plays a role in thecourse of chronic obstructive pattern at the bronchitis remains as a moot point. (Auth. periphery of the lung. It is concludedthat emphysema Abs.) was absent in the group studied. (Auth. Abs.Mod.) 71-0104. Woolf, C. R., Suero, J.T. The Respiratory Effects of Regular Cigarette Smoking 71-0101. Teculescu, D., Stanescu, D.Ventitatia d Mixica in Women. Ameri- can Review of Respiratory Disease103(1):26.37, January Pulmonara la Barbed Tined Sanatosi,Fumatori at 1971. Nefumatori. [Pulmonary Ventilationand Distribution in Young Healthy Males,Smokers and Non- smokers.] Clinical examinations, pulmonaryfunction tests, and Studil d Cercetarl de MedicinaInternet cytologic examinations of sputum 1, 11(5):419-423, 1970, Rumanian. were performed on 298 normal women between theages of 25 years and 54 years. There were 97 nonsmokers, 30 The ventilation at rest, oxygenconsumption, ventila- ex-smokers, 24 light tion equivalent for oxygen, breathing smokers, 63 moderate smokers,and 84 heavy smokers. frequency, mixing With increase in cigarette time and mixing ventilation havebeen determined in 44 smoking the prevalence of cough, sputum production, wheezing, young (mean age 21 years) healthy males in the and shortness of sitting breath increased progressively. Abnormalities position. No significant difference for all these on physical parameters examination of the chest were foundmore frequently in was found between smokers and nonsmokers, and the smokers than in nonsmokers. Sputum specimens data were pooled for the calculation of normal values. were It more frequently available from smokers than fromnon-

18 21 CARDIOVASCULAR DISEASES

capil- smokers. No malignant cells were found. Metaplasiaof second, maximal midcxpiratory flow, arterializcd lary blood oxygen tension at rest, specificconductance. epithelial squamous cells and degenerative and "irritative" uptake changes in columnar cells were found more in smokers and pulmonary diffusing capacity and fractional of carbon monoxide during exercise.liematocrit was than nonsmokers, but the differences were notsignificant. The results of the following pulmonaryfunction tests higher in smokers than in nonsmokers. (Auth. Abs.) were significantly lower in smokers than innonsmokers: forccd vital capacity, forded expiratory volume in one

See also 71-0034, 71-0052, 710064,71-0136,71-0146,71-0152

CARDIOVASCULAR DISEASES

The harmful effects of nicotine fromtobacco smoke 71-0105. Abel, H., Schonberger, W., Schimmer,G. Die are reviewed with specialreference to biological pre- Grosse der raumlichen T-Flachenvektoren unter cigarettes daily T-Area disposition in humans. A smoker of 20 Hypoxiebedingungen. [The Size of the Spatial and Zeitschrift fur Kreislaufforsch- undergoes the same effect in increased blood pressure Vectors Under Hypoxia.] pulse rate as a person doing strenuous physicalexercise. ung 59(7):599-604, July 1970, German. Pathological findings are similar to those of coronary sclerosis. Morbidity and mortality statistics that arehigher Using the Frank-system we examined in15 young de- for smokers thanfor nonsmokers arc reviewed. In healthy persons (8 smokers, 7 nonsmokers) the frequently from coro- pendence of the spatial T-area vector on heart rate. The smokers, morbidity results most nary sclerosis, lung cancer, chronicbronchitis, and athero- registration of the ECG was made first breathing normal indicate air, second under hypoxia with 12 percent 02 in N2,and sclerosis of the lower extremities. Other statistics in that 85 percent of deaths from all causesinvolve habitual third in 4 persons under hypoxia with 16 percent 02 ratio of N2. The smokers showed in hypoxia with 12 percent 02 smokers. In another statistical sampling, the insufficiency. The deaths from causes not attributed precisely tosmoking curves like patients with coronary and 13 percent for transit zone of the nonsmokers shifted to the regionof was 23 percent for heavy smokers, low heart rate. The spatial T-area vectors of all persons nonsmokers. became remarkablysmaller. There were intermediate positions in the 4 persons, with hypoxia of 16 percent Developpe- 02. It is possible to calculate the degree of coronary in- 71-0108. Barrillon, A. Comment s'Opposer au ment de l'Atherosclerose Coronarienne.[How to Prevent sufficiency by these curves and therefore also the effici- Entre- ency of the therapeutic effort. (Auth. Abs.) the Development of Coronary Atherosclerosis.] tiens de &chat, Therapeutique 1970, pp.19-22, French.

In France, coronary atherosclerosis as a causeof death 71-0106. Auerbach, 0., Hammond, E. C., Garfinkel, L., and is striking Kirman, D. Thickness of Walls of Myocardial Arterioles in is increasing by about 13 percent a year, younger people. From epidemiologicalstudiesit was Relation to Smoking and Age. Archives of Environ- illness is mental Health 22(1):20-27, January 1971. found that one predisposing condition for this tobacco smoking. The relationship between coronary Three studies were made of the thickness of myo- atherosclerosis and obliterating atherosclerosis, especially of the lower extremities,iseven more pronounced. cardium arteriole walls in relation to smoking and age. three One was done on men at autopsy. Two were done on Coronary disease between 39 and 49 years of age is 59 years beagle dogs. In men, the thickness of arteriole walls was times higher in heavy smokers; between 50 and greater, on the average, in smokers than nonsmokers and of age this risk is doubled. increased with age. Thickness of arteriole walls increased with number of cigarettes smoked per day. The thickness P., was less, on the average, among cigar andpipe smokers 71-0109. Bertrand, E., Aye, H., Beda, B., Barabe, Coronaro- than cigarette smokers. In two experiments beagle dogs Lebras, M., DeUoue, M. Quelques Aspects des Africains. daily inhaled cigarette smoke through tracheostomae; pathies Observees a Abidjan Chez des Noirs other were not exposed. The arteriole walls became (Some Aspects of Coronary Disease in Black Africans Archives des Maladies du Coeur thicker in smoking dogs than in nonsmoking dogs; thicker Observed in Abidijan.] in dogs smoking fewer cigarettes; thicker in dogs smoking et desVaisseaux 63(10):1445-1459, October 1970, nonfilter cigarettes than in dogs smoking filter-tip ciga- French. rettes. The thickness of arteriole walls increasedwith The authors are initiating a study of comparative duration of smoking. (Auth Abs.) medicine between Negroes and Europeansconcerning coronary artery diseases. In the groupof 25 patients with disease, 71-0107. Bahrmann, E. Die Angina pectoris im Aspekt clinical and electrocardiographic coronary artery this disease was found in 0.18 percent of theblack males ihrer Korrelation mit biologischer Disposition, psycho- and 17.2 percent of the European males hospitalized.The logischen and Soziologischen Einflussfaktoren. [Angina black patients' etiological and pathological factors as com- Pectoris in Relation to its Correlation With Biological populations Predisposition, and Psychological and Sociological Influ- pared to those observed in other coronary shows the black candidate to coronary disease inAbidjan Deutsche Gesundheitswesen 25(22):1050-1051, ences.] is a man in the 4th or the 5th decade, with ahigher than May 28, 1970, German.

19 22 CARDIOVASCULAR. DISEASES

average economic status, of Nigerian nationality, often a support the view that myxedema causes significantcoro- smoker, with rather high blood cholesterol and fatrates. nary atherosclerosis. (Auth. Abs.) But he is rarely obese. Two patients only had cardiac failure with discovery of coronary electrocardiographic patterns. Thirteen patients only had electrocardiographic 7 1-01 12.B y ch k ova ,1.P. 0 Giperplasticheskikh signs combined or revealed by another disease, particu- lzmeneniyakh Voloknistykh Stzuktur v Stenke Aorty larly arterial hypertension. The functional character of Krolika pri Razvitii Eksperimentarnogo Ateroskleroza. these coronary insufficiencies is discussed. Thesymptoms [Hyperplastic Changes in the Fibrous Structure of the are not very dissimilar, except for the less dramatic pains Walls of the Aorta of Rabbits During the Development of and more common lateral localizations in the ECG.The Experimental Atherosclerosis.)Kardiologila 1:-Iative rarity of coronary disease in the blackmay be 10(3):144-147, March 1970, Russian. exelained by the lesser incidence of atherosclerosis,or rather of thrombosis. The environmental factorsin the Hyperplastic changes of the fibers of connective tissue traditional rural surroundings (lowerlife expectancy, of the intima of rabbit aorta continued, for the second lower economic status, diet and life habits) causedthis rarity. (Auth. Abs.) time, immediately upon lowering of the lipidlevel. Formation of the fibrous elements appears to becon- nected with the activity of the smooth muscle cells, penetrating the inner membrane of the aorta of the 71-0110. Bierenbaum, M. L., Fleischman, A. I., Green,D. subintimal layer of the middle membrane. Formation of P., Raichelson, R. I., Hayton, T., Watson, P.B., Caldwell, the finecollagenous fibers arc connected with the A. B. The 5-Year Experience of ModifiedFat Diets on accumulation of chondroitin sulfate A and/or C and Younger Men With Coronary Heart Disease.Circulation hyaluronic acid. Solid collagenous fibers also contain 42(5):943-952, November 1970. chondroitin sulfate B. A total of 100 men, 30 to 50 years old, withdocu- mented coronary artery disease and pastmyocardial in- 71-0113. Chang, C. H. Hupyun i Tongmaek Kaengh- farction were placed under dietary managementwith a 28 wazung e Michinun Yunghyang e Kwanhan Yunkyu. 1. percent fat diet. One hundred men whose diets were not ilupyun i Jungsangin Maekbak Hyulap Mit Pibu Ondoe managed were matched with regard toage at entry to the Michinun Yunghyang e Kwanhayu. [Studies of the study, age at infarction, number of infarctions,blood Smoking Effect on the Atherosclerotic Changes of the pressure level, degree of angina, and scrum cholesterol level among other factors. Over Arteries. I. Smoking Effect on the Pulse Rate, Blood Pres- a period of 5 years the sure and Skin Temperature in Normal Subjects.]Korean diet-managed group experienced and maintaineda signifi- Journal of Internal Medicine 13(7):485-491, July 1970, cant reduction in serum cholesterol level whichthe non- Korean. diet-managed group did not. Under the dietand experi- mental conditions employed, with saturated fatcontent The effects of smoking on the cardiovascular system below 9 percent of calories, and cholesterol intake below were studied by measuring pulse rate, blood pressure and 400 mg per day, the degree of unsaturationof the fats in the experimental diets did not skin temperature before and after smoking. Following appear to influence serum smoking there was an increase in pulse rateper minute cholesterol value or mortality. Theserum triglyceride ranging from 4 to 23 (10.5 average), an increase in level was significantly lower in the diet-managedgroup systolic blood pressure ranging from 4 to 22 than in the nondiet-managedgroup; this was presumably mm Hg related to weight reduction. In the (12.37 mm Hg average)and an increase in diastolic blood group under dietary pressure ranging from 4 to 17 mm Hg (8.97 mm Hg aver- management, fatal and nonfatal myocardial reinfarction age). Skin temperature of the finger dropped 1.2° rates were lower but were significantlyso only for the to 5° C fatal infarction rates in (2.68° C average), while toe temperature decreased 1.2° men under age 45. In the diet- to 6.2°C (3.61° average). (Auth. Abs. Mod.) managed group, smokers had a reinfarctionincidence rate tv.ice that of nonsmokers whik therewere no evident differences between smokers and nonsmokersin the non- diet-managed group. Serum phospholipids 71-0114. Cloarec, M. L'Infarctus du MyocardeChez above 220 l'Adulte Jeune (Mobis de 40 Ans). [Myocardial Infarct in mg/1^^ ml were associated witha significantly lower rate of recurrent infarction. (Auth. Abs. the Young Adult (Under 40 Yeus).1 Entretiens de Mod.) Bkhat. Medecine et Biologie 1970, pp. 153.156, French.

A longitudinal study was made of 32 adults underage 71-0111. Buchanan, J.Ballistocardiographic Smoking Tests in Myxoedema. In: 40 who suffered from myocardial infarct andvarious Ballistocardiography and parameters were compared with a control group of the Cardiovascular Therapy. Proceedings of the2nd World same age. Factors considered were diet, somatic state, Co ngress on Ballistocardiographyand Cardiovascular tobacco and /or alcohol addiction, and psychiatric Dynamics, Oporto, Portugal, 1969. Bibliotheca Cardio- examinations. Twenty-one patients consumed twice the logien; Supplements ad Cardiologla 26 :89-93,1970. amount of alcohol as the average amount consumed by the control group. The greatest difference between the Positive ballistocardiographic smokingtests occurred groups was alcohol and tobacco consumption. Of the it/ in 16 of 19 patients aged under 40years with coronary patients, 30 smoked more than 20 cigarettesa day; 28 of disease but of 18 hypothyroid patients of similar age only the 30 inhaled the smoke. The most frequent associated one had a positive test. No positive tests occurred in 11 condition was duodenal ulcer found in 10 cases, and in 9 patients euthyroid after treatment of myxedemanor in of these cases it had preceded the coronary malady byan 27 apparently healthy subjects. These results do not average of 7 years.

20 23 CARDIOVASCULAR DISEASES

Theory was advanced on the association of sugar con- 71-0115. Coffman, J.D. Tobacco Smoking and the and Circulation. Heart Bulletin19(5):89-93. sumption and the incidence of myocardial infarcts Peripheral peripherial artery diseases. There seemed to be a direct September-October 1970. relationship between sug:tr consumption and cigarette by nicotineinjectioncauses smoking. This relationship was further strengthened Tobacco smoking or research which indicated that heavy cigarette smokers cutaneous vasoconstriction, an increase inskeletal muscle usually consumed hot liquids with sugar, and this associa- blood flow, and a decrease in venous distensibility. The cutaneous vasoconstriction is mediated via the sym- tion of disease-causative factors is independent of other pathetic nervous system; the mechanisms of action on the variables such as age and social status. The preponderance skeletal muscle blood vessels and the veins are, as yet. of evidence cites cigarette smoking rather than sugar as unknown. Tobacco has not been established as the actual the causative factor of these diseases. etiological agent in peripheral vascular disease but tobacco smoking can be dangerous, since it may decrease skin blood flow in an extremity with an already compromised 71-0119. De Molo, G. L'Incidenza dei Fattori di Rischio circulation. The incidence of amputation in patients with Coronarico nei Soggetti con Infarto del Miocardio. !In- arteriosclerosis obliterans is substantially greater in those cidence of Coronary Risk Factors in Subjects With who continue to smoke than in patients who stop Myocardial Infarct.)Annuli di Medicine Novak smoking. (Auth. Abs.) 75131:243.258, May-June 1970, Italian. An analytical study has been made on 386 cases of 71-0116. Cohen, S. I., Dorion, G., Goldsmith, J. R., acute myocardial infarct in order to assess the statistical factors". Permutt, S. Carbon Monoxide Uptake by Inspectors at a frequency of theso-called "coronaryrisk United States-Mexico Border Station. Archivesof Ninety-one percent of the men and 23 percent of the risk Environmental Health 22(I):47-54. January 1971. women were smokers. The influence of tobacco as a factor is discussed briefly. The author emphasizes that in Collection of expired-air carbon monoxide (CO) the present study, the association of hypertension with samples was utilized to examine inspectors on the United high levels of blood cholesterol and diabetes was present States-Mexican border to determine if significant increases in the majority of the cases. (Auth. Abs. Mod.) in carboxyhemoglobin (COHb) occur. Twenty-six border inspectors were categorized as to smoking habits and work shift CO exposures. Employees not actively engaged 71-0120. Elmfeldt. D. Rokning och Koronarsjukdom (8): in car inspection duties constituted the control group. Rokvanor hos Patienter med Hjartinfarkt. [Smoking and Following shifts when particularly high ambient CO levels Coronary Disease (8): Smoking Habits of Patients with persisted, significant increases in COHb were noted in Heart Infarctions.]Lakartidningess67(2):I68.169, both smokers and nonsmokers. Controls did not exhibit January 7, 1970. Swedish. significant alterations in COHb levels. The hazards of such COHb elevations to exposed individuals are discussed in A statistical evaluation was made of current smokers. light of recent evidence of a lack of threshold for cardio- ex-smokers forced to discontinue the habit due to coro- grouped vascular and central nervous system effects. (Auth. Abs.) nary disease, and nonsmokers. The patients were according to the type of tobacco products consumed and the intensity of their smoking habits. The prognosis for 71-0117. Cohen, S.l.,Perkins, N. M., Ury, H. K., the smokers was unfavorable andit was urged that Goldsmith, J. R. Carbon Monoxide Uptake in Cigarette patients suffering myocardial infarct abstain from smok- Smoking. Archives of Environmental Health ing. 22(1):55-60, January 1971. A study was carried out to determine whether 71-0121, Facchini, G., Tabarroni, F., Semeraso, S., smoking (1) regular, (2) low-nicotine-low-tar, or (3) non- Cremonini, G. P. Influenza del Fumo di Sigaretta Sulla tobacco (lettuce leaf) cigarettes has a differential effect Prove di Sensibilita' all'Eparina "in Vivo" Studiata con [Influence of Cigarette upon an individual's carboxyhemoglobin (COHb)level. Metodo Tromboelastografico. Each subject in the study population participated twice in Smoke on the "In Vivo" Sensitivity-to-Heparin Test, five "smoking treatments" in which they smoked various Studied by the Thromboelastographic Method.) Archi- tobacco and nontobacco cigarettes. Expired-air carbon vio di Medicine Interne 20(6):1113-1118, Nove-nber- monoxide (CO) samples were taken four times daily to December 1968, Italian. estimate COHb concentrations. Results indicate that different cigarette preparations do not result in significant The thrombophilic effect of cigarette smoke is mani- variation in a subject's COHb level. There was a significant fested in antagonizing the anticoagulant influence of difference,however, in COHb betweenindividual heparin administered intravenously to 15 healthy, normo- smokers. It may be that differences in inhalation practices coagulant subjects. The thrombodistogram shows a or factors such as pulmonary function areof some minor lengthening of the reaction time (r) and formation importance in determining whether an individual achieves of coagulum time (K), and a minor reduction of the low, moderate, or high COHb levels while smoking. maximum amplitude induced by a dosage of 0.35 mg of heparin/kg, after smoking a cigarette. Such an effect, (Auth. Abs.) theoretically, could be an epiphenomenon of thecatecho- lamine response to the smoke. 71-0118. Concours Medical. La Cigarette, le Sucre ou les Boissons Chaudes? [Cigarettes, Sugar or Hot (4): Drinks?)Concours Medical 92(34/36):6457, September 71-0122. Fodor, J. Rokning och Koronarsjukdom Pragstudien. [Smoking and Coronary Disease (4): The 5, 1970, French. 21 24 CARDIOVASCULAR DISEASES

Leclercq, A., Proteau, .1. Intoxication Par 67(2):150.152, January 710126. Prague Study.]Lakartidningen l'Oxydc de Carbone.[Poisoning By Carbon Mon- 92(48):8955.8966, November 7,1970, Swedish. oxide.)Concours Medical Research in 28,1970, French. In 1963, the Institutefor Cardiovascular smoking histories of allthe in- is discussed in terms of Prague investigated the city. Carbon monoxide poisoning habitants ages 60 to 64 yearsin one section of the physiopathology, clinical picture,development, complica- ECG The study included arecord of angina pectoris. tions, diagnosis, prognosis,etiology, toxicology, treat- infarct. The data showedthat The degree of carbon changes and myocardial myocardial ment, and medico-legal aspects. cigarette smoking favoredthe development of monoxide poisoning is proportionalto the carboxyhemo- of thecigarette 30 percent gives rise to infarct.Approximately 20 percent globin in the blood, and 10 to smokers suffered fromintermittent claudication. dyspnea, headaches, anddizziness. One form of clinical diagnosis concerns the presenceof blood carbon mon- oxide determined at thehigh level of 10 to 20 milliliters 71-0123. Gutierrez, M. T.,Dayrit, C. Some Physic°. higher, after suppression oftobacco Infarction per thousand or Chemical Characteristics ofAcute Myocardial smoke for 24 hours. Normally,the carboxyhemoglobin is Phillipine Journal of Internal heavy Among Manila Residents. equal to or less than 8milliliters per thousand. In day), this level may go Medicine7(2):8-17, June 1969. smokers (more than 30 cigarettes a above 10 milliliters per thousand.In addition to blood physical characteristics Data were gathered on some studies, the presence of carbonmonoxide can be deter- of 32 cases of acutemyocardial and cholesterol levels mined spectroscopically. infarction admitted to fourlarge general hospitalsin Manila in a one year period.There was a notable absence occupations, obesity and hyper- of fatty diets, sedentary och Koronarsjukdom (7): patients. A significant cor- 71 -0127. Liljefors, 1. Rotating cholesterolemia among these Rokvanor och Koronarsjukdomi ett Tvillingmaterial. smoking and hypertension (7): Smoking Habits and relation was found between in the [Smoking and Coronary Disease and the developmentof myocardial infarction Coronary Disease in Setsof Twins.)Lakartidningen patients. 67(2 ): 16 1-164 , January 7,1970, Swedish. of coronary disease in twins Garfinkel, L., Seidman, H. In 1959 a study was made 71-0124. Hammond, E. C., born in Sweden between1886 and 1925. Their sur- Longevity of Parents andGrandparents in Relation to their habits, such as useof tobacco, and Associated Variables.Cir- roundings, Coronary Heart Disease and various clinical factors, includingdiabetes, blood pressure 43( I ):3 I -44, January 1971. into consideration. Smoking culation and scrum lipids, were taken of was found to exert adefinite effect on the constitution from a prospective epidemiologi- Data were analyzed the twins. Changes inconstitution were those which pre- cal study in which a largenumber of men and women disease, so that smoking was after they answered a detailed disposed them to coronary were traced for six years an indirect cause ofheart disease. questionnaire. The subjects weredivided into seven groups according to thelongevity of their parents and heart disease, grandparents. Death rates from coronary S.,Gaffney, C.,Yurt, R. W., stroke were found to be 7 1-01 2 8.Linn, B. hypertensive heart disease, and Richardson, J. R. (Jr.). Determinantsof Survival of the considerably higher amongsubjects with short-lived Southern Medical Journal This Dialysis Cannula. parents than amongsubjects with long-lived parents. 63(10):1163 -1166, October 1970. was found to be the casefor coronary heart disease history of high blood pressure or among men without a A computer analysis wasconducted to determine the diabetes, who were notseriously overweight, who took significant factors concernedwith regularly. most statistically some exercise, and whonever smoked cigarettes failure of shunts for renal hemodialysis.Infection, days to (Auth.Abs.Mod.) dialysis, albumin, arterial cannula,average BUN, same size cannula and total scrumprotein were the most important factors. Smoking was not asignificant factor. 71-0125. Hay, D. R., Turbott,S. Changes in Smoking Habits in Men Under 65 YeatsAfter Myocardial Infarc- British Heart Journal J. tion and CoronaryInsufficiency. 71 -0129. Luquette, A. J.,Landiss, C. W., Merki, D. 32(6):738-740, November 1970. Some Immediate Effects of aSmoking Environment on Children of Elementary SchoolAge.Journal of School with acute myocardial Of 370 men under 65 years Health40(10):533 -536, December 1970. infarction, 74 percent were smokersat the time of hospi- interviewed up to 2 years later,the tal admission. When This study was conducted todetermine the effects of proportion of smokers among the296 survivors had fallen the heart rate, ciga- acigarette smoking environment on to 44 percent. Thenumber smoking more than 20 systolic and diastolic blood pressureof 51 elementary (37 percent) to 18 (6 percent), rettes a day fell from 137 school age children (28 males,23 females, mean age 9.8 up completely. Atleast and 38 of the former group gave years), 20 of whom came fromnonsmoking homes and 23 make some reduction in half the survivors were able to from smoking homes. An effort wasalso made to deter- their smoking. In a smaller groupof 59 patients with nonsmoking homes reacted dif- the percentage of smokers mine if the children from acute coronary insufficiency, ferently to the smoking environmentthan children from fr dropped from 75 percent to 60 percent.(Auth. Abs.)

22 25 CARDIOVASCULAR DISEASES

smoking homes and if males were affecteddifferently blood with a decreased affinity for oxygen. The increase in 2,3-DPG was proportional to the degree of hypoxemia. thanfemales.Results showed thatcigarettesmoke allowed to accumulate in a poorly ventilatedenclosure In patients under 1 month of age this relationship was not significantly increased the children's heart rate, systolic observed. Red cells from adults, but not newborns, and diastolic blood pressure, that thesmoking environ- showed rapid increases in 2 ,3-DPG when incubated under ment's effect on the children in the environment was nitrogen. Adult, but notfetal, deoxyhemoglobin was similar to the cigarette smoke's effect on the smokerbut shown to facilitate invitro synthesis of 2,3-DPG by on a reduced scale, and that male andfemale subjects and binding this organic phosphate and relieving the product children from smoking and nonsmoking homesreacted inhibition of 2,3-DPG mutase. Throughout a wide range similarly to a 30 minute exposure to a smoking and non- change in oxygen affinity as measured by the Pso is linear smoking environmatt. with respect of the 2,3-DPG concentration; a change of 430 millimicromoles of 2,3- DPG /ml of red blood cor- puscles (RBC) resulting in a change of the Pso of 1 mm 71-0130. Mathiesen, F. R., Larsen, E. E., Wulff, M. Some Hg. It appears that the 2,3-DPG of the adult's red cells Factors Influencing the Spontaneous Course of Arterial responds rapidly to metabolic and environmental in- Vascular Insufficiency. Acta Chirurgica Scandinavica fluences and in turn effects metabolism and the cellular 136(4):303-308, 1970. environment. Many of these effects are not shared by the red cells of the newborn. The spontaneous course in 474 extremities has been followed for a half to 6 years. The material demonstrates a higher mortality than a comparable groupof normal 71-0133. Platt, Lord, Ball, K. P., Brigden, W. W., Doll, R., population. In 211 cases the clinical state could be Oliver, M. F., Reid, D. D., Shillingford, J. P., Thomson, A. evaluated and showed improvement in up to two-thirds of NI., Begg, T. B. Dietary Sugar Intake in Men With Myo- the patients during the relatively short follow-upperiod. cardialInfarction. Report tothe Medical Research Termination of smoking increased the number of patients Council by Its Working-Party on the Relationship Be- displaying spontaneous improvement. Anti-coagulation tween Dietary Sugar Intake and Arterial Disease. Lancet treatment in a smaller part of the material was not able to 2(7686):1265-1271, December 19, 1970. increase improvement and circulation measurement could not be demonstrated to have any prognostic value, but The sugar consumption of men with myocardial th.: impressive high percent of spontaneous improvement infarction was compared with that of matched controls in makes it necessary to arrange control series when thera- four different centers. The average sugar consumption was peutic measures are to be evaluated. (Auth. Abs.) slightly greater in the patients with myocardial infarction than among the controls, but the differences were not statistically significant. Findings in one center suggest that 71-0131. Newton, R. M., Scale, D. L., O'Brien, W. M., the slightly higher sugar intake in patients with myo- McGuire, L.B. Clinical Correlations With Coronary cardial infarction was likely to have been due to an Arteriography.Virginia Medical Monthly association between the consumption of sugar and the 97(11):688-692, November 1970. smoking of cigarettes. (Auth. Abs.)

The description of chest pain, the electrocardiographic findings and the associated risk factors of age, smoking 71-0134. Rose, G. A Proposed Trial of Heart Disease and scrum cholesterol were related to the anatomical Prevention in Industry.Transactions of the Society of findings at coronary arteriography in 89 subjects. The Occupational Medicine 20(3):109-111, July 1970. differencesin arteriograms for cigarette consumption were significant both in terms of nonsmokers andin terms A trial plan for coronary heart disease prevention in of average number of cigarettes per day. The diagnostic British industry involving 20,000 middle-aged men (ages value of a classically anginal pattern of pain and the signif- 40 to 59) distrib:oed among 20 factories (10 treatment icance of the risk factors were demonstrated. When chest and 10 control) and with a 5 to 7 year follow-up period is pain was not exclusively and typically anginal, many outlined. Screening examinations would determine high patients did not have coronary stenoses. Inadequate riskindividuals. Preventive measures would then be cardiacacceleration despitethe completion of a applied, including cessation of smoking, reduction of prescribed standard exercise stress appeared to be a cause blood cholesterol, regular moderate physical activity, of frequent falsely negative results in post-exercise elec- treatment of even mild hypertension and control of trocardiograms, although further exercisetonearly obesity. Health propaganda and prevention advice at the maximal levels did not always elicit electrocardiographic group or factory level would also be made available. The follow-up would measure the effect of advice and treat- abnormalities in patients with stenoses. ment on coronary heart disease mortality and the in- cidence of other major manifestations of disease. 71-0132. Oski, F. A., Gottlieb, A. J., Miller, W. W., Delivoria-Fapadopoulos, M. The Effects of Deoxygenation of Adult and Fetal Hemoglobin on the Synthesis of Red 71-0135. Scheidt, S., Ascheim, R., Killip, T. (111). Shock Cell2,3-Dephosphoglycerate and Its InVivo Con- After Acute Myocardial Infarction. A Clinical and Remo- segue nc es.Journal of Clinical Investigation dynamic Profile. American Journal of Cardiology 49(2):400-407, February 1970. 26(6):556-564, December 1970.

Patients over 1 month of age with arterial oxygen pres- Clinical features, predisposing factors, precipitating found to have elevated events, laboratory and hemodynamic observations, sures of less than 60 mm Hg were pathologic findings, prognostic indicators and the results redcell2,3-diphosphoglycerate (2,3-DPG) levels and

23 26 CARDIOVASCULAR DISEASES

of therapy arc surveyed for 73patients in whom shock developed after acute myocardial infarction. District. Medical Journal of Australia2(11)1:492494, The in- September 12.1970. cidence of previous myocardial infarction.angina pectoris and hypertension was similarin patients with and without shock. Other factors, such One hundred and ten males ofan average age 54.7 as prior digitalis therapy, heart years have been interviewed more than failure and smoking. werenot clearly implicated. No six months after myocardial infarction. None of thesepatients had been precipitating cause for shock other thanacute infarction treated in a coronary itself was consistentlypresent. Hypovoleinia. anemia, care unit, and only four were arrhythmia and drugs could not be receiving long-term anticoagulanttherapy. All patients incriminated as were living in the country. The important factorsinthe genesis of shock. Extensive nature and frequency of post-myocardial infarction pain in these myocardial damage, coronary atherosclerosisand left patients have ventricular hypertrophy been classified, and attitudestowards physical exercise, were found atpostmortem the use of glyceryl trinitrate examination in most patients who died,but similar and smoking habits have findings were notedin been examined. The study hasbeen compared with an patients who diedwithout earlier study performed evidence of shock. Delay in onset of on patients attending the Royal shock in many cases Melbourne Hospital. The results suggested progression of cardiac damageafter the initial are similar, suggesting clinical that the initial management of event. Hemodynamic studiesin 19patients the patient does not influ- showed that cardiac indexwas less than half of the ence subsequent pain patterns. (A uth.Abs.) normal index, stroke volume indexabout a third of normal, and peripheralresistance generally increased. (Ruth. Abs. Mod.) 71 -0139. Thiseus, S., Tibbling,L. Rokning och Koron- arsjukdom (9): Angina PectorisEller Angina Cardiac? [Smoking and Coronary Disease(9): Angina Pectoris or 71-0136. Sepaha, G. C., Jain, S. R., Chhabra, Angina Cardiac ?)Lakartidningen67(2):165-167, M. L., Dixit, January 7, 1970, Swedish. V. P. Chronic Cor-Pulmonale.(A Study of 1,000 Cases.) Indian Heart Journal21(4):383-388, October 1969. The investigation dealt withwomen, who presented a rather unusual picture of anginapectoris when they were Some of the epidemiological smokers. Both pregnancy andoverweight predisposed aspects of chronic cor them to hiatus hernia. In all, pulmonale cases are analyzed at theShri G. S. Cardiology 600 patients were sys- Department, M. Y. Hospital, lndore, India. tematically investigated forpressure inside the esophagus The disease and the pH there. It forms 15 percent of organic heartdisease at the hospital was found that a disease diagnosedas and among inpatients it forms angina pectoris oftenwas really adisease of the 24.4 percent of cardi ac esophagus, and a cardiac insufficiency admissions and is responsible for26.7 percent of total attributed to cardiac deaths. The peak incidence smoking was actuallyan esophagus irritation due to of the disease is during smoking. January and February. The diseaseoccurs in a 3 to I ratio of males to females, withsmokers accounting for 70 percent of the males and 10 percent ofthe females. Chronic bronchitis is present in 76 71 -0140. Tibblin, G., Wilhclmsen,L. Rokning och percent of the cases, Koronarsjukdom (5): 1913 Ars ischemic heart disease in 7.9percent and ECG evidence of Man. [Smoking and Coro- nary Disease (5): People Born in 1913.] right auricular, ventricularhypertrophy and/or strain in Lakartidningen 78 percent. 67(2):153.155, January 7, 1970,Swedish.

In 1963, 973 people fromGoteborg born in 1913 were selected for a heart disease study. 71-0137. Stamler, J., Lilienfeld,A. M. (Chairmen). Pri- In 1967, a follow- mary Prevention of the Atherosclerotic up study was made of 803 availablesubjects. In addition Diseases.Circula- to morbidity and mortality, tion 4216):ASS-A95, December1970. a number of parameters were observed, including smokinghabits. The results clearly Epidemiological, clinical and experimental indicate that smoking isan important risk factor in evidence, coronary disease.In both animal and human, isreviewed which supports the a sample of 22 persons who judgment that there is a causal developed myocardial infarctbetween 1963 and 1969, relationship between risk only one was a nonsmoker. factors, particularlycigarette smoking, hypercho- lesteremia and hypertension, andthe development of coronary heart disease. Research findings on the risk 7 1-01 4 1. factors strongly indicate the Wenzel, D. G., Azmeh,N. Chronically possibility of effective pri- Adv.:nistered Nicotine and the mary prevention of atherosclerotic diseases,particularly Blood Pressure of premature coronary heart disease. Nomiotensive and Renal HypertensiveRats. Archives Recommendations are Internationales de Pharntacodynamie made for a national commitmentto primary prevention as et de Therapie 187(2):367-376, October 1970. the principal means of controllingcoronary heart disease and other atherosclerotic diseases,and include changes in diet to prevent or control hyperlipidemia, The chronic administration oflow doses of nicotine obesity, hyper- (1.14 or 2.28 mg/kg/day) in tension and diabetes, elirainutionof cigarette smoking, the drinking water ofrats elevatedthe mean systolic and pharmacologic control ofelevated blood pressure. pressure. As previously demonstrated, when thistreatment was prolonged the pressor effect was reversed and a depressoreffect was ultimately obtained. With larger 71-0138. Stephens, W. B. Post-MyocardialInfarction Pain doses (3.42 or 4.56 in a Series of Male Patientsin the Albury-Wodonp mg/kg/day) only a depressor effectwas observed. With- drawal of nicotine during the depressorphase produced a

24 OTHER DISEASES AND CONDITIONS

observed until the ncurogenicallymaintained phaseof marked, fluctuating, and prolonged pressor response. dis- Administration of either the "low" or the "high" doses of renal hypertension was established. The results are nicotine lowered the systolic pressure of renal hyper- cussed in terms of the potential effects of smoking in tensive rats to below control levels. This effect was not normotensive and hypertensive individuals. tAuth. Abs.)

See also71-0006,71-0016,71-002 L, 71-0023,71-0024,71-0038,71-0043,71-0044,71-0065,71-0087, 71-0091,71-0094

OTHER DISEASES AND CONDITIONS

71-0142. Brown, A. M., Young, A. The Effects of Age For 10 years 221 smoking women (smoking 440 ciga- and Smoking on the Maturation of the Oral rettes a day) have been compared to 1200 nonsmoking Mucosa.Acta Cytologica14(9):566.569, November- women. The women came lo a sterility clinic. Menstrual December 1970. disorders were found in 36 percent of the smokers as compared with 35 percent of the nonsmokers. For those Palatal, buccal and lingual cytological specimens were smoking over 10 cigarettes a day the number was about taken from 106 subjects to determine possible differences 50 percent higher. The premenstrual endometrium biopsy in the normal mucosal maturation patterns of males and showed a pathological condition in 84 percent of the females and the effects of age and smoking on these smokers as compared with 81 percent of the nonsmokers. patterns. Effects were measured by means of the Trichomoniasis was found in 28 percent of the smokers Karyopyknotic Index, which was computed as the ratio against 17 percent of the nonsmokers. Post-inflammatory of anucleate squames and superficial (pyknotic) cells to changes of the adnexa appeared in 64 percent of the all cells of a specimen. The results demonstrated different smokers, against 38 percent of the nonsmokers, pathologi- Karyopyknotic Indices for different areas of the oral cal conditions in salpingography appeared in 81 percent mucosa and these indices varied with the age andsmoking of smokers compared to 60 percent nonsmokers. The habits but not the gender of the subject. The buccal and effect of smoking on gynecological inflammations appears lingual mucosa showed an increased Karyopyknotic Index to be indirect, and has more of a sociological aspect. with age, in distinct contrast to the palatal mucosa. Smoking increased the Karyopyknotic Index of all three mucosal areas in all age groups and thus appears to have 71-0145. Dummett, C. 0. Systemic Significance of Oral the most profound and consistent effect on oral mucosal Pigmentation.Postgraduate Medicine49(I):78-82. maturation. January 1971. Embedded dental amalgam and tobacco stains are 71-0143. Chin, C. T., Lee, K. W. The Effects of Betel-Nut examples of local causes of color changes of the oral Chewing on the Buccal Mucosa of 296 Indians and Malays mucosa. Color changes may also result from endogenous in West Malaysia. A Clinical Study.British Journal of conditions which include heavy metal intoxication such as Cancer 24(3):427-432, September 1970. bismuthosis, plumbism, argyria. mercurialism and arseniasis. Systemic diseases and disorders known to Changes in the buccal mucosa of 296 Indian and produce oral discolorations include Addison's disease. Malay betel-nut chewers in Perak, West Malaysia, were deficiency of vitamin B2. jaundice, Peutz-Jeghers studied clinically. One-hundred and sixty-seven out of syndrome, and polycythemia. (A uth . Abs.) 212 Indian subjects incorporated tobacco in their quids, while 45 out of 84 Malay subjectsincorporated "Gambir". The Indians appeared to show a higher propor- 71-0146. Harris, J. 0., Swenson, E. W., Johnson, J. E.. tion of mucosal changes, particularly when tobacco was (III). Human Alveolar Macrophages: Comparison of used. "Gamble did not appear to be potent in the pro- Phagocytic Ability, Glucose Utilization, and Ultra- duction of mucosal changes. Comparison with studies in structure in Smokers and Nonsmokers.Journal of other parts of the world suggested comparable findings Clinical Investigations,49(11):2086-2096, November with respect to both tobacco and non-tobacco chewing 1970. samples, and there would appear to be some evidence that tobacco-containing quids are likely to produce a higher Phagocytic ability, glucose utilization, and ultrastruc- proportion of mucosal changes as compared to non- tural morphology were studied in human alveolar macro- tobacco-containing quids. An attempt to demonstrate a phages in smokers and nonsmokers. The macrophages dose-effect relationship by dividing the subjects into were obtained by bronchopulmonary lavage and the "slight" and "heavy" chewers did not yield significant studies were carried outin vitroin the absence of smoke. differences between these two categories in each of the Phagocytic ability was measured as the decrease in the groups. (Auth. Abs.) number of viableStaphylococcus albus organismsin- cubated with the macrophages. Measurements of 14CO2 formation from glucose-U-14C were made in a resting 71-0144. Drac, P., Kopecny, .1. Steri litat bei Raucherin- state. Of the cells obtained by lavage. 90-95 percent were nen and Nichtraucherinnen. [Sterility inSmoking and large mononuclear macrophages of which approximately Nonsmoking Women.]Zentralblatt fur Gynakologie 90 percent remained viable at the end of the experiment. 92(27):865-866, July 4,1970, German. Smokers yielded many more macrophages per lavage

25 28 OTHER DISEASES AND CONDITIONS

(mean 46.4 X 106, ±7.4) compared to the nonsmokers to correlate the histological changesseers with the clinical (mean 10.2 X 106 ±2.3). The decline in viable organisms habit in leukoplakias from chewers usingtobacco-con- was the same in each group, indicating phagocytic com- taining quids suggested that epithelial petence of alveolar macrophages removed from smokers. atrophy appeared to be significantly related to the duration ofthe habit but However, the mean glucose utilization for the smokers not to the "intensity" of the habit. (Auth. Abs.) was 4.3 ±0.2 micromoles/106 cells and 1.4 40.7 micro- moles /106 cells for the nonsmokers. This very significant difference(P<0.0001) suggests that smokers' macro- 71-0150. Lefcoe, N. M., 1ncukt, 1. phages have a higher resting energy requirement than I. Particulates in Domestic Premises. 1. Ambient Levels andCentral Air those of nonsmokers. Comparison of the ultrastructural Filtration.Archives of Environmental Health morphology of the alveolar macrophages from eachgroup 22(2):230 -238, February 1971. reveals that the cells from smokers differ fromthose of nonsmokers in that they are slightly larger, and contain Air particulates were surveyed in more golgi vesicles, endoplasmic reticulum, and residual a home with central ventilation and an electrostatic filter in themain air duct bodies. The residual bodies in smokers' cells containdis- with the returning air sampled. The tinctive fiber-like inclusions. (Auth. Abs.) average counts, in the 0.3, 0.5, and 1.0 micron ranges,were related to the normal activities, children playing,house cleaning, and smoking, with the following observations: 71-0147. Johanson, C. R., Ronge, H. Acute Irritation Counts in all Effects of Tobacco Smoke in Room Air. ranges under minimal activity were significantly different Translated when the filter was on comparedto when the filter was fromNordisk Hygienisk Tidskrift46:49-50, 1965. off. Cleaning and dusting in thehome overwhelmed the filter. Smoking one cigar in the home Complete English Translation of F-01848. raised particle counts from 10 to 100 times. These particlecounts stayed up for at least three hours when the filterwas off. The counts returned towards base line levels inone to two 71-0148. Lebbe. J.. Lafarge. J.-P.. Laplace. M. Recherche hours with the filter on. (Auth. Abs.) et Dosage de la Nicotine Dans les Urinespar Chromatographie en Phase Gazeuse. [Research and Mea- surement of Nicotine in the Urine by Gas Moms- togaphy.1 71 -0151. McGlothlin, W., Jamison, K.,Rosenblatt, S. Archives des Maladies Professionnelles de Marijuana and the Use of Other Medecine du Travail et de Securite Sociale28(6):558-560, Drugs.Nature June 1967, French. 228(5277) :1227-1229, December 19, 1970. In October 1969, during Operation Gas chromatographic studies, usinga flame ionization Intercept (a detector, showed that there is a substance present in the government effort to diminish the supply ofmarijuana), urine of smokers which retains nicotine. Elimination 478 graduate and undergraduatestudents and 116 and patients from a free clinic specializing metabolism of nicotine in these subjectsmay be checked in treatment of by physical or physical chemical methods. A male drug users were surveyed to determine theincidence and subject frequency of use of various drugs, whether who smoked 30 cigarettes a day showed 1.39mg of nico- those using tine over a 24-hour period of urine collection. marijuana had reduced theiruse during Operation Inter- A male cept, and whether the frequency of who smoked 30 g of pipe tobacco eliminated 1.28mg of use of other drugs had nicotine over a 24-hour urine-collection period. increased as a result of the marijuana shortage.Marijuana Nicotine prices during the spring, can be detected from a volume of urine on the order of summer and autumn of 1969 10 ml. were also compared. Fewer studentsthan free clinic patients used tobacco and alcohol. Theuse of other drugs was strongly correlated with the frequency ofmarijuana use in the students and to a lesser extent inthe patients. 71-0149. Lee, K. W.. Chin. C. T. The Effects ofBetel-Nut In the patients, frequent marijuanausers reported less use Chewing on the Buccal Mucosa:A Histological of alcohol. The preference forhashish over marijuana was Study.BritishJournal of Cancer24(3):433.441, more common among patients than students.Of those September 1970. using marijuana 10 times ormore, 44 percent of the students and 51 percent of the patientsreported below normal use of marijuana between May Sixty-two "leukoplakias" from the checks ofbetel-nut and October 1969 chewers in West Malaysia were studied histologically. as a result of its unavailability. Studentssubstituted Ten hashish, alcohol and strong hallucinogens. biopsies were from non-tobacco betel-nutchewers. An Patients has a amorphous von Kossa positive layer similar preference but also substitutedsedatives, stimu- was seen on the lants and opiates. The mean price of marijuana keratin surface in 42 specimens. Tobacco didnot appear per ounce essential for its formation, and it appeared rose from $10.13 during the spring of 1969to $11.87 in to be signif- October 1969. icantly associated with parakeratosis. Itspossibl e sig- nificance as a cuticle-like layer prolongingcontact be- tween carcinogens and the mucosa is discussed.Parakera- tosis appeared to be the most 7 1-015 2. Miles, S. TheRespiratory System and common form of cornifica- Sport. tion seen, and the mitotic activity in Journal of the Royal College of GeneralPrac- parakeratinized titioners18(86):181 -185, September 1969. leukoplakias appeared to be significantlygreater than orthokeratinized leukoplakias. Comparison withstudies on other population samples using different quids The smoking habits of 337men who were given the sug- Harvard Pack Test for Physical Efficiency gested that severe histological changeswere more likely to were studied. be seen when tobacco-containing quids Of the total, the 256 smokers havea mean fitness index were chewed as of 60 whereas that of the nonsmokers compared to non-tobacco-containing quids. Anattempt is 73. The index does not vary greatly with the number ofcigarettes 26 BEHAVIORAL AND EDUCATIONAL RESEARCH

smoked. There are too few pipe smokers in theseries to 71-0154. Schinen, C. Die kinderlose Ehe. Moglichkeiten draw any rum conclusions. There is littledoubt that und Grenzen der Behandlung aus andzologischer Sicht. smoking has an adverse effect on performance.However [The Childless Marriage. Possibilities and Limitations of there will be those who claim that the lossis worth the Treatment From the Anthological Viewpoint.]Fort- accepting for the comfort given by smoking and there are schritte der Medizin 88(27):1047-105I, September 24, even top class athletes who findthat a quiet cigarette 1970. German. before the ordeal has a steadying effect on the nerves. Hormone therapy may be of value in correcting dis- turbances in male fertility if this is the cause of family 71-0153. Myslinska, M. Wplyw Palenia Tytoniu na childlessness. The treatment is contraindicated however in and Foziom Rodankow w Slinie Mieszanej Oraz lzolowanej z cases of varicocele, heavy consumption of tobacco, Gruczolu Przyusznego. [Influence of Tobacco Smoking the intake of various therapeutic agents. Nicotine has a on Thiocyanate Level in Saliva Mixed orIsolated From pronounced influence on human reproductive organs. A the Parotid Gland.]Roczniki Pomorskiej Akademii statistical evaluation of the fertility of smokers and Aledycznej lmienia Genera la Nary la Swierczewskiego w nonsmokers revealsnothing of significance but ob- Szczecinie 16:255-289, 1970, Polish. servation of individual patients shows that heavy cox- sumption of cigarettes results in serious disturbances in Studies were performed on the concentration of thio- sperm motility. Thissensitivitytoward nicotineis cyanates in mixed saliva of 234 persons, 137tobacco individual since certain males can smoke 80 cigarettes per smokers and 97 nonsmokers, aged from 7 to 60 years. At day without evidence of this syndrome. In nicotine- the same time the CNS" contents in saliva both mixed and sensitive males, a withdrawal of nicotine results in an isolated from the parotid glands of persons aged 7 to 60 increase in sperm count and sperm motility. years were compared. A mumber of experimentsdealing with tobacco smoke and the saliva were carried out in vitro. As concerns the mixed saliva alone, the studies were 71-0155. Vavercak, F. Smoking and Pregnancy, Trans- accomplished in 2 groups of normrl people: a) those lated From Ceskoslovenska Gynekologie 33(3):197.200, exposed to chemical noxiousness of the work medium, b) 1968. those employed in the atmosphere free of that noxious- ness. The results obtained revealed that the lowestlevel of Complete English Translation of A-09388. thiocyanate in the mixed saliva was found in soldiers of the general military conscription (both smokers and non- smokers), the highest was in the studying youth. The 71 -0156. Vertes. L. Schadliche Wirkungen vom Rauchen chemical noxiousness, recorded in the industrial plants auf die Gestation. [Noxious Effects of Smoking on Gesta- being investigated, failed to display any perceptible effect tion.]Zentralblatt fur Gynakologie 92(42):1395-1398. on the CNS" concentration in the mixedsaliva. The in- October 17, 1970, German. vestigations of the rust series of experiments as well as the comparisons of values referring to saliva mixed and iso- Research is reported of 243 cases of spontaneous lated from the parotid gland itself indicated that the to- absortion in pregnant women 96 percent of whom bacco smoking exerted an essential influence on the CNS' smoked. Births came earlier in proportion to the higher level in saliva, since the number of smoked cigarettes was number of cigarettes smoked. Nicotine involves depolari- accompained by an increase of the CNS' concentration in zation and affectsthe ganglions, sympathetic and saliva both isolated and mixed. In mixed saliva of the parasympatheticnervous system.Itactivatesthe smokers, the thiocyanate concentration increased propor- hypothalamus-neurohypophysis system. A tocogram tionally to the intensity of smoking, while in the isolated shows data on women giving birth to their first child, time saliva, the increase in the same order was not propor- between contractions, and amplitude from 5 to 7 milli- tional. On the basis of the preliminary studies covering meters, factors being influenced by nicotine presence. the composition of the tobacco smoke, it may be assumed Smoking is known as an etiological factor of fetus motion that a high level of rhodanates in mixed saliva of tobacco up to the event of birth. Many authors agree that non- smokers is likely to be derived from the saliva supersatu- smoking women become passive smokers and thus suffer rated in the oral cavity at the time of inhaling the ciga- the deleterious effects of the habit. Smoking during rette smoke. In nonsmokers, the thiocyanate level in the pregnancy is not only dangerous, but unfair to the unborn isolated saliva from the parotid gland exceeded almost child. twice the CNS' concentration in the mixed saliva, which may result from inhaling the air containing a high amount of tobacco smoke without personally smoking the ciga- rettes. (Auth. Abs. Mod.)

See also 71-0027, 71.0040, 71-0128, 71-0158, 71-0167

BEHAVIORAL AND EDUCATIONALRESEARCH

71-0157. Becker, W. Schulkind und Tabak. [Students and Since it has been determined that in Germany during Tobacco.]Theropie der Gegenwart 109(8):1198-1207, 1968, an increasing high rate of deaths from bronchial August 1970, German. and respiratory diseases was registered, a campaign against

27 30 BEHAVIORAL AND EDUCATIONAL RESEARCH

smoking was started by the physicians, especially directed A survey was made of drug abuse (marihuana, LSD, toward students who had not yet acquired the tobacco methedrene, pep pills, alcohol and cigarettes) among 7000 habit. In addition to alcohol, tobacco should also be students ages 12 to 22 in the school system of Sioux prohibited in working places. Legal backingwas obtained, Falls, South Dakota. The figures are not considered to be as well as aid from educators and counselors, but the alarming, but do indicate that the problem of drug abuse example of parents who give up smokingwas considered is likely to become worse in the near future. Several sug- greater motivation to youth. Nonetheless, more tobacco gestions are offered for making physicians aw:e e of the products are being sold than formerly in Germany and drug abuse problem. this suggests that more youths are acquiring the habit. Twenty-five percent of 14 to 16 year olds smokere- gularly, probably influenced by mass acceptance oftheir 71-0162. Horn, D. Factors Affecting the Cessation a peers, status symbols, and social prestige. Because youth Cigarette Smoking: A Prospective Study. Presented at are emancipated at earlier ages today, the use of hashish the Eastern Psychological Association Meeting, Washing- has become more prevalent, since tobacco productscan ton, D.C., April 18. 1968,11 pp. generally be purchased throughout the world by youths under 15 years of age. Mass media must attack the in 1964, a sample of US. adults was interviewed on problem more actively, and cigarette vendingmachines should be restricted. knowledge, attitudes, beliefs and practices with regard to smoking. Twenty months later 1,570 persons identifiedas cigarette smokers or ex-smokers were reinterviewed to determine the predictive value of attitudes, beliefs, smok- 71-0158. Cendron, H., Val Icry-Masson, J. TheEffects of ing practices and various types of background information Age on Masculine Sexual Activity. Incidence of Several for subsequent success in stopping smoking. Of the 1,570 Factors Including Tobacco. TranslatedfromPress, persons, 52.9 percent considered giving up smoking, 34.4 Medicate78(41):1795-1797, October 3, 1970. percent tried to quit, 155 percent achieved short-term success, and 7.1percent achieved long-term success. Complete English Translation of 70-1127. Those who considered quitting accepted the requirement Of a cigarette warning label, were less likely toexpect to be smoking 5 years from now, had a lower dosagescore, 71-0159. Davison, R. L. An Analysis ofan Anti-Smoking were more likely to smoke filter or low tar cigarettes, Research Study in a College of Further Education.Jour- were more likely to know someone who would make it n,.1 of the Institute of Health Education3:77-81, 1970. hard for them to quit and were more likely to have been advised to stop or cut down. Those trying to quitwere This study compared differences in the effectiveness less likely to agree on having additional restrictionson of two educational methods in their influenceon the places prohibiting smoking, were less likely to expect to smoking behavior of 173 students (11men and 162 be smoking 5 years from now, smoked fewer cigarettes women), ages 17% to 21 years, at a small college. Each of and had a lower dosage score. Those with short-term two groups was given a short talk in reinforcement of the successes smoked fewer cigarettes, had a lower dosage visual aid ant: questions wen. invited; whereas the"dis- score and were more likely to use filter cigarettes. Those cussion" group was asked for comment immediately after with long-term successes were more likely to expectnot the film and was encouraged to participate in freediscus- to be smoking 5 years from now and were less likely to sion. AU students filled out questionnairesconcerning have been advised to stop or cut down. The perception of their smoking habits and again 6 months later,Results the threat of smoking was broken down into: (1) im- showed that a greater percentage of the studentson the portance of the threat, (2) personal relevance of the "discussion" group had quit smoking; however, the dif- threat, (3) capability for cessation, and (4) value ofcessa- ference between the two groupswas only slightly signi- tion. The influence of these four factors and their inter- ficant. In looking at students who started smoking in each action on the four steps in giving up smokingwere group, the "discussion/decision" method showeda greater analyzed. AU the factors except Capability for Cessation apparent effect in preventing nonsmokers from taking up contributed to considering quitting. This factor also inter- the habit. This difference was statistically significant.Two acted with Importance to reduce its effect. Both Im- admitted deficiencies in planning were lack of informa- portance and Capability for Cessation contributed to tion about parental smoking habits and theabsence of a control population. attempting to quit. Capability for Cessationwas most important in predicting short-term success. Value of Cessation also contributed to short-termsuccess. Personal 71-0160. Egsmore, T. Comunicacion Social Relevance contributed positively and significantlyto y Salud thinking about quitting, negatively but not significantly Publics. [Social Communication andPublic Health.) to trying to quit and to short-term success, and signif- Salud Pubtica de Mexico12(4):437-440, July- icantly and negatively to long-term success. August 1970, Spanish.

The use of mass media to educate and informsociety of various problems in public health, particularly 71-0163. Huttner, 1., Huttner, IL Die Motivation des cigarette Gesundheitsverhaltens. Tell 3.[Motivation to Stay smoking and automobile accidents, is discussed. Healthy. Part 3.)Zeitschrift fur Arztliche Fortbildung 64(11):561-565, June 1,1970, German.

71-0161. Frost, D. M. The Physician's Role in the S.Dak. Drug Scene, People are motivated to stay healthy by their parents, South Dakota Journal of Medicine their age, their general state of health, the advice of 23(9):47-51, September 1970. a physician, and material and career setbacks due to disease.

31 28 BEHAVIORAL AND EDUCATIONAL RESEARCH

The smoking habit is most strongly affected Oy parents. Analgesia, Current Researches 49(5):667.679. Septem- One out of every four nonsmokers was deterred from ber-October 1970. smoking because his parents impressed upon him the health hazards of smoking. However, parental influence The concept of "normality" in the range of those varies and depends on their educational level and age. physiologic functions with which anesthesiology is con- cernedisexaminedinterms of possible iatrogenic sequelae,theeffects of smoking, obesity. cucadian 71-0164. Kahn. E. B., Edwards, C. N. Smoking and rhythms and aging, and induced jaundice. Youth: Contributions to the Study of Smoking Behavior in High School Students. Journal of School Health 49(10):561.562, December 1970. 71-0168. National Center for Health Statistics. Changes in Cigs.ette Consumption Between June 1966 and August The cigarette smoking behavior of 1348 junior and 1968. U.S. Department of Health. Education, and Wel- senior high school students and their respective parents fare, Public Health Service, Health Services and Mental was studied. Results showed that males started smoking Health Administration, Rockville, Maryland, Monthly because their parents smoked or because their peers Vital Statistics Report. Health Interview Survey Data, smoked, and particularly, if their siblings smoked. They 19(9, Supplement):L -4, December 18. 1970. were most effectively deterred from smoking by a con- cern for their health. Females were found to be more Data on the daily consumption pattern of smokers open to experimentation, less influenced by parental between June 1966 and August 1968 show that the only behavior and most frequently deterred by social de- consistent decline during this period was for persons sirability. Females were also influenced by siblings who smoking 10 or fewer cigarettes daily, a 3 percent decrease, smoked. and was largest in those 65 years and over. In the 11-20 cigarettes/day group, males 45-64 years of age showed a S percent increase and females 65 years and over showed a 71-0165. Kanekar, S., Dolke, A. M. Smoking, Extra- 15 percent increase. For those smoking 21-40 cigarettes version, and Neuroticism. Psychological Reports daily, there was an increase of 24 percent for males and 26(2):384, April 1970. 43 percent for females 65 years and over. Persons aged 17-24 years smoking more than 2 packs per day showed a The Eysenck Personality Inventory was administered decrease for both sexes. to 100 male Indians ages 25 to 35 years who were divided into nonsmokers, light smokers (1 to 10 cigarettes /day) moderate smokers (11 to 20 cigarettes/day) and heavy 71-0169. Newman. I. hi., Ang, J., Irwin. R. P., Smith, J. smokers (over 20 cigarettes/day). Results showed a posi- McC. Adolescent Cigarette Smoking. New Zealand tive relationship between amount of smoking and degree Medical Journal 72(460):161.166, September 1970. of extraversion, and a negative relationship between amount of smoking and degree of neuroticism. The A questionnaire was administered to 2.024 male and findings are consistent with Eysenck's theory regarding female high school students from both North and South the association between smoking and extraversion but Island schools. Results of this survey indicated that be- suggest a complex relationship between smoking and tween one-quarter and one-third of New Zealand high neuroticism which is inconsistent with the theory. school students, depending on form in school, were admitted cigarette smokers. In addition, itis reported that,while more males than females were cigarette 71-0166. Kanter, F. H. Self-Monitoring: Methodological smokers, females tended to b'gin their smoking earlier Limitations and Clinical Applications. Journal of Con- than males. Students who smoked had been smoking for sulting and Clinical Psychology 35(2):148-152, October more than one year tended to select filter tipped ciga- 1970. rettes. Cigarette smokers had lower educational aspira- tions and dropped out of school earlier than non;snokers. This paper discusses some methodological, clinical and A higher percentage of female smokers predicted they theoretical issues concerning McFall's study of the effect would still be smoking in five years time, and there was of selfmonitoring on smoking behavior. The difficulties also evidence that a higher percentage of female smokers in ascertaining reliability of self-reports for events which were involved in the competitive athletic program of their have no external referents and the reactivity of self- school. It is pointed out that, considering the medical monitoring limit the utility of self-observation as a con- evidence to link cigarette smoking to certain pathological trol procedure in evaluating behavior therapy techniques. conditions, there is a real need for educational programs In clinical application, self-monitoring has been noted to to reduce tobacco consumption as a necessary step in modify behavior, but its controlling variables have not yet general preventive medicine. (Auth. Abs.) been explored. Self-observation is an initial step in self- directed behavior change. Therefore, its consideration is alsorequired for conceptualization of self-regulatory 714)170. Orne, M. T. From the Subject's Point of View, processes, viewed as integration of response feedback When is Behavior Private and When is it Public: Problems utilization, self-control, and self-reinforcement, to attain of Inference. Journal of Consulting and Clinical Psycho- self or externallyprescribed performance standards. logy 35(2):143 -147, October 1970. (Auth. Abs. Mod.) In an invited discussion, methodological questions concerning McFall's study of the effect of self-monitoring 71-0167. Mushin, W. W. The Normality of the Abnormal. on smoking behavior are raised. It is emphasized that re- Eighth Annual Baxter-Travenol Lecture. Anesthesia and sults of such studies should be evaluated from the point

29 32 TOBACCO ECONOMICS

of view of the subject rather than the investigator. Some on hashish addiction in Germany. it is stated that about measures assumed to be unobtrusive by the investigator 25 percent of young students have tried hashishand share qualities of deception experiments. It must be deter- about 8 percent smoke marijuana on a fairly regular basis. mined. therefore, whether it is the subject or the experi- The euphorious effect of higher dosages of these narcotic menter who is deceived. Procedures that may be helpful agents is noted. Frequent use results in hallucuationi, and in clarifying such questions and the difficulties of time and space distortions. The aphrodisiacal properties generalizing results to other contexts are discussed. (Auth. of hashish are disputed. Abs.)

71-0174. Tobacco. U.S.S.R. Nothing Done by Authorities 71-0171. O'Rourke, A., O'Sullivan, N., Croke, M. A to Discourage Smoking Habit.Tobaccol72(2):23-24, Study of Children's Smoking Habits in Kerry.Irish January 8, 1971. Nurses Journal3(3):17-19, March 1970. The failure of Russian authorities to limitor dis- A smoking habit survey of 1516 boys and girls courage the use and sale of tobacco products is briefly attending vocational schools in Kerry was conducted in discussed. 1969. Results showed that 22.7 percent of the boys and 9.6 percent of the girls were current smokers. Over half of the school population had tried smoking. Although Kerry 71-0175. Van Proosdij, C. De Problematiekvan de pupas did not smoke quite as much as their Dublin Gehechtheid aan Tabaksgebruik. [The Problem of the counterparts, 38 percent of 16-year-old boys were con- Attachment to Tobacco Use.)Nederlands Tijdschrift firmed smokers. (Auth. Abs. Mod.) Voor Geneeskunde114(40):1662-1667, October 3, 1970. Dutch.

71-0172. Piper, G. W., Jones, J. A., Matthews, V. L. The Tobacco is addictive when it becomes an important Saskatoon Smoking Project The Model.Canadian Jour- motive in the smoker's existence. It is difficult nal of Public Health to induce 61 (6):503-508, November-December people to stop smoking, and they will doso only when 1970. they develop a serious syndrome suchas oral cancer, Buerger's disease or . Many countries The behavioral processes involved in a student-directed have a flourishing tobacco and cigarette industry smoking education program are examined along with and a cessation of smoking would have severe economiccon- model that deals with group behavior and with individuals sequences. Switching from cigarettes to cigars and pipes as members of a group. The model defines five stages would be a step in the right direction. The time isnot ripe through which a person adopts a new form of behavior for complete abstinence, but there is hope of promoting and describes the influences to which he is susceptibleat smoking pauses during which people would cease smoking each stage. Questions arising from the application of the for a certain length of time, and later of extendingthese model to smoking education andsome of the con- pauses. sequences of such programs are discussed.

71-0176. Weissmann, K. Um Teste de Realidade. Lutoe 71-0173. Remschmidt, H., Dauner,1. Klinische and Tabagismo. [A Test of Reality. Mourning and soziale Aspekte der Drogenabhangigkeit bet Jugend Tobacco- lichen. ism.)RolvistaBrasileira de Medicine25(3):190-191, Tell 1. [Clinical and Social Aspects of Drug Dependency March 1968, Portuguese. in Young People. Part1.)Mcdizinische Klinik 65(45):1993-1997, November 6,1970, German. The psychoanalytical relationship between mourning and tobacco smoking is discussed briefly, and it isstated Various aspects of dangerous drugs, including lysergic that inveterate smokers have been known acid diethylamine, to give up mescaline, hashish, and morphine smoking during mourning. Thisisattributed to the derivatives, are reviewed in terms of increasing dosage,as emotional impact resulting in a greater expressionof well as physical and psychological dependency. In maturity on the part of the mourners, due to the removal Germany, as in most western European countries, most of unconscious resistance to forego smoking. This isthe youths over 16 years of age smoke. Psychologistshave test of reality. In normal mourning there is an improve- elicited reasons given for smoking as: pleasure and enjoy- ment in the general psychosomatic condition of the ment, custom and habit, and relaxation and unwinding. individual due to suppression of smoking. In abnormal Only three percent of youths replying gave no reason for mourning, many individuals who were formerlynon- taking up the habit. Although statisticsare not available smokers, take up the habit. Seealso71-0068, 71.0151

TOBACCO ECONOMICS

71-0177. Hedrick,J.L. Cigarettes and the Econo- my. The importance of tobacco production to the south- Bulletin National Tuberculosis and RespiratoryDis- eastern economy and how tobacco is grown, harvested ease Association 57(1):9.10,January 1971. and cured are briefly described. It is pointedout that the

30 BILLS AND LEGISLATION manufacturers of tobacco products have not been allotments and changes in tobacco processing requiring affected much by the recent downward trend in tobacco less tobacco per cigarette, who is caught in the price-cost consumption, since they have diversifiedinto new squeeze. Attempts are being made to develop a lesshaz- businesses. Itis the tobacco farmer, faced with rising azdous tobacco and better filter and design characteristics production costs, less demand, small government acreage to reduce the hazards of the cigarette

BILLS AND LEGISLATION

7 1-017 8. Lancet. Tobacco and Snuff Bill. Lancet Various methods for curtailing the consumption and 2(7687):1368, December 26,1970. sale of tobacco in Great Britain are briefly examined, including a higher tobacco tax, warnings on all tobacco GreatBritain's proposed Tobacco and Snuff Bill products, a more extensive ban on tobacco advertising, would require health warnings and tar and nicotine con- removal of cigarette vending machines from public places. tents printed on all tobacco product containers and higher fees for licenses to sell tobacco, state-controlled packages, and would ban all advertising by all media of all tobacco stores and increased antismoking advertisements. tobacco products. The problem of indifference to law if tobacco smoking were illegal is mentioned.

71-0179. Nature. Clouds of Smoke, Confusion and Oblivion. Nature 229(5280):75.76, January 8. 1971.

SMOKING CESSATION METHODS

71-0180. Bride', D. A. Les Produits And-Nicotine ou products is not habit forming. Another category is pre- Anti-Tabac.[Anti-Nicotine or And-Tobacco Pro- pared from a silver nitrate base (e.g.. Nosmoke, Omozone, ducts.)Schweizerische Apotheker Zeitung 108(23):903, Pastaba, Nicot-exsin). These iniVoe the mucosa and thus November 19, 1970, French. have a deterrent effect on smokers. The third category, having a vegetable base, are of doubtful efficacy. Brand Three categories of pharmaceutical agents developed names are: Libbs. Nicocortyl. and Tabazero. The habit of to help overcome the tobacco habit are briefly reviewed. smoking c.,rt be overcome only by will power. Some tricks Those with a base are Banton, Lobidan, and to overconw the addiction include: hide all reminders of Tabusine; they act on the respiratory system and replace smoking, suit as ashtrays; use the vacation period as a the nicotine present in the tissues of the smoker so the trial no-smoking period; and avoid the company of lack of nicotine is not perceived. This rust category of smokers.

GENERAL

71-0181, Cotterot,E., Rieckert, C., Daneyrolle, C., Studies have shown that lung cancer, laryngeal cancer, Eyraud, C. Etude et Amelioration de l'Efficacite des thrombosis, angina pectoris, chronic bronchitis, lung Filters de Cigarettes.[Survey and Improvement of deflation, reduced lung function, premature and under- Efficiency of Cigarette Filters.)Chimie et Industrie weight births, and stomach and duodenal ulcers occur 103(16):2035-2041, October 1970, French. more frequently in smokers than in nonsmokers. Despite the evidence, it has had only short-lived effects on the The efficiency of a towards a given smoking habits of the public. In many countries, experi- component of tobacco smoke may be studied by frontal ments are under way to raise the price of tobacco, to chromatography. Itis established that the sorption of require health warnings on tobacco products, to ban to- acrolein is a process of mere adsorption on active C, com- bacco advertising and to educate children and youth. bined adsorption and absorption on fibrous cellulosic Demands are also being made to decrease the acreage for products. In this last case, the retention is improved by growing tobacco, to set age limits for buying tobacco and incorporating a swelling agent into the fibers. The amount to prohibit smoking in public vehicles. However, none of of solute retained at steady state is not changed, on the these measures will be effective as long as smoking is contrary, its speed of diffusion in the solid is increased. socially acceptable. (Auth. Abs.) 71-0183. Silvers, D. In Southwestern Virginia, Students 71 -0182. Evang, K. Tupakointi Tetveyden Vaarana. Set Up Antismoking "Teach-ins" 207 of Them. Bul- [Smoking as a Health Hazard.) Suomen Laakmilehtl, letin National Tuberculosis and Respiratory Disease Finlands Lakartidning 24:3108. 3111,1969, Finnish. Association 56(11):9-10, December 1970. 31 GENERAL

An antismoking education program is briefly described tette Smoking. Bulletin National Tuberculosis and which used 38 high school student speakers to conduct Respiratory Disease Association S6(10:13-14,December 207 antismoking sessions for over 6000 elementary grade 1970. students. Presentations were given to 30 students ata time and involved slides, films, felt board displays. Smok- Comments are presented on the efforts on the anti- ing Sam mannikins (to demonstrate tar accumulation) and smoking campaigns, some new information on the effects question-and-answer periods. of smoking,the importance of focusing antismoking efforts on the youth, the decreasing consumption of ciga- rettes and its consequences, and the antismoking efforts 71.0184. Terry,L. L. So Little Done... and So Much To of the voluntary health agencies. Do! From the NTRDA Annual Meeting Session on Ciga-

32 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

71 -0185. Alt land, P. D., Brubach, H. F., Parker, M. G., 71-0188. Battig. K. Differential Effects of Nicotine and Dieter, M. P., Murayama, M. Effects of Smoke on Toler- Tobacco Smoke Alkaloids on Swimming Endurancein the ance of Rats to Hypoxia. Journal 01 Applied Physiology Rat. Psychupharmacolugia18(31:300-304. November 30(3):352-357, March 1971. 24.1970. AU rats survived 4-hour exposure to tobacco smoke The swimming endurance of rats in a water tub 55.a. (nkutine <1.8 mg/cigarette, carbon monoxide 0.045 per- measured until the animals submerged for two seconds cent) or corn silk smoke (no nicotine, CO 0.031 percent) under the water surface. The total alkaloid traction e- in 20.9, and in 11.8 percent 02. The mortality of rats in uracted from cigarette smoke produced deterioration of tobacco smoke was greater than in corn silk smoke in performance in doses of 0.05 to 0.2 mg/kg. whereas pure 10.4, 8.3, and 6.6 percent 02. This difference was attrib- nicotine (0.1 and 0.2 mg/kg). as well as nicotine pre- uted to higher COHb saturations and to nicotine in the treated analogously to the extraction process of the total tobacco smoke. Rats exposed to 0.045 percent CO in 8.3 alkaloids. produced performance improvements. (Auth. percent 02 without smoke had a higher survival than rats Abs.) exposed to tobacco smoke in 8.3 percent 02 though COHb concentrations were equivalent. Both types of smoke produced an immediate reduction in breathing rate 71-0189. Bhagat, B. Influence of Chronic Administration in all 02 concentrations, but 0.045 percent CO alone had of Nicotine on the Turnover and Metabolism of Noradren- no such effect. Hypothermia produced in rats by hypoxia aline in the Rat Brain.Psychupharmacolugia was intensified only by exposure to tobacco smoke. 18(4):325-332, 1970. Blood glucose and serum lactic acid values were higher in rats in tobacco than in corn silk smoke at all hypoxic Chronic administration of nicotine (0.5 mg/kg. sub- levels. The critical 02 concentration which produced "ex- cutaneously, 3 to 5 times a day for 6 weeks) accelerated cess lactate," an index of anaerobic metabolism, was 6.6 the rate of disappearance of intraventricularly adminis- percent 02 without smoke, 8.3 percent 02 in corn silk tered 3H-noradrenaline from rat brain. This was associ- smoke, and 10.4 percent 02 in tobacco smoke. (Auth. ated with normal levels of 311.normetamphrine suggesting Abs.) an increase in intraneuronal deamination. The rate con- stant of amine decline in animals chronically treated with nicotine was significantly greater than that of controls 71-0186. Saint, J. A., Bondurant, S., Kyriadkides, E. C. while the steady state level of brain noradrenaline was Lecithin Biosynthesis in Cigarette Smoking Dogs. Ar- about equal in both groups of rats. Amphetamine. rescr- chives of Internal Medicine 127(4):740 -747, April 1971. pine, acetylcholine, histamine, pheniprazine, pargyline and nicotine affected the catecholamine levels in the rat The effects of acute exposure to cigarette smoke on brain treated with nicotine to the same degree as they did the synthesis of lecithins in lung, pulmonary surfactant, in the controls. It is concluded that chronic administra- heart, and liver were studied in anesthetized dogs after tion of nicotine may increase noradrenaline turnover in intravenous injection of 32PO4, cholinemethyVH and the brain and possibly increase the deamination of this either methionine-methyl"C, ethanolamine-1-2-14 7, or amine. (Auth. Abs.) palmitic acid-1-14C. Control dogs and dogs exposed to heavy doses of smoke were anesthetized and ventilated with a positive pressure respirator through an endotra- 71-0190. Burke, D. H., Mann, D. E. (Jr.) Influence of cheal tube for 90 to 220 minutes after isotope injection. Several Autonomic Drugs on Sodium Nitropruuide and The pool size of lecithins was not changed by smoking, Oxotremorine-Induced Hypothermia in Immature and but statistically significant decreases in choline and phos- Mature Mice.Journal of Pharmaceutical Sciences phate incorporation were observed in the lecithins of lung 59(12):1814-1818, December 1970. and pulmonary surfactant and in the linoleoyl lecithin of the heart. No significant differences were noted in terms Sodium nitroprusside and oxotremorinc each pro- of isotope incorporation in liver, the phosphatidyl etha- duced body temperature depression that was independent nolamines of any tissues, or in surface activity of lung of age. Atropine inhibited oxotremorinc hypothermia in extracts. (Auth. Abs.) both age groups, but was ineffective in modifying thermal responses to nitroprusside in both age categories. Pilocar- pine administration did not alter oxotremorinc activity at 71-0187. Bartle, K. D., Novotny, M. Mau Spectrometric either age level, while nitroprusside hypothermia was en- and Gas Chromatographic Evidence for Some New Com- hanced and partially reversed, respectively, in immature ponents in the Gas Phase of Tobacco Smoke. Beitrage and mature mice. Nicotine and tetraethylammonium chlo- zur Tabakforschung 5(5):215-219, November 1970. ride were unable to modify hypothermia produced by oxotremorine and nitroferricyanide in adult mice. Nico- The gas phase of fresh tobacco smoke was injected tine enhanced nitroprusside hypothermia in 10-day-old onto an open-tubular gas chromatography column at low mice, while temperature depression due to oxotremorine temperature. Mass spectra and retention data for compo- was unaffected in the same age group. Administration of nents eluted on temperature programming suggest the pre- tetraethylammonium chlorideto immature animals sence of six new compounds: 1,1-, 1,2- cis-. and I ,2-trans- treated with oxotremorine and nitroprusside resulted in dime thylcyclopropanes; 1-chloro-5-methylhexane: greater temperature depression. Chlorpromazine, which 1,3 5-hexenene; and 2-methyl-l-octene. (Auth. Abs.) produced no change in oxotremorine or nitroprusside

33 36 :5 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

hypothermia in 10-day-old mice, partially blocked oxo- Brain During Carbon Monoxide Poisoning. Pharmacol- tremorine-induced hypothermia in mature animals; the ogy 5(1):5563. 1970. weak parasympatholytic produced no sly- nificant difference in hypothermia when given prior to In carbon monoxide poisoned mice enhanced glyco- nitroprusside in the adult group. (Auth. Abs.) genolysis and lactate production in the brain are not pre- vented by pretreatment of the animals with reserpine or an adrenergic 13-receptor blocking agent (Ko 592). Since, 71-0191. Chyle, P., Chyle, M.. Patocka, V. Virus Tabalt- furthermore, glycogenolysis is not accompanied by ove Mozaiky a Polyfenoly Jab) Prirozene se Vyskytujici changes in the phosphorylase a content or phosphorylase Kancerogeny v Tabaku. [Tobacco Mosaic Virus and Poly- a/phosphorylase (total) ratio, it becomes unlikely that ad- phenols as Naturally Occurring Carcivngens in Tobac- renergic mechanisms play a major role in the stimulation co.]Casopis Lekaru Ceskych 110(8):189-190, February of carbohydrate breakdown during carbon monoxide 19, 1971,Czech. poisoning. It appears more likely that by analogy to the condition in heart glycogenolysis is stimulated by an acti- It was found that tobacco n.Psaic virus is present in vation of phosphorylase b due to changes in the concen- the majority of tobacco products. Infectious virus is trans- tration of metabolites which are known to inhibit (ATP, ported via the smoke even into the respiratory tract of glucose-6-phosphate) or activate (AMP, inorganic phos- other persons. The higher carcinogenic activity of Virginia phate) phosphorylase b. (Auth. Abs.) type tobaccos may be due to the fact that they ar.: not fermented but flue-cured and thus TMV and all the phe- nolic compounds are preserved in them. Most likely the 71-0195. Estler, Ammon, H.P.T., Heim, F. Metals- oncogenic effect of tobacco is due to the synergistic au. oliten des Kohknhydratstoffwechsek und energiereiche tion of polyphenols and various viruses in the animal cell. Phosphate hn Gehirn weisser Mause nach wiederholter (Auth. Abs.) Kohlenmonoxydvergiftung. [Metabolites of Carbohydrate Metabolism and High-Energy Phosphates in the Brain of Mice After Repeated Carbon Monoxide Poisoning.]Ar- 71-0192. Dalhamn, T., Rosengren, A. Effect of Different chie Fur Toxikologie 27(2):I24.128, 1971, German. Aldehydes on Tracheal Mucosa. Archives of Otolaryngol- ogy 93(5):496-500, May 1971. The influence of single (4 hours) or repeated (35 ;Imes, 9 hours plus once for 4 hours within a period of 7 In connection with investigations of the ciliostatic weeks) exposure to 0.1 percent (v/v) carbon monoxide in effect of tobacco smoke, aldehydes have been of special air on the glycogen, pyruvate, lactate, ATP and phospho- interest as many of them have an irritating effect on the creatine content of the brain and on the blood glucose tracheal mucosa. A comparison of the ciliostatic effect of level was investigated in mice. By a carbonmonoxyhemo- formaldehyde, acrolein, acetaldehyde, crotonaldehyde, globin concentration of 35 percent after a single exposure and methacrolein shows that there are significant differ- to carbon monoxide, the pyruvate content of the brain ences between the substance's regression lines. Formalde- wa.; found to be increased and the blood glucose level hyde seems to be the most toxic substance followed by dec.-eased. After 7 weeks of repeated exposure, additional acetaldehyde and acrolein. Crotonaldehyde and meth- changes found by the same CO-Hgb content included an acrolein have the weakest slope. The technique for ob- increove in the lactate and a decrease in the phosphocre- serving the tracheal ciliary activity is the in vitro tech- atine content of the brain. The changes produced by re- fugue which has been used in many other investigations. peated carbon monoxide poisoning were found to be only (Auth. Abs.) partly reversible after the animals were subsequently al- lowed to breathe normal air for 15 hours. (Auth. Abs.) 71-0193. Dontenwill. W., Harke, H.-P., Baars, A., Goertz, E. Expedmentelleat,_ ntersuchungen uber Aufnalune und 71-0196. Fazekvs, L. G., Kosa, F. Uber histologische Ablagerung von t aehbestandtellen bei der pastiven Veranderungen by% akuter Nikotinvergiftung. [Histologi- Berauchung von Go-allutrnstem mit Zigarettenrauch. [Ex- cal Changes in Acute Nicotine Intoxication.]Zacchia; perimental Studies on Intake and Deposition of Smoke Archivo di Medicina Legate, Societe e Criminologica Particles in Golden Hamsters When Exposed to Cigarette 6(2):200-218, April-June 1970, German. Smoke.] Arzneimitrel-Forschung 21(1):142-143, Janu- ary 1971, German. Among the post-mortem material of the Medico-legal Institute at Szeged University for the years from 1921 to Labeling cigarette smoke with n-hexadecane/n4texade- 1968, there are 46 cases of acute nicotine intoxication. In cane-1-14C makes the measurement of smokeintake and 34 of them, the organs (various regions of the brain, smoke distribution during passive smoke exposure of spinal cord, heart, lungs, spleen, liver, kidneys, stomach, Syrian golden hamsters possible. Investigations show that small and large intestine) have been histologically exam- the nasal clearance removes less than 50 percent of the ined. The histological changes observed in acute nicotine smoke particles. The highest amount of deposited parti- intoxication can be attributed, in part, to the shock due cles per surface unit was found in the respiratorytract in to the accentuation of the activity of the sympathico- the area of the larynx, and therefore, the intensity of adrenalinic system. They are revealed above all by a modi- histopathological findings in this region is understandable. fication of the blood distribution (agglutination with con- (Auth. Abs.) centration of the embolic type of the leucocytes in the arteriole lumen, loosening of the endothelium cells and their well visible accumulation in the single, sections, 71-0194. Estler, C.-J., Heim, F., Ammon, H.P .T., Zimmer- poverty of blood and cell elements in the spleen, increase mann, V. Catecholamine-Independent Glycogenolysis in of lymphoreticular elements in Cite lumen of the arteries

37 34 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

and the veins of the spleen), by changes of the hematolog- on Pulmonary Cells and Serum Antitrypsin Levels.Ar ical picture (inversion of the normal neutrophil-lympho- chives of Environmental Health22(3):366-369, March cyte ratio), thickening of the arterial walls of a muscular 1971. type with reduction of their lumen, prominence of the intima into the vasal lumen, shrinking of the membrana A significant increase in the number of polymorpho- elastica intema and its dissociation, stasis in the capillary nuclear leukocytes recoverable from the lungs of guinea vessels and the veins and perivascular hemorrhages in the pigs has been demonstrated to occur in response to ex- phylogenetically most ancient cerebral territories. The fol posure to cigarette smoke. This inclease was accompanied lowing direct destructive effects in relation to the toxic by no change in serum antitrypsin levels over the ten- action of nicotine can be observed: mobilization of the week exposure period. These observations, if applicable to hepatic cells, loosening of the alveolar epithelia, as a result man, suggest that a source of proteolytic enzymes in rela- of the high degree pulmonary hemorrhagic edema, necro- tively high concentrations may be continuously present in sis of the epithelia in the renal tubuli, loosening and dis- the lungs of cigarette smokers. The depressant effect of sociation of the epithelia in the tubuli contorti of the cigarette smoke on natural respiratory defenses leaves the second degree, lipofuscinic e-posits in the plasma of the system increasingly susceptible to bacterial infections and cardiac cells, as well as large changes caused by concentra- even greater inflammation results. When this is added to tion of the myofibrillae of the cardiac muscle. (Auth. an already excessive number of leukocytes chronically Abs.) present, the resultant concentration of proteolytic en- zymes may be greater than can be counteracted by the available enzyme inhibiting agent. (Auth. Abs.) 71-0197. Federation of American Societies for Experi- mental Biology. Life Sciences Research Office. A Review of the Biomedical Effi.v.ts of Marihuana on Man in the 71-0199. Graham, J.D.P., Suhaila, A., Tai, A. Response to Military Environment. Prepared for Life Sciences Divi- Acetylcholine and Nicotine of the Perfused Vessels of the sion, Army Research Office, Office of the Chief of Re- Rabbit Ear.British Journal of Pharmacology search and Development, Department of the Army, 41(3):500-506, March 1971. Washington, D.C. under Contract No. DAHCI9-71-C- 0006, AD-718083, December 1970, 101 pp. The vessels of the isolated rabbit car were perfused at 23 mbar with Krebs solution with (tonic) and without This review documents in detail the current state of (atonic) noradrenaline (5.9 X 10-7M) at selected tempera. knowledge of the effects of marihuana on man. The study tures of 20 ° -38° C. Peripheral resistance units (PRU) were examines the relationships between marihuana use and calculated from the observed peak flow rates and altera- performance of the man in a military environment and tions caused by drugs expressed as A percent PRU. Ace identifies opportunities for future research by the Army tylcholinc (ACh) is a constrictor in the atonic vessel. ACh in this field. The scope of the study includes the botany is a vasodilator of the tonic vessel perfused with noradren- and phytochemistry ofCannabis saliva,isolation, charac- aline (NA). This effect is potentiated by anticholinester- terization, and synthesis of the plant constituents, the ase and by denervation, unaffected by botulinum toxin pharmacology of these compounds, and the need for and antagonized by atropine. ACh also dilates the vessel quantitative estimation of the tctrahydrocannabinols and perfused with vasopressin. Increasing the temperature their derivatives in biological samples. Special attention is reduces the responses to ACh but increases the effect of directed to the effects of smoking marihuana, the compo- anticholinesterase. Nicotine causes a dose dependent dila- sition of marihuana cigarette smoke, and the resulting tation of the tonic vessels, reduced but not abolished by somatic, subjective, perceptual, and cognitive changes that hexamethonium (C6) by atropine. by botulinum toxin may influence the performance of the smoker. This re- and by dencrvation. Nicotine causes a dose dependent view includes a description of behavioral tests used to constriction of the atonic vessels, abolished by C6 and by measure marihuana effects, the influence of an individ- phentolamine, reduced by denervation, but unaffected by ual's expectations, and effects of environmental setting on botulinum toxin. (Auth. Abs.) human subjects. The anecdotal literature on marihuana is being replaced by reports of controlled laboratory studies; however, investigations that measure performance in real- lifesituations are required to answer crucial military 71-0200. Graham, J. F. Cigarette Smoke Analysis by questions on marihuana effects. Information on the chem- Computer GLC.Beitrage zur Tabakforschung istry, pharmacology, and behavioral effects of marihuana 5(5):220-228, November 1970. that is necessary for these future studies is being devel- oped at the present time. The report identifies and as- A two-stage GLC system has been developed to pro- sesses the research opportunities that are related to the duce a separation of cigarette smoke "semi-volatiles" into requirements of the Army. It is suggested that the unique several hundred peaks per analysis. Quantitative measure- research experience and facilities of the Army in assessing ments of the separated peak areas, with correction for the performance abilities of men exposed to incapaci- baseline drift and an internal standard value, are made by tating agents may be utilized to answer the pressing ques- an off-line computer, using a digital output obtained from tions concerning marihuana smoking and its influence on the GLC system on punched tape. The main features of the performance rf the man in the military environment. the computer program used are described. and typical Suggestions for future research are outlined. (Auth. Abs.) output data are shown. Results of analyses dealing with cigarette smoke composition, and the selective effect of various filters, are presented. The use of neophytadiene as 71-0198. Flint, G. L., Maxwell, K. W., Renzetti, A. D. reference compound for the selectivity calculations is (Jr.) Influence of Cigarette Smoke on Guinea Pigs. Effect described. (Auth. Abs.)

38 35 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

71 -0201. Groenen, P. J. Chemische Aspecten van Sigaret- Activities with selective-detectors in gas chromatography tenrook. [Chemical Aspects of Cigarette Smoke.]Jaar- suggested a possible system for the determination of boek Kankeronderzoek en Kankerbestrijding 19:65-75, oxides of nitrogen in the gas phase of smokes. Work in 1971, Dutch. areas less directly related to the routine operations also produced promising results. A study of the polarographic The physicochemical properties of smoke and the properties of N-nitrosamines suggests the possibility of standardized machine-smoking of cigarettes are briefly the electrochemical determination of the N-nitrosamines discussed. A survey is given of the constituents of ciga- in condensates. Trimerhylsilylation of pyridine solutions rette smoke, which on the basis of animal experiments or of cigarette smoke condensate allowed the reproducible theoretical considerations are thought to be possibly in- generation of gas chromatograms displaying more than volved in the genesis of various forms of cancer in man, or thirty of the major constituents of whole condensate in in promoting them. Some recent controversial develop- less than one hour. The direct application of a flame ments in smoke analysis are described, such as: the im- photometric detection system to the gas chromatography portance of volatile smoke constituents, which in animal of the gas phase of cigarette smoke allowed the visualiza- experiments are often removed from the condensates tion of hydrogen sulfide, carbonyl sulfide, carbon disul- before application; the possible presence of nitrosamines; fide, thiophene and ten other sulfur-bearing smoke con- the role of alphabeta unsaturated lactones and other un- stituents in fractions of a puff of smoke. (Auth. Abs. saturated carbonyl compounds. Acetic aldehyde, a major Mod.) cigarette smoke constituent, is also touched upon. Special attention is drawn to those compounds in smoke that might be collectivelycharacterized as thiolophilic or 71-0203. Hoffmann, D., Wyndcr, E. L. A Study of To- mercaptophilic. Finally, the influence of the tobacco vari- bacco Carcinogenesis. Xl. Tumor Initiators, Tumor Accel- eties, incorporated in cigarettes, on smoke composition erators, and Tumor Promoting Activity of Condesate and on inhalation habits of smokers, is discussed. Fractions. Cancer 27(4):848-864, April 1971.

The neutral portion of cigarette smoke condensate, its 71 -0202. Guerin, M. R., Shults, W. D. Tobacco Smoke fraction B, and subtraction BI are the only portions of Analysis Program Progress Report for the Period January cigarette smoke condensate which are active as carcino- 1, 1970, to September 1, 1970. Oak Ridge National gens and tumor initiators. BI amounts to about 0.6 per- Laboratory, U.S. Atomic Energy Commission, Oak Ridge, cent of dry "tar" and contains polynuclear aromatic Tennessee, Report No. ORNL 4642, January 1971, 207 hydrocarbons (PAH), N- and O- heteroaromatic coin- pp. pounds, chlorinated insecticides, and some of their pyrol- ysis products, esters, terpenes, and quinones. Heretofore, The Tobacco Smoke Analysis Program is establishing 12 known carcinogens and several tumor accelerators have chemical assays and applying them to the smokes ofa been identified. BI was separated into 5 portions. The series of 23 experimental cigarettes to provide informa- active portion (Blh, 0.09 percent) was chromatographed tion to better define the relationship between cigarette into 80 subfractions. Blh 55-56 were highly active as characteristics and experimental tobacco carcinogenesis. tumor initiators, but did not contain known carcinogens; During this period, cigarettes were smoked and the gener- Blh 71-78 contained known as well as unidentified carcin- ated particulate matter was analyzed to determine the tar ogens. Such alkylated PAH, as alkylated fluoranthenes, and nicotine deliveries of all the experimental cigarettes. cyclopentaphenanthrenes, and chrysenes, are present in The data were studied in detail to provide measures of the significant concentration in the active Blh subfractions. facility's ability to generate precise, meaningful results Of all tobacco "tar" fractions, only the acidic portion and to allow ranking the experimental cigarettes accord- showed significanttumor promoting activity. (Auth. ing to their deliveries of particulate matter. Acetaldehyde Abs.) and acrolein were determined in the gas phases of the cigarettes. The formaldehyde and hydrogen cyanide con- tents of the gas phases are presently being determined. 71-0204. Ingenito, A. J., Barrett, J. P., Procita, L. An Research and development activities emphasized support Analysis of the Effects of Nicotine on the Cerebral Circu- of the routine operations. One result of these activities is lation of an Isolated, Perfused, In Situ Cat Brain Prepara- an analytical system capable of excellent precision in the tion. Stroke 2(1):67 -75, January-February 1971. simultaneous determination of acetaldehyde and acrolein. Studies of the gas chromatographic properties of nicotine, To determine the effects of nicotine HCI on thecere- nornicotine and monohydric phenols greatly facilitated bral circulation of the cat, without the complicating the selection of chromatographic conditions for the ac- rou- tions of the drug at other sites in the body, the drugwas tine analyses of these compounds. The application ofa perfused at concentrations of 1, 10 and 100 micrograms/ liquid chromatograph to the separation of phenanthrene, ml through a vascularly isolated, perfused in situ cat brain benz(a)anthracene and benzo(a)pyrene suggests the possi- preparation. Cats having selective section of cranialnerves bility of greatly shortening the time required for the de- 9, 10, 11 and 12 and the cervical sympathetic trunks termination of these polycyclic hydrocarbons in conden- comprised various experimental groups. Nicotine was also sates. A consideration of the characteristics of the cya- perfused through an isolated, denervated hindlimb of the nide-specific electrode suggests a superior approachto the same cat for comparative purposes. Nicotine caumd only determination of the hydrogen cyanide delivery of ciga- a mild and transient vasoconstriction of the etrebral circu- rettes. Experience with porous-polymer gas chromatog- lation, mediated primarily by stimulation of the superior raphy facilitated the development of means for the deter- cervical ganglia, and a small direct cerebral vasoconstrictor mination of water in particulate matter, water and ace- component. An acute tolerance to the cerebral vasocon- tone in condensates, and suggested the possibility of strictor effects of repeated increments of nicotine was determining formaldehyde gas chromatographically. also observed. The cerebral vasoconstrictor effect of CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

nicotine was diminished in the presence of intact vagi, 71-0207. Joyet, G. The Thorium-Series in Cigarettes and suggesting a cerebral vasodilator role for these nerves. In in Lungs of Smokers. Experientia 27(I):85-89, January contrast, the effect of nicotine on the denervated hind- 15, 1971. limb vasculature was a weak but sustained vasodilation. The mechanism of action of nicotine on the cerebral cir- The gamma-spectrum of several brands of cigarettes culation is discussed along with the relevance of these were measured to determine their thorium content. The findings to the potential health hazards of tobacco smok- thorium weight for 9000 cigarettes, which corresponds to inginindividuals with cerebrovascularinsufficiency. the annual amount consumed by a smoker of 25 ciga- (Auth. Abs.) rettes/day, ranged from 9 to 36 mg. In gamma-spectrum measurements of the chests of 10 smokers and 2 non- smokers, 5 smokers showed a thorium content from 1.7 71-0205. I noki, R., Kojima, S., Tamari, Y., Yamamoto, I. to 2.4 ± 0.6 mg. Effects of Nicotine on Salivary Amylase Secretion From Rabbit Parotid Gland. British Journal of Pharmacology 41(2):285 -293, February 1971. 71-0208. Judd, H. J. Levels of Carbon Monoxide Re- corded on Aircraft Flight Decks. Aerospace Medicine The effects of nicotine on amylase secretion induced 42(3):344-348, March 1971. by auriculo-temporal nerve stimulation were studied. Nicotine caused a transient increase in secretion as well as This paper reviews the toxicology of carbon monox- flow rate of amylase. No difference in nicotine action was ide, points out the essential meteorological conditions found between acute sympathetic decentralization of the under which this becomes of practical importance, and gland and acute denervation. The increase in amylase se- demonstrates the significance of pressurization, tobacco cretion due to nicotine was not inhibited by plienoxy- smoking, and the results of carbon monoxide levels re- benzamine, bretylium and chronic denervation, but was corded on the flight decks of assorted jet aircraft under prevented by hexamethonium, propranolol and adren- normal operational conditions. The object of this study alectomy. The increase in flow rate due to nicotine was was to attempt to outline any potential dangers arising not inhibited by propranolol, chronic denervation and from carbon monoxide on aircraft flight decks. The re- adrenalectomy, but was prevented by hexamethonium, sults obtained in the present series of tests are not conclu- phenoxybenzamine and bretylium. These results show sive, but the prevailing conditions at the time were not that the action of nicotine in increasing amylase secretion likely to give rise to high concentrations of carbon mon- is neither a direct action on the ganglion nor on the nerve oxide. In addition, little is known regarding the levels of terminal of the cervical sympathetic nerve, but is an in- carboxyhemoglobin in air crews prior to boarding the air- direct action of catecholamines released from the adrenal craft as a result of exposure to general atmospheric pollu- medulla on the post junctional receptors. The study also tion and smoking of tobacco. (Auth. Abs. Mod.) suggests that the initial acceleration of salivary flow due to nicotine is characterized by a mechanism different from that of amylase secretion. (Auth. Abs.) 71-0209. Kaminski, E. J., Lazanas, J. C., Wolfson, L. L., Fancher, 0. E., Calandra, J. C. Fate of Aflatoxins in Ciga- rette Tobacco.Beitrage zur Tobakforschung 71-0206. Jacobs, L., Sampson, S. R., Comroe, J. H. (Jr.) 5(4):189-192, August 1970. Carotid Sinus Versus Carotid Body Origin of Nicotine and Cyanide Bradycardia in the Dog. American Journal of Commercial nonfilter cigarettes were treated with 100 Physiology 220(2):472-476, February 1971. micrograms or 300 micrograms of aflatoxin B1 and smoked in a smoking machine. The 25-mm butts, the par- When cyanide (50 micrograms) or nicotine (5 micro- ticulate phase of smoke collected on Cambridge filters, grams) was injected into the common carotid arteries of the gaseous phase of smoke, and the ashes combined from dogs anesthetized with chloralose, reflex bradycardia 10 cigarettes in each experiment, were tested for the pres- occurred; this bradycardia was most striking when the ence of aflatoxins by TLC and spectrophotofluorometry. reflex tachycardia initiated by lung inflation was pre- In six separate smoking experiments, no trace of aflatoxin vented by paralyzing the dog with succinylcholine and B1 could be detected in any of the fractions examined. stopping the respirator immediately before making an in- The crystalline aflatoxin B1 used in these experiments jection. After selective surgical denervation of the carotid was prepared by growing cultures of Aspergillusflavus on sinus in six dogs, cyanide or nicotine, in the doses pre- rice. The acute oral LDso (12 days) in weanling rats was viously used, still produced a marked bradycardia. After 75 mg/kg and the acute oral LDso (7 days) in one-to- surgical denervation of the carotid body alone, the same three-day old white Pekin ducklings was 0.78 mg/kg ± doses of these chemicals had no effect on heart rate. Cya- 0.30 m%/kg. The melting point of aflatoxin B1 was nide or nicotine, in doses which caused hyperpnea and 263-264 C, and the molar extinction coefficient was bradycardia before section of the carotid nerve, never 25,000 and 13,400 at wave lengths of 361 millimicrons elicited a prompt increase in electrical activity in 21 ca- and 265 millimicrons, respectively. The fluorescence exci- rotid baroreceptor fibers. Because cyanide and nicotine tation and emission wave lengths were 363 millimicrons still elicit bradycardia after the carotid sinus fibers are cut and 423 millimicrons, respectively. (Auth. Abs.) and the carotid body is intact, but do not do so when the carotid body i., denervated and the carotid sinus is intact, this bradycardia must originate in the carotid body che- 71-0210. Maehlv, A. C., Swensson, A. Cyanide and Thio- moreceptors. (Auth. Abs.) cyanate Levels in Blood and Urine of Workers With Low-

40 37 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

Grade Exposure to Cyanide.Intemationales Archiv fur Facilitating Action of Amphetamine and Nicotine on Arbeitsmedizin 27:195 -209, 1970. Learning in Rats.PsychopharmacologiaI9(3):231.240, February 16, 197L The concentrations of free cyanide in the blood and in the urine, and the levels of "free" thiocyanate (oxidized DI...amphetamine sulphate (2 mg/kg) and nicotine (0.2 to cyanide and distilled) as well as "total" thiocyanate mg/kg) showed a facilitatory action on the acquisition of (directly determined and quite unspecific) were deter- a conditioned response in a shuttle-box by rats and this mined in the urine of 140 volunteers. There were four was reversed by pretreatment withalpha-MT(30 nig/kg). main categories of volunteers: (I) nonsmokers, not ex- Pretreatment with dibenaminc (10 mg/kg) impaired the posed to cyanide in the atnwsphere, (2) smokers, not action either of amphetamine ornicotine. Nethalide exposed to cyanide, (3) nonsmokers, exposed to various (5 10 mg/kg) exerted a partial protection on the depres- levels of cyanide in their occupa'ion, and (4) smokers sant effect produced by the interaction between dibena- who were also exposed to cyanide. The cyanide concen- mine and nicotine. Animals treated withalpha-MT(30 tration in the blood did not show a clear relationship to mg/kg) and kept in the cold (4 6° C for 3 h) also showed either smoking or moderate occupational exposure; the a depressed learning capacity. DL-Dopa (200 mg/kg) pro- levels were found to lie between 2.0 and 15.0 micrograms vided a partial protection on the depressive effects caused of free cyanide per 100 ml of blood, with an average of by the interaction ofalpha-MT withamphetamine, nico- 5.4 micrograms for all categories of volunteers. lt, was tine or cold. It is suggested that the facilitatory learning found that the individual concentrations of free CN and action of amphetamine and nicotine involves a common CNS in the urine varied considerably and could not be adrenergic mechanism. The depressant effects of amphet- used for detecting undue chronic exposure to cyanide at amine, nicotine or cold afteralpha-MTtreatment are attri- the concentrations encountered in the atmosphere.. The buted to depletion of "functional pools" of catechola- average values, on the other hand, varied in a regular pat- mines. (Auth. Abs.) tern for each of the four categories listed above. The in- fluence of smoking had a far greater effect on the values obtained than the influence of atmospheric cyanide. Be- 71-0213. Papacostas, C. A., Jackson, A. F. Pressor Action cause of the great, variation caused by other factors, con- of Nicotine Following 'Reversal' During Alpha Adrenergic centrations of CN and CNS in the urine are not appropri- Blockade.Pharmacological Research Communications ate tools for individual routine control of minor occupa- 2(3):257-266, September 1970. tional exposure to cyanides. However, nonsmokers ex- posed to moderate cyanide levels in the air, and any indi- In anesthetized, atropinized dogs which have received vidual exposed to hip cyanidedevels show higher than a high dose of the alpha adrenergic blocking agent, phen- average values of CN and CNS in their urine. The cya- oxybenzamine, nicotine salicylate 0.2 mg/kg i.v. induces a nide values reported in this paper may be useful for the blood pressure reversal which is followed by a relatively evaluation of analytical results from individual cases long lasting pressor response ranging in magnitude from where poisoning from cyanide in the atmosphere is 'sus- 10 to 65 mm Hg. The latter response is characterized by a pected. (Auth. Abs.) decreased heart rate and cardiac output and a marked increase in total peripheral resistance. The pressor effect can be completely blocked by the adrenergic neuron 71-0211. Meyer, D. H., Cross, C. E., Ibrahim, A. B., blocking agent, guanethidine. Endogenous catecholamines Mustafa, M. G. Nicotine Effects on Alveolar Macrophage do not appear to be directly responsible for the response. Respiration and Adenosine Triphosphatase Activity.Ar- Several other possible mechanisms are discussed. These chives of Environmental Health22(3):362-365, March include the spare alpha receptor hypothesis, release of 1971. serotonin or vasopressin, and activation of the renin- angiotensin system. (Auth. Abs.) Pulmonary alveolar macrophage cells (PAMs) manifest a high endogenous respiration (0.16 micromols /liter of 02 per milligram of protein per second) and a Mg dependent 710214. Pappano, A. J., Rembish, R. A. Nicotine- Na+, le stimulated adenosinetriphosphatase (ATPase) ac- Induced Restoration of Action Potentials to Cardiac tivity at the cellular level (2.2 micromols of phosphate per Tissue Depolarized by Potassium.Life Sciences milligram of protein per hour). Nicotine adversely af- 9(24):I381.1388, December 15, 1970. fected the PAM respiration and ATPase systems. Concen- trations above 03 millimols/liter inhibited PAM ATPasc The results of the study indicate that nicotine retains activity; a 33 percent inhibition occurred at 5 millimols/ its sympathomimetic activity _under conditions in which liter of nicotine. Preincubation exposure of PAMs to nico- the membrane potential of intracardiac adrenergic stores tine for one to two hours deteriorated the ATPase system (sympathetic neurons and/or chromaffin cells) had been further; a 50 to 60 percent inhibition occurred at 5 depolarized by elevation of the external potassium ion mols/liter of nicotine. Low concentrations of this alkaloid concentration. The features of the proposed mechanism (<5 millimols/liter) stimulated cell respiration by 20 per- by which nicotine releases catecholamines within the cent; high concentrations (> 10 millimolsfliter) were inhi- heart are in general agreement with the hypothesis ad- bitory. Preincubation of cells for one to four hours in the vanced for nicotine-induced release of adrenal medullary presence of 0.1 to 5.0 millimolsfliter of nicotine caused catecholamines. abolishment of biphasic response and greater respiratory inhibition. (Auth. Abs.) 710215. Pradhan, S. N., Bowling, C. Effects of Nicotine on Self-Stimulation in Rats.Journal of Pharmacology 71-0212. Orsingher, 0. A., Fulginiti, S. Effects of Alpha- and Experimental Therapeutics176(1):229-243, January Methyl Tyrosine and Adrenergie Blocking Agents on the 1971. 41 38 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

Rats were trained to press a lever to receive ultra- 71-0217. Schlolzhauer, W. S., Schmeltz. I., Osman, S. F. cranial electric stimulation through a stereotaxically im- Evidence for the Origin of Monoalkenes in Cigarette planted bipolar electrode in two different areas of the Smoke. (Letter)Chemistry and Industry43:1377-1378, hypothalamus. Nicotine was given i.p. at several dose October 24, 1970. levels (122;400 micrograms/kg; base). The effects of nicotine were found to be rate-dependent. Facilitation of Observations on possible precursors for the pyrosyn- responding for self-stimulation was observed at 37.5 thesis of alk-l-enes, showed that tobacco leaf paraffins micrograms/kg and higher doses of nicotine in rats with contribute to at least three classes of cigarette smoke con- low response rates. In rats with high response rates, nico- stituents as a function of temperature: aromatic hydro- tine had very little effect or even caused depression. How- carbons formed by pyrogynthesis at the temperature of ever, when the rates were lowered in such rats by reducing the burning cone (860C); monoalkenes and lesser current intensity or after prolonged lever pressing, a facili- amounts of simple aromatic hydrocarbons produced at tatory effect of nicotine was demonstrable. Nicotine had the lower temperatures behind the burning cone (650° C); no appreciable effect on unreinforced responses and it and paraffins released into the smoke stream by distilla- counteracted the depressant effect of barbiturates on self- tion at an even lower temperature (450° C). The results stimulation. The facilitatory effect of nicotine on self- substantiated that pyrolysis of materials possessing long stimulation resembled that of amphetamine in many re- carbon chains can give rise to alkenes at 650° C. Long spects. Facilitation of self-stimulation by nicotine was re- chain alcohols may also play an important role in forming duced or blocked by . a tertiary ganglion alkenes present in cigarette smoke. blocking agent, arid could not be produced in animals treated with reser sine 24 hours earlier. Itproposed that nicotine, by acting on a central nicotinic-cholinergic re- 71-0218. Silver, H. M. Carbon Monoxide in Health and ceptor, may liaiirectly cause release of norepinephrine Politics.Medical Annals of the District of Columbia which, it turn, produces the facilitatory effect on self- 40(3):169-171, March 1971. stimulation. (Auth. Abs.) Carbon monoxide (CO) is a significant air pollutant which impairs oxygen delivery to the tissues with harmful 71-0216. Rosecrans, .1. A. Effects of Nicotine on Behav- effects, particularly in the central nervous system. The ioral Arousal and Brain 5-Hydroxytryptamine Function in key elements in carboxyhemoglobin levels (COHB) are Female Rats Selected for Differences in Activity.Euro- concentration of inspired CO and duration of exposure. pean Journal of Pharmacology14(1):29.37, March 1971. Automotive exhausts contain approximately 33 percent CO while that of cigarette smoke is close to 2 percent. The effects of various doses (s.c.) of nicotine (200, and inhaled smoked is 0.04 percent. A half-a-pack-a-day 400 and 800 micrograms/kg) on exploratory behavior and smoker averages 3.8 percent COHB, a two-pack-a-day forebrain 5-hydroxytryptamine (5-HT) metabolism were smoker, 6.9 percent COHB. In the Washington, D.C. area, studied in female rats selected for differences in spontane- CO production which causes air pollution is almost exclu- ous activity. The results of this study indicated that nico- sively automotive in origin and prospects for its regula- tine affected each activity group differently; high activity tion, through emission controls, automotive inspections rats (H.A.) appeared more susceptible to the chemical and civic action, are hopeful. Abatement of air pollution effects of nicotine (200 and 400 micrograms/kg) as 5-HT is intertwined with the sociopolitical problems of this area accumulation in pargyline monoaminc oxidase inhibitor and physicians may contribute to the solution by provid- (MAGI) treated rats was significantly reduced, while low ing public information and participating in community activity (LA.) rats appeared more susceptible to behav- action. ioral stimulation due to nicotine (200 and 800 micro- grams/kg). The 400 micrograms/kg dose, which induced both a maximal facilitation of arousal levels and a signifi- 71-0219. Smit, H. Die Wirkung einiger Feuchthaltemittel cant reduction of 5-HT accumulation was studied in auf die Eigenschaften eines rohrengetzockneten Tabaks. greater detail, and was observed to initiate similar effects (The Effect of Several Humectants on the Properties of a following repeated doses. However, in acute situations Flue-Cured Tobacco.)Beitrage zur Tabakforschung nicotine appeared to modulate behavior as evidenced by a 5 (5):231-238 , November 1970, German. stimulation of behavior in LA. rats and a depression in the H.A. animal. Further chemical correlation studies in- The water-vapor transmission of four polyhydric alco- dicated that nicotine (400 micrograms/kg) reduced 5-HT hols has been determined for the products themselves as turnover (as measured using the MA01, pargyline) to a well as after a 3-percent application on a flue-cured to- greater extent in the forebrains of H.A. rats, while caudal bacco type. These polyhydric alcohols are glycerine, (brainstem) areas were inhibited more in L.A. rats. This sorbitol, propanedio1-1,2 and butanedio1-1,3. The butane- investigation presented evidence which indicated that the dio1-1,3 shows the most hygroscopic properties. Of the nicotine-induced elevation of arousal levels were corre- four products examined, the same butanedio1-1,3 has the lated (at the 400 micrograms/kg dose) to an inhibition of strongest fungistatic effect. The taste of the cigarettes 5-HT systems. While these data were essentially prelimi- with butanedio1-1,3 is better than that with sorbitol or nary in nature, this study does give encouragement to the propanedio1-91,2 (and diethyleneglycol). The smoke nico- concept that nicotine's variable effects on the behavior of tine content of cigarettes, the tobacco of which is treated animals of different temperaments could be related to its with 3 percent butanedio1-1,3. is significantly lower than effects on the forebrain 5-HT projection system. Further- that of cigarettes out of the same type of tobacco with mote, this study supports previous research in this labora- the other humectants or out of untreated tobacco. This tory which suggests that there may be a significant rela- can possibly be caused: a) partially by a relatively high tionship between animal temperament and forebrain bio- moisture equilibrium of the tobacco; b) partially by a genic amine function. (Auth. Abs.) selective nicotine absorption in the butt (not in the filter);

42 .39 CHEMISTRY. PHARMACOLOGY AND TOXICOLOGY

and c) possibly there is still another effect, because the which give rise to the nociceptive responses to acetylcho- nicotine totals show a minimum with the glycol ciga- line administered into the femoral artery are nicotinic in rettes; however, further experiments were not done. nature. (Auth. Abs.) (Auth. Abs.)

71-0223. Turner, D. M. Metabolism of Small Multiple 71-0220. Stalhandske. T. Effects of Increased Liver Me- Doses of (14C) Nicotine in the Cat. British Journal of tabolism of Nicotine on Its Uptake, Elimination and Tox- Pharmacology 41 (3 ):521-529 , March 1971. icityinMice. A cta PhysiologicaScandinai'ica 80(2):222.234, October 1970. The distribution and metabolism of (2'-14C) nicotine given as a series of small intravenous injections (4 micro - Male albino mice were injected intraperitoneally or in- grams/kg every 60 seconds for 20 minutes) have been travenously with 14C-labelled nicotine. Both untreated studied in the cat. Blood concentrations of (I4C) nicotine and phenobarbital pretreated mice were used. The con- reached a maximum of 100 ng/ml at 20 minutes whereas centrations of nicotine and metabolically formed cotininc blood concentrations of cotininc were maximal shortly were determined in the brain, liver and blood, I, 2.5, 5, afterwards. The maximum concentration of nicotine in 10, 20 and 60. minutes after injection. It was found that the blood was greater than that obtained by giving the phenobarbital pretreated mice exhibited an enhanced liver same total dose as a continuous infusion ((4 micrograms/ metabolism of nicotine in nitro and in vivo. The increased kg)/minute for 20 minutes). Urinary excretion accounted liver metabolism caused a significant decrease of nicotine for 90 percent of the total multiple dose in 72 hours. concentration in the brain only when nicotine was given After 24 hours, however, only 2.5 percent of the radio- intraperitoneally. Phenobarbital pretreatment elevated the activity as (14C) nicotine and 0.05 percent as (14C) intraperitoncal LDso value 2-3 times and also increased cotininc was excreted. Gastric juice after two hours con- tolerance to repeated sublethal doses of nicotine. No tained significant amounts of activity which was almost changeinthe intravenous LDso value was observed. entirely composed of (14C) nicotine and (14C) cotininc. (Auth. Abs.) There were significant regional differences in the concen- tration of (14C) nicotine in the brain; amounts were greatest in cerebral hemispheres and smallest in the spinal 71-0221. Strudel, G. Teratologie Experimentale. Action cord. The hypothalamus and thalamus contained signifi- Teratogene du Sulfate de Nicotine sur l'Embryon de cantly higher-concentrations of (14C) nicotine than the Poulet. (Experimental Teratology. Teratogenic Action of whole mid-brain. (14C)Cotinine concentrations were Nicotine on Chick Embryo.] Comptes Rendus Heb highest in the cerebellum. (Auth. Abs.) domadaires des Seances de l'Acadamie des Sciences. Serie D: Sciences Naturalles 272(4):673-676, January25, 1971, French. 71-0224. Victor, M. Tobacco Amblyopia, Cyanide Poison- ing and Vitamin 812 Deficiency. In: Smith, L. (Editor). Nicotine sulfate injected into the yolk of a chick Miami Neuroophthalmology Symposium.Hallandale, embryo incubated 48 hours chiefly induces malforma- Florida, Huffman Publishing Company, 1970, pp. 33-48. tions of the cervical vertebral column. The results indicate that the teratogenic agent exercises its action on the cord The hypothesis linking vitamin B deficiency, cyanide whose deformations then secondarily induce malforma- poisoning and tobacco amblyopia is examined. Although tions of axial organs. experimental applications of cyanide have produced le- sions of the optic nerves, these have been mild in degree and have occurred only in the presence of other cerebral 71-0222. Taira, N., Nakayama, K., Hashimoto, K. Nico lesions. The effects of the sublethal hypoxic insults of tinie Acetylcholine Receptors Subserving Noeiception in cyanide on the nervous system are not analogous to the the Dog Hindlimb. Japanese Jourhal of Physiology effects of smoking and should not be used to support the 20(5):571-583,0ctober 15,1970. idea that cyanide in tobacco smoke can damage the optic nerves. In examining the notion that cyanide in tobacco Properties of nociceptors excited by acetylcholine in only damages the optic nerves in patients deficient in vita- the hindlimb were investigated on conscious dogs utilizing min 1312, it is shown that the body contains a mechanism vocalization as a measure of nociception. All compounds for detoxifying cynanide in tobacco that is effective and were administered into the femoral artery through a rapid, and largely independent of vitamin B12. Nutri- chronically indwelling catheter. Acetylcholine and two tional deficiency is shown to be the one undoubted cause nicotiniccompounds, nicotine and DMPP, produced of so-called tobacco amblyopia. The best defined form of vocalization, withdrawal or shaking of the hindlimb, nutritional amblyopia is that due to vitamin B12 defi- biting andstruggling. Three muscarinic compounds, ciency, but it is likely that other B vitamins and perhaps bethanechol, methacholine and McN-A-343, failed to other nutritional factors produce the same pathological cause any sign indicative of nociception in the hindlimb effect. even with large doses producing severe signs of generalized parasympathetic excitation. The nociceptive responses to acetylcholine were blocked by prior (1 to 2 min) adminis- 71-0225. Weiss, G. B., Rosecrans, J. A. Alteration of tration of hexamethonium, tetraethylammonium, or 5-Hydroxytryptamine-14C Uptake and Metabolism in In- DMPP in doses equal to those of acetylcholine, but not by testinal Smooth Muscle. European Journal of Pharma- comparable doses of l- hyoscyamine. The nociceptive cology 14(2):130-139, April 1971. responses to equi-effective doses of histamine or brady- kinia were not affected either by any of these blockers. The effects of procaive,, nicotine, 0°C, iodoacetic acid, These results indicate that the afferent neuroreceptors and ouabain on the distribution and metabolism of

43 40 MORTALITY AND MORBIDITY

5-hydro xytryptamine-"C (5-HT-14C) in both guinea pig marked increases were observed in the lung (12-fold) and Heal longitudinal smooth muscle and tacnia coli prepara- placenta (4-fold), although increases were also observed in tions wcrc measured. lodoacctic acid or 0°C (but not the intestine and in maternal and fetal liver. (Auth. Abs.) ouabain)consistently and markedly dccrcascd both 5-1IT-14C and 14C- labeled 5-hydroxy-3-indoleacctic acid (5-HIAA-14C) levels; the 5-HT-14C tissue spaces approxi- 71.0227. Wenzel, D. G., Wheatley, J. W., Byrd, G. D. mated that of the extracellular space. Both iodoacctic Effects of Nicotine on Cultured Rat Heart Cells. TOXi acid and 0°C apparently block the inward transport of cologE and Applied Pharmacology17(3):774.785, 5-HT-14C at the cell membrane. Procaine and nicotine November 1970. increased both 5-HT-14C uptake and intracellular pll, whereas only procaine &creased the 5-HIAA-14C space Cells from hearts of 2- to 4-day-old rats were separated and, also, inhibited 5-11IAA-14C formation in guinea pig into cultures of 93 percent endothelioid (E) cells. and 95 brain mitochondria.Nicotinemay alter 5-HT-"C distri- percent muscle (M) cells. on the basis of the rapid-attach- bution or binding by increasing intracellular pH. In addi- ment of E-cells to culture dishes. Cells beat longer in tion to this action, procaine could block 5-HT-14C metab- cultures composed chiefly of M-cells than in unseparated olism by inhibiting monoaminc oxidase, by preventing cultures. Incorporation of nicotine alkaloid (0.003-0.6 access of 5-HT-"C to monoaminc oxidase at the mito- mM) in the medium of M-cell cultures produced a further chondrial membrane, or by some combination of these increase in the duration of beating and slowed the time- two actions. (Auth. Abs.) related decline in beating rate. These actions of nicotine were not attributable to effects on eell attachment or to stimulation of cells which had stopped beating. Differ- 71-0226. Welch, R. M., Loh, A., Conncy, A. H. Cigarette ences between the two types of cells, in response to Smoke: Stimulatory Effect on Metabolism of 3,4-Benz- higher concentrations of nicotine (1.5 mM and 6.0 mM), pyrene by Enzymes in Rat Lung. Life Sciences 10(4, Pt. wcrc demonstrated by vacuole formation and nuclear 1):215-221, February 15,1971. changes. Untreated cultures, initially either 93 percent E- cells or 95 percent M-cells, differed in glucose6-phos- The enzymatic hydroxylation of 3,4-bcnzopyrcnc phate dehydrogenase (G6-PDH), lactic dehydrogenase (BP) by lung was increased 34 percent and18 perccnt in (LDII) and its isoenzymes, pyruvic kinasc (PK) and iso- rats exposed to cigarette smoke for 2 or 4 hours,rcspcc- citric dehydrogenase linkedto nicotinamide adenine tively. Induction of BP-hydroxylase in lungby cigarette dinucleotide phosphate (ICDII -NADP) activities over an smoke was completely blocked by actinomycinD or 18-day period. With the exception of a decreased fall in puromycin. An increase in BP-hydroxylase activitywas the LDH-H subunit activity in both cell types. treatment also observed in various organs ofpregnant rats exposed with nicotine (0.016 mM to 0.6 mftl) did not alter any of to cigarette smoke 5 hours daily for 3 days.The most the enzyme activities measured.

See also, 71-0241, 71-0243, 71-0267, 71.0268, 71-0271, 71.0294, 71-0306, 71-0313, 71-0316, 71-0331, 71-0352

MORTALITY AND MORBIDITY

71-0228. Carnow, B. W. Air Pollution and Physician system, the leading cancer in males, continues its upward Responsibility.Archives of Internal Medicine incidence trend with the rate in females increasing at a 127(1):91-95, January 1971. greater perccnt than in males. Though mortality front heart disease in Connecticut residents has leveled some- The relationship of air pollution to disease and other what in recent years, it is a disease which strikes in thc health problems is reviewed. The ubiquitous effects of air early life and, unlike cancer, may lead to many unproduc- pollution as compared to cigarette smoking, its constitu- tive years of disability preceding death. Chronic condi- ents, its lethal effects during high concentrations and its tions such as emphysema and bronchitis may also begin chronic effects dining lower than lethal doses arc dis- early in life and account for many years of limited living cussed. The physiological effects of some of the more before causing death or contributing to demise from in- toxic air pollutants, including carbon monoxide, lead, fection. (Auth. Abs.) pesticides and radioactive materials are briefly described. The role and responsibility of the physician in regard to air pollution and its control is outlined. 71-0230. Enslein, K., Rose, C. L. Computer Based Data Analysis in Longevity Research. Computers and Bio medical Research 4:289 -329 , August 1970. 71-0229. Christine, B. W., Sullivan, P. D. Effects of Ciga- rette Smoking on Connecticut Residents. Connecticut Multiple procedures of data analysis wcrc applied to a Health Bulletin 85 (1):23-28, January 1971. body of data consisting of the life history information gathered from next of kin listed on death certificates of Data for some of the conditions for which cigarette 500 white male deaths in Boston during 1965. Seventy smoking has been implicated in a causal relationship is variables wcrc analyzed by zero-order correlation, multi- presented. In Connecticut, cancer of the respiratory plc regression, linear discriminant analysis. factor analysis,

44 41 MORTALITY AND MORBIDITY

nonlinear discriminant analysis and nonlinear clustering. These international studies show that reported differ- In the univariate analysis of the 70 variables and their ences between countries in mortality from chronic lung correlation with longevity, smoking variables showed high disease cannot be lightly dismissed. Some confusion and negative correlations. However, this correlation could be disagreement about the basis for making diagnoses of em- accounted for by the secular increase in smoking of ciga- physema or bronchitis still persist. But, generally speak- rettes. it is shown that in a study such as this, in which all ing, population surveys of respiratory symptoms and individuals die essentially at a single point in time, the function in several countries agree in the ranking of the effect of smoking on longevity cannot be measured since burden of chronic lung disease between the rates of prev- the probability of a given individual being a cigarette alence thus found and the death rate from chronic lung smoker is a very strong function of the birth year. A diseases as a whole. The effect of differences in national substantial shift was found in significance of independent smoking habits, such as the Danish use of pipes and cigars variables as one proceeds from univariate to multivariate and the British excessive use of cigarettes, emphasizes the and from linear to nonlinear analysis. Various perturba- benefit of a national taxation policy which favors the first tions in such studies are outlined, such as the effects of rather than the second. The fact that current smoking secularity and bimodal distributions. The substantive find- habits cannot completely explain the high rates of chronic ings suggest that physical predictors are more important lung disease in British cities suggests that air pollution or than social predictors to account for advanced longevity some as yet unknown factor in the British urban environ- while the contrary holds for moderate longevity. Al- ment accentuates the effect of smoking, especially among though social variables are more valuable to secularity older men. That respiratory symptoms are less common in than physical variables (which whittle down their pres- Japanese middle-aged cigarette smokers than in those in ence in the variable set and consequently their ability to the U.S. or Europe points to the need for continuing emerge as important relative to physical variables), there studies of the rate of evolution of lung disease in a popu- was some evidence of their being more important than lation being newly and rapidly exposed to the respiratory physical variables. hazards of a dense industrial community adopting West- ern habits of life. Cigarette smoking, formerly less com- mon among Japanese men than in the US. or Britain. is 71-0231, Hedrick, J. L. The Economic Costs of Cigarette increasing rapidly and followup studies should show Smoking.HSMHA Health Reports 86(2):179-182, Feb- whether chronic lung disease among the Japanese will ruary1971. evolve towards the Western mode. The apparent change in the frequency and character of respiratory disease among A report issued by the Canadian Department of Na- migrants from Britain to the US. and South Africa dem- tional Health and Welfare which presents the estimated onstrates the importance of the social and climatic envi- cost of certain consequences of cigarette smoking in Can- ronment and the potential for improvement in Britain. ada is reviewed and its applicability to the US. situation is assessed. The extrapolated health cost associated with smoking is $5.3 billion for the United States. This sum is 71-0234, Seltzer, C. C. Cigarettes and Heart Disease, (Let- greater by 20 percent than the $4.4 billion in total con- ter)New England Journal of Medicine284(10):557-558, sumer expenditures, excluding taxes, for cigarettes in March 11, 1971. 1966. Much research is needed to provide a firm estimate of the direct and indirect economic costs of smoking for Percentage changes in adult per capita cigarette con- the US. Such research may show, for example, that an sumption are compared with death rates for arterioscle- accurate estimate of health costs is perhaps 50 percent roticheart diseaseinseveralcountries duringthe greater or lesser than the figure extrapolated fzom the 1965-1967 period. The data do not support the parallel- Canadian study, However, the magnitude of such costs is ism of secular changes in cigarette consumption and significant and justifies concern over the allocation of na- heart-disease mortality. tional resources to nonproductive and even harmful uses. (Auth. Abs. Mod.) 71-0235. Terry, L. L. The Future of an Illusion,Ameri- can Journal of Public Health and the Nation's Health 71-0232. Lancet. Counterblaste to Tobacco.Lancet 61(2):233-240, February 1971. 1(7689):69-70, January 9,1971. The magnitude of the cigarette-induced problem in the The Royal College of Physicians of London's 19.71 US., some of the countermeasures that are showing in- report on the effects of smoking on health is briefly re- creasing efficacy, and some of the measures being used viewed. The report is praised for its dogmatic presentation abroad to regulate cigarette smoking are discussed. of scientific and medical evidence which clearly indicates the health hazards of cigarette smoking, for its emphasis on the evident reduced risks of stopping smoking, and for 71-0236. Weizenecker, R., Deal, W. B. Tobacco Cropper's its recommendations to restrict cigarette usage, sales and Sickness.Journal of the Florida Medical Association advertising. Some criticisms as to insubstantial data,un- 57(12):13-14, December 1970. supportable evidence and statistical jugglingare also made. An illness occurring among harvesters of Type 14 to- bacco is described. Though the illness is common among tobacco farmers in north central Florida, no previous re- 71-0233. Reid, D. D., Fletcher, C. M. International Stud- ports have appeared in the medical literature. The noxious ies in Chronic Respiratory Disease.British Medical Bulle- material is presumed to be in green tobacco gum and to tin27(1):59.64, January 1971. be absorbed through the skin. Preliminary observations

,dp 45 42 NEOPLASTIC DISEASES

suggest individual susceptibility and that intoxication can be prevented by the use of waterproof gloves and cloth- ing. (Auth. Abs.)

See also.71-0237,71-0245,71-0246,71-0249,71-0257,71-0265,71-0290

NEOPLASTIC DISEASES

71-0237. American Cancer Society. 1971 Cancer Facts and Figures.American Cancer Society. Inc..1970, 31 creased incidence of pulmonary adenomas and skin pupil- PP. lomas in progeny that were delivered surgically and nursed on foster mothers. The progeny of DMBA-treated Basic cancer data, including statistics on morbidity mothers also developed ovarian tumors that were not ob- and mortality, site and sex incidence, and survivability are served in progeny of controls or BP-treated mothers. presented. The importance of early detection, trends in (Auth. Abs.) individual sites of cancer, ways for individual protection against cancer, public and professional cancer programs and public attitudes toward cancer are discussed. Specific 71-0240. Chyle, P., Chyle, M., Korb, J., Papanek, M. Vi- information is provided on cancers of the breast, colon- rus Tabakove Mozaiky, Polyfenolya Kancerogenita rectum, lung, mouth area, skin and uterus, as well as leu- Tabakoveho Navyku. [Tobacco Mosaic Virus. Poly- kemia. The recent ban on radio and television advertising phenols and the Carcinogenicity of the Tobacco Hab- of cigarettes, government subsidies to the tobacco indus- it.]Ceskoslovenska Epidennologie, Mikrobiologie. Minn- try and health-related tobacco research are mentioned. ologie20( I ):3242, January 1971, Czech. Recent research on the effects of cigarettes on the non- smokers in a smoking environment, the induction of lung It was found that tobacco mosaic virus was present in cancer in dogs with cigarette smoke, and the low birth 84 out of 91 samples of tobacco products from 21 coun- weight of neonates from mothers who smoked during tries (snuff, cigarettes, cigars, and pipe tobacco). But it pregnancy is reviewed. Various activities of the American was not possible to prove any direct oncogenic activity of Cancer Society, including its antismoking program, sup- the virus in the animal cell although a empathic effect port of the International Association of Laryngectomees, was observedin vitro.There is considerably less TMV in research sponsorship, and clinical investigation program cigar and pipe tobaccos than in cigarettes. This is due to arc described along with some of the economic aspects of differences in the fermentation processes employed. TMV cancer. is transported via the smoke even into the lungs of non- smokers who dwell in the vicinity of people indulging in the tobacco habit. Polyphenols play an important role in 71-0238. Anderson, D. L. Cause and Prevention of Lip the plant organism, especially in connection with virus Cancer.Journal of the Canadian Dental Association infections. The fermentation process is a very important 37(4):138-142, April 1971. factor influencing the final content of phenolics in the finishedproduct. The introduction of the flue-curing This analysis of recent incidence rates shows that the method for Virginia type tobaccos runs parallel with the major cause of lip cancer is accumulated irradiation by rising incidence of lung cancer among smokers. Phenolic ultraviolet light from the sun in individuals deficient in compounds are typical of smoke from Virginia tobacco. melanin pigment. Sun-screening ointments provide the These act synergistically with various viruses and most best protection and should be used by white males with probably are the long sought for oncogenic factor of ciga- outdoor occupations, especially in the Prairie and Atlantic rette tobacco. (Auth. Abs.) provinces which have a high lip cancer incidence. Al- though many lip cancer patients smoke pipes, pipe smok- ers are a minority among lip cancer patients. Studies on the association of pipe smoking and lip cancer show 71-0241. DiPaolo, J. A., Nelson, R. L., Donovan, P. J. stronger statistical correlations for residence, nativity, Characteristics of Primary Tumors by Carcinogenic Poly- outdoor occupations and age than for tobacco, smoked or cyclic Hydrocarbons in Syrian Hamsters.Journal of the unsmoked. In addition, lip cancer is rare in Negro pipe National Cancer Institute46(I):171-181, January 1971. smokers. Six primary subcutaneous tumors induced with a sin- gle injection of benzo(a)pyrene or 7,12-ditnethylbenz(a) 71-0239. Bulay, 0. M., Wallenberg, L. W. Carcinogenic anthracene were analyzed for histopathology, growthin Effects of Polycycic Hydrocarbon Carcinogen Adminis- vitro,transplantability, and karyology. All tumors were tration to Mice During Pregnancy on the Progeny.Jour- fibrosarcomas with varying degrees of differentiation. nal of the National Cancer Institute46(2):397402, Feb- Tumor cultures were characterized by rapid growth and ruary 1971. increase inacidity of medium followed by quick degeneration and survival of a few cells which produced a Intraperitoneal injections of either benzo(a)pyrene population that grew indefinitelyinvitro.The initial (BP) or 7,12-dimethylbenz(a)anthracene (DMBA) into populations were diploid, near diploid, or tetraploid and mice during the last half of pregnancy resulted in an in- had some acentric pieces, chromatid rearrangements, and

46 43 NFOPLASTIC DISEASES

marker chromosomes but without any common karyo- 4-hydro xy -7 ,I 2-DM BA and 4-methoxy-7,12-DMBA were typic change. Subsequently, heteroploidy increased. Cells inactive undertheseexperimental conditions. Only lacked orientation and occasionally piled up. Cloning DMItA andits7-hydroxymethyl metabolite induced without a feeder resulted in diverse colonies, some of breast cancer in addition to subcutaneous sarcomata. The which were randomly oriented with crisscrossing of fila- high. &wee of carcinogenicity of the most active com- ments. Tumors derived from these cultures were trans- pounds, considered together with their chemical struc- plantable into hamsters. These tumors were more anaplas- ture, suggest that conversion to more reactive intermedi- tic than primary tumors. Comparison of these studies ates must occur in vivo. (Auth. Abs.) with in vitro studies in which quantitative transformation was obtained with Syrian hamster embryo cells and poly- cyclic hydrocarbon carcinogens leads to the conclusion 71 -0244. Gasinska, T., Gburek, Z. 0 Szkodliwosci thatinvitro investigations of transformation provide Przewleklego Palenia Tytoniu. (The Harmful Effects of information relevant to in vivo transformation. (Auth. Chronic Tobacco Smoking.)Wiadomosci Lekarskie Abs.) 23(24):2157-2162. December 15, 1970, Polish. The authors reviewed 3466 case records to determine 71.0242. Fischer, G. Acerca de laCausalidad de los the frequency of certain diseases in relation to chronic Tumores Vesicales (BajoEspecial Consideraciondel tobacco smoking. It was found that weight deficiency and Consumo de Cigarillos).[The Causality of Bladder upper respiratory tract infections were statistically more Tumors (As Related to Cigarette Consumption).]Folio significant in all smokers above 40 years, while pulmonary Clinica Internacional 20(12):784490. December 1970, emphysema and cor pulmonale were significantly more Spanish. frequent in women above 40 years. bronchial and pulmo- nary carcinoma was more frequent in men above 40 years, This statistical study demonstrates that heavy smoking peptic ulcer was more frequent in all patients with the over a number of years can influence, at least in men and exception of women below 40 years, while in women in in a manner as yet undefined, the development of bladder the same age group, arterial hypertension was more fre- tumors. The data show that of the patients with tumors quent. Neuroses were more frequent in all patients. of the bladder, 55 percent were heavy smokers, 14 per- (Auth. Abs.) cent light smokers, 28 percent ex-smokers, and 3 percent nonsmokers. In contrast to this, the figures show that individuals affected with benign hypertrophy of the pros- 714245. Graham, S., Levin, M. L. Smoking Withdrawal in tate were comprised of 24 percent nonsmokers, 423 per- the Reduction of Risk of Lung Cancer. Cancer cent ex-smokers, 173 percent light smokers, and 16 27(4):865-871. April 1971. percent heavy smokers. A study of about 700 cancer patients and 2,000 con- trol patients from Roswell Park Memorial Institute was 71-0243. Fleshes, 1. W. The Possible Role of Reactive made to examine variations in risk associated with differ- Metabolites of Polycyclic Hydrocarbons in Oncogene- ent lengths of time since ex-smokers withdrew from sis.In: Proceedings of the Tobacco and Health Confer- tobacco. Of some significance to preventive medicine is ence, Conference Report 2. Lexington, Kentucky, Feb- the finding that increases in length of time since the in- ruary 24-25, 1970. University of Kentucky, Tobacco and dividual has withdrawn from smoking are associated with Health Research Institute, 1970, pp. 99-112. decreases in his lung cancer risk. In our series, risk after not smoking cigarettes for 10 years approached that of Previous experiments have establishedthat7- persons who had never smoked. Risk declined for individ- h y dr o xy-dimethylbenz(o)anthraceneisformed from uals who had smoked over exceedingly long periods of dimethylbenz(a)anthracene (DMBA) by rat liver homog- time (3040 years) as well as for persons who had smoked enates. Its formation represents a toxification reaction, as for shorter periods. These findings also offer further it is clearly more toxic than DMBA. The compound is also evidence of epidemiologic significance: the dose-response a potent carcinogen. Studies of its distribution showed relationship inherent in observations of increased risk that far less of the hydroxy derivative than DMBA reaches with increased amount smoked applies to withdrawal, as the mammary gland and other fatty tissue. This was in well. (Auth. Abs.) accordance with the finding of its lower carcinogenicity for mammary tissue. A hypothesis that the ultimate carcinogen is a highly reactive carbonium ion was tested. In conformity with this hypothesis it has been found that 71-0246. Ivakhno, G. 1. Nekotoryye Voprosy Etiolo- tumors are rapidly formed following repeated subcu- gicheskoy Obshchnosti Rasa Gortani i Legkogo. [Some taneous injection of compounds which would be expected Problems of the Etiological Community of Cancer of the to be precursors of carbonium ions. Each compound was Larynx and Lungs.]Zhurnal Ushnykh, Nosovykhi administered inI mg doses (in sesame oil) by subcu- Gorlovykh Boleznei 27:30-32, May -June 1967. taneous injection on alternate days for 20 doses. 7- 1 od ometh y1-1 2 -meth y lb en z(a)anthracene, 7-bromo- Statistical investigations established non-uniformity of meth y1-1 2 -m eth ylbenz(a)anthracene, 7-benzoyloxy- morbidity and mortality from cancer of the larynx and meth y1-12-methylbenz(o)anthracene were the most active the lungs in various regions of the Ukraine. A pronounced and rapidly induced sarcomata at the site of injection. correlation was found between the climatic and geograph- 7-Hydroxymethy1-12-methylbenz(o)anthracene, 7- ical features, and also between the quantity of consumed f or m y1-1 2 -methylbenz(a)anthracene, and 7-me thoxy- tobacco, and mortality due to cancer of the larynx and met h y I-12-methylbenz(o)anthracene werelessactive; cancer of the lungs. (Auth. Abs. Mod.)

47 44 NEOPLASTIC DISEASES

71-0247. Jussawalla, D..1. The Epidemiology of Oral and cer mortality, which has increased nearly three-fold in the Oropharyngeal Cancer in India, Proceedings of the In- last 40 years. Genetic (hormonal) factors were discarded ternational Congress on Otorhinolaryngology, 9th Con- and environmental factors such as cigarette smoking and gress, 206:832-839,1970. industrial exposure were emphasized in terms of an associ ation with pancreatic cancer. Evidence was cited from Tobacco, especially when chewed, is an important national origin and racial comparisons as supportive of contributory factor in the etiology of cancer of the buccal environmental association. An air pollution linkage with cavity and pharynx. This association is probably as close pancreatic cancer, at least based on comparative Califor- as that of smoking and lung cancer. Tobacco fumes in nia city air pollution levels was dismissed, due to a non haled during smoking create a stream which impinges significant (p > .10) association. A broader epidemiologic directly on the tonsils, palate and base of the tongue, and study focusing on cigarette-smoke and industrial chemical are probably responsible for the relatively higher fre- exposure constituents is suggested. (Auth. Abs.) quency of cancer at these sites in the buccal cavity smokers. Unlike the cigarette, the Indian 'bidi' contains very little tobacco dust and is unlikely to create enough 71-0250. Krasnyanskaya, P. N. Eksperimental nYye Issle smoke to reach the bronchi when inhaled. It thus causes dovaniya o Roli Kureniya vProislchozhdenii Raka its carcinogenic effect higher up the respiratory tract on Legkogo. [Experimental Investigation on the Role of the palate, tonsils and base of the tongue. Other etiologi- Smoking in the Development of Lung Cancer.]Voprosy cal causes exist, however, such as sharp teeth, which Onkologii 17(1):5962, 1971, Russian. appear to cause cancer in the anterior two-thirds of the tongue, along the lateral borders. Submucous fibrosis is In two series of experiments on 95 rabbits, changes in probably caused by an allergic reaction to a spicy diet the respiratory tract (nasal cavity, trachea and lungs) were acting as a low-grade chemical irritant on tissues debili- studied under continuous smoking conditions using ciga- tated by malnutrition from an inadequate diet and rettes containing Georgian tobacco, using a method simi avitaminosis. Auto-immune response as a causative factor lar to natural smoking of man. In the first series, where has not yet been adequately investigated. the animals were exposed only to smoking, pre-tumorous changes developed in the third to fourth year of the experiment. In the second series, where the animals were 71-0248. Kempski, H. W. Nuevos Aspectos Endocrinosen exposed to the combined effect of smoking and a single el Cancer Pulmonar. [New Endocrinous Aspects in Pulmo- 15 to 20 mg intratracheal injection of benzo(a)pyrene, nary Cancer.] Folia Clinica Internacional pretumorous changes developed in the first year to a year 18(7/8):436.438, July-August 1968, Spanish. and a half. Smoking was considered to be an insignificant carcinogenic factor for pulmonary tissue. (Auth. Abs. Observations of 22,450 patients have furnished the Mod.) basis for this endocrinological view of smoking habits. In view of the decisive influence of the endocrinium in many cancers, it is essential to try to equilibrate the sexual life 71-0251. Krivinka, R., Kubik, A. Koureni Cigaret a in the most physiological manner (attention to coitus Riziko Vzniku Plicni Rakoviny. [Cigarette Smoking and interruptus), especially at the critical age, when the reduc- the Hazard of Lung Cancer.]Ceskoslovenska Zdravot- tion in sex hormone production results in a well-known nictvi 19(2) ;5761, 1971,Czech. greater incidence of malignant growths. The abuse of smoking and its consequences in lung carcinogenesis may A group of 12,322 men aged 40-64 years with a be prevented by a comprehension of sexual problems in normal radiophotogram (mass Xray examination of the both sexes. The fertile and infertile days of women should population of the Kolin district in 1966) according to a be noted, especially for the biological regulation of con- brief questionnaire completed simultaneously with the ception. The use of oral contraceptives may complicate radiophotographic examination included 51 percent ciga- the endocrine state, so closely related to the nervous rette smokers, 12 percent former cigarette smokers, 2 system. Often, it may be the reason for more pronounced percent smokers or former smokers of cigars or pipes and ' and earlier sexual decline with its consequences, especially 35 percent nonsmokers. During the subsequent 3 1/2 in women, conducive to known psychic alterations which years in the above group, 61 cases of lung cancer con- can then lead to heavier smoking. By balancing temporary firmed by histological or cytological examination were abstinence in sexual life with more work and paying detected; of these, 44 were in the group of 2707 smokers attention to the fertile and infertile periods in women, who smoked more than 200,000 cigarettes, I Iin the many malignant growths may be prevented by healthy group of 3635 smokers who smoked less than 200,000 living without excesses (eating, drinking, smoking, etc.). cigarettes, 5inthe group of 1487 former cigarette Human understanding and consideration of the neuro- smokers, and one in the group of 4271 nonsmokers. The endocrinologic factor are necessary in order to avoid the assessment of a brief smoking history by means of a consequences of tobacco abuse, especially in relation to questionnaire during mass radiography is a useful screen- lung cancer. (Auth. Abs. Mod.) ing method for the detection of groups with a high hazard of lung cancer in men aged 40-64 years with a normal X-ray finding of the lungs. (Auth. Abs. Mod.) 71-0249. Krain, L. S. The Rising Incidence of Carcinoma of the Pancreas. American Journal of Gastroenterology 54(5):500-507, November 1970. 71-0252. Kubik, A., Krivinka, R., Stasek, V., Svandova, E., Krivanek, J., Neumann, V. Screening for Lung Cancer Genetic (hormonal), and environmental factors were High-Risk Groups. Scandinavian Journal of Respiratory evaluated in terms of an association with pancreatic can- Diseases 51(4):290-300, 1970.

48 45 NEOPLASTIC DISEASES

The role of serial radiography in early detection of (Editorial)Chest 59(4):358-359,April 1971. lung cancer, particularly slow-growing cases, continues to be an open problem from both medical and economic Studies showing the direct relationship between the aspects. The cost of finding a potential survivor can be increased incidence of bronchogenic carcinoma since the reduced if groups at great risk are investigated. In a pro- mid- 1930's and rising cigarette consumption are reviewed. spective study of 12,322 males, aged 40-64 years. with a Most primary lung cancers are preventable since they are normal chest film on entry, a brief standard interview caused by smoking, and physicians should admonish all done at the occasion of a mass Xray survey was con- patients to refrain from or quit smoking. firmed to be a useful screening method for identification of lung cancer high-risk groups. An association, between the following characteristics recorded at interview and the 71-0257. Rickard, V. D., Sampson, C. C. Incidence of occurrence of proved lung cancer during the subsequent 3 Bronchogenic Carcinoma in Negroes. Statistical Analysis 1/2 years was found: heavy cigarette-smoking, chronic of 94 Cases.Journal of the National Medical Association cough, deterioration of cough. expectoration of sputum 63( I ): I 0-12, January 1971. and blood spitting in the past year. The predictive value of cough and expectoration has been maintained 2-3 An analysis of bronchogenic carcinoma of 94 Negro years after the interview had been held. (Auth. Abs.) patients is presented. The incidence and relationship of smoking to bronchogenic carcinoma in Negroes appears to be the same as in other racial groups. (Auth. Abs.) 71-0253. Lee, P. N.. Peto, R. The Effect of the Age of Mice on the Incidence of Skin Cancer.British Journal of Cancer24(4):849.852, December 1970. 71-0258. Roe, F.J.C., Peto, R., Kearns, F., Bishop, D. The Mechanism of Carcinogenesis by the Neutral Fraction of The plausibilities of two hypotheses explaining the Cigarette Smoke Condensate.British Journal of Cancer increased cancer incidence rate in old age caused by a 24(4):788-806, December 1970. constant dose of carcinogen (tobacco smoke condensate) were compared using a mouse skin painting experiment in Sixteen groups, each of 50 Swiss female SPF mice. which two groups of mice started treatment at different were treated thrice weekly with various combinations of ages. It was shown that the hypothesis of the increased 3,4-benzopyrene (BP) and/or the neutral fraction of ciga- rate being caused simply by increased vulnerability of old rette smoke (NF) in acetone applied to the skin. Some animals was not as plausible as the alternative hypothesis groups received one carcinogen, some the other and some of the carcinogen acting to some extent cumulatively a mixture of the two. Skin tumor incidence rates were (Auth. Abs.) found to increase both with the dose of NF and with the dose of BP. With BP alone a threshold dose was found beyond which a very heavy incidence rate of malignant 71-0254. Malhotra, S. L. Clues to the Possible Mode of skin turors occurred. After correction of the results for Action of Cigarette Smoke in the Pathogenesis of Lung intercurunt deaths, it was found that when NF and BP Cancer.Journal of the Indian Medical Association are applied together as a mixture they do not act indepen- 55(8):265-270, October 16, 1970. dently in the production of malignant skin tumors but interact positively. This suggests that some of the com- SeeAbstract 70-0108. ponents of NF act as cocarcinogens rather than as com- p letecarcinogens. Treatment with NF appeared to increase the incidence of malignant lymphomas. The data 71-0255. Nelson, J. F., Ship, I. I. Intraoral Carcinoma: were not suitable for deciding whether the various treat- Predisposing Factors and Their Frequency of Incidence as ment.> influenced the rates of incidence of internal tumors Related to Age at Onset.Journal of the American Dental of other types, for example, lung tumors. (A uth. Abs.) Association82(3):564-568, March 1971.

Results of a study of 191 patients with primary intra- 71-0259. Saccomanno, G., Archer, V. E., Auerbach, 0., oral carcinoma during a ten-year period are reported. The Kuschner, M., Saunders, R. P., Klein, M. G. Histologic age of the patient at the time cancer was diagnosed was Types of Lung Cancer Among Uranium Miners.Cancer used as the basis for comparing the frequency of predis- 27(3):5 I5 -523, March 1971. posing factors that may b, ar a relationship to intraoral malignancy. The variables studied were heavy alcoholic A panel of pathologists classified 121 cases of lung intake, heavy smoking, syphilis, hepatic cirrhosis, chronic cancer from American uranium miners by cell type, and anemia, diabetes mellitus, tuberculosis and oral trauma. 138 cases of cancer in non-miners. Undifferentiated carci The data presented provide evidence that the frequency nomas showed a higher incidence with increasing radia- of these predisposing variables is negatively associated tion exposure and age and cigarette matched controls. At with age at the time of diagnosis, for example, thatper- highradiation exposures, the WHO 2B cell type ac- sons with a higher frequency of predisposing factors counted for more than half the total. An average of 15.9 develop malignancy at an earlier age, and that the rela- years elapsed from the beginning of mining to develop- tionship is consistent regardless of sex and racialgroup- ment of cancer. It was longest among the highly exposed ings. (Auth. Abs. Mod.) men and was shortest among men with small cell, undif- ferentiated carcinoma who had less than 700 Work Level Months exposure. In all age and cigarette groupJ, radia- 71-0256. Ochsner, A. Bronchogenic Carcinoma, a Largely tion ::xposure increased the small cell, undifferentiated, Preventable Lesion Assuming Epidemic Proportions. but, decreased the epidermoid tumors. Age showed an

49 46 NONNEOPLAST1C RESPIRATORY DISEASES

increase ,,inepidermoid carcinoma.Undifferentiated ence on symptoms of cough and phlegm, but endogenous small cell types were slightly increased among the lowest factors seemed largely responsible for dyspnea and bron- exposure groups. Cigarette smoking in uranium miners chialobstruction.Itseems advisablethatyoung appeared to be a potent carcinogen with respect to lung CNSLD-patients do not start cigarette smoking as they are cancer, but exerted little, if any, influence on the ceU probably predisposed for lung cancer. (Auth. Abs.) type of lung cancer. (Auth. Abs. Mod.) 71.0261. Werf-Messing, B. van der, Kaalen, J.G.A.H. 71-0260. Wal, A.M.V.D., Lende, R. van der. Cara, Beroepen en Rookgewoonten van Rotterdamse Blaascarci. Rookgewoonten en Bronchus Carcinoom. [Chronic Non- noompatienten. [Occupations and Smoking Habits of Specific Lung Disease, Smoking and Lung Cancer.]Jaar- Bladder Carcinoma Patients in Rotterdam.]Jaarboek bock Kankeronderzoek en Kankerbestrijding 19:87-96, Kankeronderzock en Kankerbestrijding 19:77-85, 1969, 1969, Dutch. Dutch.

The correlation between lung cancer, cigarette smok- The relationship of occupational exposure and smok- ing and CNSLD (chronic non-specific lung disease) was ing habits of 346 male bladder carcinoma patients treated studied in 150 lung cancer patients, 150 control-patients in a Rotterdam hospital between 1960 and 1964 was in- matched for sex, age and home environment and in 100 vestigated statistically. The number of light smokers in control persons matched in addition for cigarette smok- cancer patients and controls increased significantly with ing. The carcinomas were largely (101 times) of the age, the number of heavy smokers decreased proportion- squamous cell type. CNSLD was found in 96 percent of ately, and the percentage of average smokers remained the lung cancer cases and in 34 percent and 28 percent of constant. The smoking habits of cancer and control the control-groups. On the bronchograms of the lung patients in each age group were almost identical. No cancer patients, CNSLD characteristics were frequently demonstrable connection was found between the cigarette (75 percent) found outside the tumor area both in the smoking habits and the clinical manifestation of bladder light and the heavy cigarette smokers. In an epidemiologic carcinomas. The average duration of exposure to hazard- study of chronic non-specific lung disease in the Nether- ous conditions was significantly longer in the cancer lands, exogenous factors as expected had a definite influ- patients than in the controls.

See also, 71-0203, 71-0285, 71-0310

NON-NEOPLASTIC RESPIRATORY DISEASES

71-0262. Alanko, K. Prevalence of Asthma in a Finnish alence of 1.21 percent, women having a slightly higher, Rural Population. A Study of Symptomatic Subjects but insignificant, prevalence than men. First-degree rela- Tested for Bronchial Hyperreactivity.Scandinavian tives of asthmatics had significantly more asthma than the Journal of Respiratory Diseases (Supplement 79):1.64, controls. Asthmatics had significantly more bronchial 1970. obstruction than either controls or nonreactive bronchitic subjects. Asthmatics smoked as much as controls, but less This study was aimed at developing a method for than the bronchitics. Smoking was not considered to be estimating asthma prevalence by demonstrating, in stan- an etiologic factor, although tobacco and cigarette smok- dard tests, abnormally increased bronchial reactivity in ing may provoke an asthmatic attack in some patients. subjects whose symptoms conformed to the clinical pic- ture. The study was made in two stages on the 10 to 59-year old population of Harjavalta rural commune 71-0263. Barach, A. L. Pulmonary Emphysema: Patho- (Satakunta, Finland). The rust stage consisted of a survey genesis and the Illusion of Increased Incidence. Medical of 2562 males and 2725 females to determine such Counterpoint 3(2):4043, February 1971. symptoms as wheezing, persistent cough and breathless- ness at rest, and whether asthma or hay fever had been Arguments against the overpublicized view that there diagnosed by a doctor. Symptoms were found in 667 is an increase in the incidence and mortality of pulmonary subjects. Males had more symptoms than females in all emphysema are presented. The pathogenesis of the disease age groups, and in both sexes symptoms increased with is analyzed as related to and affected by cigarette smok- age. Asthma had been diagnosed in 1.2 percent of males ing,inhalation of tobacco smoke, cigarette-produced and 1.6' percent of females, while hay fever and other cough; and cessation of smoking. Ciprette smoking is a allergic rhinitis occurred in 4.2 percent of males and 5.6 frequent cause of chronic bronchitis but more studies are percent of females. Smokers and ex-smokers accounted needed to prove conclusively that the bronchitic type of for 50 to 80 percent of men 15 years and older. Less than pulmonary emphysema isin fact caused by tobacco 30 percent of all women smoked. A follow-up study of smoke. 284 symptomatic subjects and 104 controls revealed abnormally increased bronchial reactivity in 78 subjects (53 of a high degree and 25 of a mild degree). Marked 71-0264. Brille, D. Possibilities du Depistage au Stade hyperreactivity increased with age, but not in those with Initial de al Bronchite Chronique et de l'Emphyseme mild hyperreactivity. The population had an asthma prey- Pulmonaire. [Possibilities of Detecting Early Stages of

50 47 NON NEOPLASTIC RESPIRATORY DISEASES

Chronic Bronchitis and Pulmonary Emphysema.]Revue 71-0268. Dalhamn, T., Rosengren, A., R y la nder de Medecine , R. Nasal 11(37):2201.2210, October29,1970, Absorption of Organic Matter in Animal Experiments. 1. French. Experimental Technique and Tobacco Smoke Absorp- tion. Archives of Environmental Health 22(5):554-556, Detection of chronic obstructive bronchopulmonary May 1971. diseases in the initial stages is possible, as epidemiological studies have proved. Systematic detection should now be Most of the long-term tobacco smoke exposure experi- developed with the aim of applying individual therapeutic ments have been performed with animals inhaling through . measures as soon as this initial stage appears. A few sug- their nares. It seems important to know to what extent gestions and propositions have been put forward. They the tobaco smoke is resorbed in the nasal cavities. The rely on various types of medical consultations andespe- experimental equipment consists of two gas analyzers and cially industrial medicine, public health clinics and the two recorders, one of each serving the gas stream which family doctor. Investigations which aim at detection has passed through the nose of a living animal, and the should include mainly a systematic case history to dis- reference gas stream, respectively. The results suggest that cover whether there exists a chronic cough or expectora- a significant amount of smoke is absorbed. The mean tion and to specify the quantity ci tobacco consumed, value from eight animals of organic matter absorbed was and the recording of u spirogram of forced expiration. 32 percent. (Auth. Abs.) Several tables in the report show the incidence of cough and expectoration in smokers and nonsmokers and the consumption of cigarettes by male and female smokers 714269. Daly, W. J. Single-Breath Gas Distribution in (three age groups). It was speculated that the influence of Chronic Obstructive Lung Disease. Isoproterenol Effect age could be attributed in part to a longer exposure to on Neon Dilution Volume and Diffusing Capacity. Ar. tobacco smoke. (Auth. Abs. Mod.) chives of Internal Medicine 127(4):763 -766, April 1971.

Forty-nine patients with increased airway resistance 71.0265. Christie. D. Australian BronchitisMortal- ity. Medical Journal of Australia I(I):21.25, January 2. (AR) and ten normal nonsmoking men were studied 1971. before and after isoproterenol hydrochloride inhalation. They were subdivided on the basis of chest roentgeno- gram, sputum production, and history Over recent years extraordinary progress has been into asthma, chronic bronchitis, and emphysema groups. The study made in the management of chronic lung disease, based upon rational use of drug therapy and understanding of reconfirmed the observation that normal nonsmoking males have virtually complete equilibration ofa neon test the disordered physiology. Nevertheless death rates from gas during a single ten-second breath hold. Isoproterenol chronic bronchitis have increased substantiallyamong men, and the beginnings of the same disturbing rise are hydrochloride increased neon dilution volume (VA) but not diffusing capacity (SL), which was much less in the apparent among women. It appears unlikely that air pollu- tion is responsible in Australia, the evidence pointing to emphysema, highest in the asthma, and intermediate in the chronic bronchitis group. Neon dilution volume/ increased cigarette smoking as the major causative factor. (Auth. Abs.) plethysmographic lung volume (TLC) and DL/VAwere similarly affected, except that VA/TLC was not increased afterisoprotercnol administrationinthe emphysema group. These results confirm the anatomic observation 71-0266. Colley, J.R.T. Respiratory Disease in Child- that the capillary bed is not abnormal in emphysema and hood.British Medical Bulletin27(1):9-14, January 1971. suggest that AR, which determines pulmonary gas distri- bution, is less responsive to bronchodilators in emphy- sema. They also suggest that dilution volume added by Data are reviewed from surveys of respiratory morbid- bronchodilators may have less than usual blood-gascon- ity and mortality that seek to assess the role of such tact. (Auth. Abs. Mod.) external factors as social and domestic conditions, air pollution and smoking in the aggravation of chest disease in children and the possible long-tam effect of such ill- 71-0270. EI-Sewery, A. Z., A wad, S., Me wally, M. Spiro- nesses on the evolution of chronic lung disease in later metric Measurements in an Egyptian Portland Cement life. Factory. Journal of the Egyptian Medical Association 53(2) :179-186,1970. 71-0267. Corn, M. Dose to the Respiratory Tract From Two hundred and twenty-three workers in dusty jobs Personal, Occupational and Community Air Pollu- and 90 workers in clean jobs at an Egyptian cement fac- tants. Environmental Letters I (1):29.39, January 1971. tory were examined for cement bronchitis using spiro- metric measurements. There was a significant difference The doses (concentration x time) to the respiratory between workers in the clean and dusty jobs due to the tract by urban, occupational and personal (smoking) chemical irritation of the hydrated cement productson pollutants were calculated by assuming pollutantconcen- the bronchial tree, namely calcium hydroxide, hydrated tration in air equivalent to air quality standards, threshold dicalcium and dicalcium silicate. The effect of smoking limit values and reported cigarette smoke concentrations, respectively. The calculations suggest that the most on pulmonary physiology was inferior to the cement severe hazard. (Auth. Abs. Mod.) challenge by a large margin, is that posed to the packa day cigarette smoker. Assumptions and results of calcula- tions arc presented. (Auth. Abs.) 71-0271. Fisher, A. B., Hyde, R. W., Baue, A. E., Reif, J. S., Kelly, D. F. Effect of Carbon Monoxide on Function

51 48 NONNEOPLASTIC RESPIRATORY DISEASES

and Structure of the Lung. Journal 01 Applied Physiol- commonly following acute bronchitis if they were over ogy 26(1):4 -12, January 1969. 40. Sixty-three percent of the cases started after this age. when the interval between onset and disability rapidly Four human subjects who inhaled 6 percent carbon decreased as the onset was later. Smoking appeared to be monoxide for 18 sec had no significant change in lung more concerned with an insidious than an acute onset and volumes, mechanical properties, or diffusing capacity. aggravated the established disease. No evidence was found Further investigations of possible histotoxic effects of of the influence of dusty work on the disease, though carbon monoxide were performed in seven anesthetized work out of doors may have such an influence. (Auth. dogs. After insertion of a tracheal divider and occlusion of Abs.) the left pulmonary artery with a balloon catheter, the left lung was ventilated for 14-20 min with a gas containing 8-14 percent carbon monoxide while the right lung 71-0274. Howard, P. A Long-term Follow-up of Respira- breathed air or oxygen. Femoral artery blood carboxy- tory Symptoms and Ventilatory Function in a Group of hemoglobin saturation did not rise higher than 18 per- Working Men. British Journal of Industrial Medicine cent. Measurements of diffusing capacity and pressure- 27(4):326- 333,October 1970. volume curves of both lungs over the next 1/249 hr and examination of the lungs by light- and electron micro- Out of a group of 289 industrial workers. 159 have scopy failed to reveal changes which could be attributed been studied for a period of I I years beginning in 1956. to carbon monoxide inhalation. Another dog that devel- The mean rate of fall of forced expiratory volume oped a carboxyhemoglobin saturation of 61 percent had (FEV)0:75 was 0.034 liter/year and the rate of fall of congested, edematous, and hemorrhagic lungs. Therefore, forced vital capacity (FVC) was 0.064 liter/year. There the lung damage seen with carbon monoxide poisoning is was little change in the FEV percent INC over the period. probably related to impaired oxygen transport by the Sudden drops of FEV were observed in a few men. Be- blood and is not a result of histotoxicity of the alveolar tween 1956 and 1962 the number of men with regular carbon monoxide. (Auth. Abs.) sputum expectoration increased, but after 1962 more men lost this symptom than acquired it. The FEV was often markedly reduced by the time regular symptoms of 71-0272. Goldsmith, J. R., FaUat, R. J. Prospects for the bronchitis appeared. It seemed likely that symptomatic Prevention of Disabling Pulmonary Disease. Milbank Me- evidence of bronchial inflammation and infection and morial Fund Quarterly 47(3, Part 2):235.249, July 1969. smoking were not related to the loss of ventilatory capac- ity in most men. Factors considered important to the Information concerning the natural history and epide- genesis of airways obstruction, such as smoking, bronchial miology of chronic pulmonary disease is presented and inflammation, atmospheric pollution and occupation, four preventive strategies are proposed. People born with may differ in their importance in different environments. an alpha, antitrypsin deficiency should be counselled not In this study atmospheric pollution was probably the to smoke, not to be employed in an occupation with an most important factor. (Auth. Abs.) irritating or dusty pollutant exposure and not be exposed to domestic or urban pollution. Prophylactic and early treatment of pulmonary infections should be emphasized 71 -0275. Hutchison, D.CS., Cook, P.J.L., Barter, C. E.. and genetic counselling may be of some value. Smokers Harris, H., Hugh-Jones, P. Pulmonary Emphysema and with cough and sputum should be counselled to diminish Alpha, -Antitrypsin Deficiency.British Medical Journal exposure to smoking. The measurement of carbon mono- 1(5751):689.694, March 27, 1971. xide exposure by such methods as the breath-holding ex- pired air analysis can permit specific counselling. The Of 72 patients with radiological evidence of pulmo- treatment of hyaline membrane disease, pertussis, asthma nary emphysema, emphysema occurred either alone or in and bronchitis is an effective mode of prevention. The association with bronchitis in 61, and 8 of these (13 per- control of emissions is an important strategy for commu- cent) were found to have alpha -antitrypsin deficiency. nity air pollution, for cooking and heating and other The main features of this condition arc:cxertional fumes in the home, and for occupational exposure. Such dyspnea of relatively early onset (generally between 30 controls are of greatest importance to smokers, to those and 45 years of age), severely impaired FEV, and TLCO, with other types of risky exposures and to those with and radiological emphysema predominantly affecting the inherited defects that make them unusually susceptible. lower zones of the lungs. It is probable that any patient Evidence of interaction of exposure to smoking and air with all the above abnormalities has lpha, - antitrypsin pollution is sufficient that the prevention of a second deficiency. There is evidence to suggest that cigarette exposure should be advised. smoking may hasten the onset of this type of emphysema. (Auth. Abs.)

7141273. Gregory, J. A Study of 340 Cases of Chronic Bronchitis.Archives of Environmental Health 71.0276. Laval, P. P. Colloques sur la Bronchite Chro- 22(4):428439, April 19 71. nique. H. Prophylaxie et Traitement des Bronchites Chroniques.(Discussions on Chronic Bronchitis.II. At a Sheffield (England) steelworks 340 cases of frank Prophylaxis and treatment of Chronic Bronchitis.) Re- disabling bronchitis were found between 1955 and 1961. vue de Tuberculose et de Pneinologie 34(5):765-811, The prevalence rate was 64 per 1,000 and the men lost July-August 1970, French. 7.2 man-years in sickness-absence because of this disease per 1,000 man-years worked. Forty-seven cases started Data concerning the causative factors and treatment of before the age of 15 years, and of the remainder 106 had chronic bronchitis are presented in numerous tables in an acute onset due to respiratory infection or gassing, this round table discussion. The importance of tobacco in the etiology of the disease is emphasized.

52 49 NONNEOPLASTIC RESPIRATORY DISEASES

71 -0277. Marwaha, R., Pande, R. S. Lung Function in both ventilatory insufficiency and impairment of oxygen Indian Smokers. (Letter) New England Journal of Medi- transfer among soft-coal miners, severe pulmonary insuffi- cine 284(7):394, February 18,1971. ciency is not unusual among nonsmoking miners. Dis- abling respiratory insufficiency occurred in the absence of In a study of ventilatory capacities of 66 nonsmokers roentgenographic evidence of progressive massive fibrosis and 38 smokers in the 16-25 age range, significant differ- and in the absence of significant ventilatory insufficiency. ences were found between smokers and nonsmokers Impairment of oxygen transfer was commonly associated regarding maximum breathing capacity, timed vital capac- with disabling symptoms regardless of roentgenographic ity and residual volume. Smoking is believed to result in findings or ventilatory function. (A u th. Abs.) airway obstruction and air trapping or hyperinflation.

71-0280. Reichel, G., Ulmer, W. T., Gary, K., Leuschner, 71 -0278. Mueller, R. E., Keble, D. L., Plummer, J., A., Roske, G. Einfluss des ortlichunterschiedlichen Walker, S. H. The Prevalence of Chronic Bronchitis, Versehmutzungsgrades im Stadtgebiet von Duisburg auf Chronic Airway Obstruction, and Respiratory Symptoms die Haufigkeit unspezifischer Atemwegserkrankungen. V. in a Colorado City. American Review of Respiratory Mitteilung, [Influence of the Locally Different Grade of Disease 103(2):209-227, February 1971. Pollution in the Township of Duisburg on the Incidence of Non-Specific Respiratory Diseases. V. Communica- A study of the prevalence of chronic respiratory dis- tion.]Internationales Archly fur Arbeitsmedizin ease symptoms in a random sample comprising one fifth 27(1/2):110-129, October 30, 1970, German. of the adult population of Glenwood Springs, Colorado was conducted in the spring of 1967. Standard methods A total of 1292 men and 843 womcn having their were used that permitted comparison of results with cer- residences for more than 10 years in the town district of tain other studies. The high prevalence of chronic bron- Duisburg were examined during the February 1965 to chitis was found to be strongly related to smoking, partic- June 1966 period. According to the amount of total dust ularly of cigarettes, and was independent of age, sex, or and of SO4 precipitate, the residential districts may be history of dust exposure at work. Chronic airway obstruc- divided into three different zones of dust nuisance. Com- tion was found to be predominantly a disease of elderly parison of the partial groups, being similar in their socio- male smokers and increased in frequency with increasing logic structures, their smoking habits and their age com- age after 49 years. Male smokers with a history of dust positions, does not show any prevalence of cough, expec- exposure at work had a higher rate of chronic airway toration and dyspnea in dependence of the SO4 or total obstruction than smokers without such a history. The dust precipitate. The same is true of the auscultation prevalence of nonobstructive chronic bronchitis did not findings and diverse lung function parameters like intra- change significantly with age in men whereas that of bronchial flowresistance, arterial blood gases and combined chronic bronchitis and chronic airway obstruc- arterio-alveolar carbon dioxide pressure difference. Divi- tion increased. Chronic airway obstruction without bron- sion of the urban pollution zones according to their SO2 chitis increased with age in mcn older than 49. It was and dust precipitate remains nevertheless a problem, uncommon in women, regardless of smoking habits. because the concentration of other noxious substances Exertional dyspnea was related to heart disease, increasing does not go hand in hand with the amount of dust precip- age, female sex. and smoking, but it correlated most itate and SO2 emission as can be shown, for example, in strongly with spirometric evidence of airway obstruction. case of the fluorine content of leaves. Information, in Wheezing was more common in male and female cigarette how far industrial air pollution altogether has a noxious smokers, and was more common in male ciga- effect on the bronchial system, is, however, to be gained rette smokers than in nonsmokers. In all studies with from the comparison between a rural population not which comparison was made, chronic bronchitis was exposed to industrial waste gases and the town population strongly associated with smoking, but significant inter- of the Ruhr-district. This comparison did not show any study variation in prevalence was found both among differences between town and country population which smokers and nonsmokers, so that other factors might be would let assume an orientated influence of unspecified of importance. More limited comparisons of the preva- airway diseases by air pollution inthe Ruhr-district. lence of chronic airway obstruction showed a consistent (Auth. Abs Mod.) relationship of this condition to smoking in men but not in women. (Auth. Abs.) 71-0281. Rivero-Serrano, 0., Ponce de Leon, H. M. Enfermedad Pulmonar Obstructiva Cronies. [Chronic 71 -0279. Rasmussen, D. L., Nelson, C. W. Respiratory Obstructive Pulmonary Disease.]Goceto Medico de Function in Southern Appalachian Coal Miners. Ameri- Mexico 100(9):889 -917, September 1970, Spanish. can Review of Respiratory Disease103(2):240 -248, February 1971. A comprehensive study of the medical advances, limitations, and the similarities and differences concerning The results of pulmonary function studies of 368 soft- chronic obstructive broncho-pulmonary diseases-- coal miners from the southern Appalachian coal fields chronic bronchitis, emphysema, and bronchial asthma-- showed no correlation between roentgenographic cate- is presented. The subject is reviewed with relation to gories of pneumoconiosis and the results of ventilatory incidence, residence, and etiological factors which are function tests. Impaired oxygen transfer was somewhat known to affect the diseases, such as air pollution, smok- greater in subjects with advanced pneumoconiosis (pro- ing, occupations, and infections. The pathology and gressive massive fibrosis), although equally severe impair- symptoms of the diseases and their respiratory and cardio- ment was found among many miners with simple vascular repercussions ate discussed, along with an analy- pneumoconiosis or less definite roentgenographic abnor- sis of what preventive measures, medical treatment, malities. Although cigarette smoking might contribute to physical therapyand rehabilitation, and surgery are applicable to them. 53 SO , NONNEOPLASTIC RESPIRATORY DISEASES

71 -0282. Sluis-Cremer, G. K. Allergic Diathesis in Rela- The distribution pattern shows an increase in the preva- tion to Chronic Bronchitis.South Africian Medical Jour. lence of persistent cough in chemical workers as com- nal44(47):1324-1329, November 21. 1970. pared with agricultural workers. A striking decrease in the prevalence rate of the recurrent exacerbating form of An investigation was undertaken into the incidence of bronchitis in chemical workers also deserves mention. The a personal or family history of certain allergic conditions unfavorable influence of smoking on the prevalence of in a random sample of males over the age of 35 years bronchitis seems to be equally pronounced in both miners and nonminers in a Witwatersrand mining town. groups. The incidence of chronic bronchitis, wheezing, change of chest symptoms with weather and chest illness was then established in the allergic and non-allergic groups for both 7 1-0285. Yamanaka, A. Pulmonary Emphysema in dust-exposed and non-dust-exposed persons. It was found Japan.Pathologiaet Aficrobiologia35(1/2):161-166. that these clinical phenomena were commoner in dust- 1970. exposed persons. In addition, thereis evidence that a personal history of an allergy parameter renders the The results of 489 autopsies to determine the presence person more liable to develop chronic bronchitis or other and degree of chronic pulmonary emphysema and aged chest conditions investigated. This is much less definite in lung are reported along with histological findings. A new the case of a history of allergy in a blood relation. This concept of pulmonary emphysematosis is introduced and difference was not accounted for by differences in smok- problems concerning age distribution, sex incidence, air ing habit. (Auth. Abs. Mod.) pollution, smoking and pulmonary cancer are briefly discussed. A distinctincrease of chronic emphysema among heavy smokers was found. 71-0283. Teculescu, D. B., Stanescu, D. C. Lung Diffusing Capacity. Normal Values in Male Smokers and Non- Smokers Using the Breath-Holding Techniques.Scandi- 7I-0286. Zivy, P., Fournier, E. Tabagismc, Emphysemc navian Journal of Respiratory Diseases5 1 (3): 137-149 , Bulleux et PneumOthorax Spontane (PSI) Idiopathique. 1970. [Tobaccoism, Bullous Emphysema and Spontaneous Idiopathic Pneumothorax.]Annales de Medecine In- Breath-holding measurements of lung diffusing capac- tense121(12):1049 -1056, December 1970, French. ity were carried out in 89 healthy males (42 smokers). Age, anthropometric, and spirographic values were similar Prolonged experimental inhalation of cigarette smoke in smokers and nonsmokers; the lung diffusing capacity. causes a chronic toxic tobacco lung with cortical emphy- lung permeability, and diffusion constant were signifi- sema. Tobacco lungs of heavy inhaling smokers usually cantly lower in smokers. A normal distribution of the present an evolutive bilateral bullous apicitis. The other diffusing capacity and diffusion constant was found. etiologic factors, vary from case to case, inhalation of Prediction equations were developed for DL (based on age smoke often being preponderant. The analysis of 61 cases and height or BSA), DLVA, and K (on age) for smokers of spontaneous idiopathic pneumothorax defines the role and nonsmokers separately. The causes of thedifference of inhalation smoking. It is discreet in the casts occurring between smokers and nonsmokers are discussed. (Auth. before the age of 26 years: there, it acts like classical Abs.) spontaneous pneumothorax of the young, whose etiology is dominated by congenital, endocrinometabolic condi- tions and by conditions linked with growth. Paralleling theincreaseincigarette consumption, spontaneous 71-0284. Ulrich, L., Malik, E. Chronic Bronchitis in Agri- pneumothorax is observed more frequently today in the cultural and Chemical Workers.Arhiv za Higi/enu Rada i 30 to 50 year age groups, than formerly resulting from Tokslkologiju21 (1):35. 47,1970. bullae, aggravated, if not caused, by inhalation smoking. This probably disturbs the lipidic- and surface-tension An epidemiological study of chronic bronchitis was alveolar functions, a conditioni intervening in the genesis made in a group of 1193 randomly sampled agricultural and development of the bullae. Smokers in which a spon- workers and 268 chemical workers in Bratislava. The prev- taneous idiopathic pneumothorax occurs, in comparison alence of bronchitis amounted to 19.8 percent in farmers with the others, present a higher ponderal deficit, usually and 31.7 percent in chemical workers. According to sex reversible after 25 years of age, after discontinuance of and smoking habit, the rate of bronchitis was, as ex- smoking. Like the lesions of tobacco lung when they pected, more than, three times higher in males than in assume an unusual importance, the condition can be the females, the relation of smokers to nonsmokers being the result of an immunological alveolar disorder linked with same. The residence factor (north, south) seemed to be a inhalation smoking. Toward the fifties, this precipitates much weaker influencing factor than sex and smoking emphysematous involution and can lead to severe respira- habit, but more pronounced differences were found in the toryinsufficiency.Inhalation smoking considerably distribution pattern of particular syndromes, such as aggravates the prognosis, especially functional, of respira- simple bronchitis and recurrent bronchitic exacerbations. tory diseases, particularly tuberculosis.

See also,71-0186, 71-0192, 71-0228, 71-0233, 71-0244, 71-0260, 71-0299

54 51 CARDIOVASCULAR.DISEASES

71-0287. Aron ow, W.S. The Effect of SmokingCigarettes on the Ap ex c ardiogram in Coronary Heart Dis- the same age groups were included in this prospective study. The disease was most prevalent in malesbetween ease. Chest 59(4):365-368, April 1971. 35 and 39 years of age. High serum cholesterol, smoking, occupational and emotional stress, caloric intake Twenty men smokers with coronary heart disease had greater than 2400 calories per day, a high animal fat intakeand apexcardiograms performed before and immediately,two, diabetes mellitus were the most important risk four, and six minutes after smoking factors in two high-nicotinc the development of coronary heart disease, while cigarettes, two low-nicotine cigarettes, andtwo non- a posi- nicotine !entice tive family history of coronary heart disease, cerebro- leaf cigarettes. The mean maximum vascular disease, hypertension, high saturated fat intake increase in A wave ratio above the base line level was 6 and a high cholesterol:lipid phosphorus ratiowere less percent after smoking the non-nicotine cigarettes, 13 important as risk factors. Type of occupation, percent after smoking the low-nicotine cigarettes, and 34 socio- economic status, overweightness and degree of physical percent after smoking the high-nicotine cigarettes. The activity were not considered to be important risk factors. mean A ratio was significantly increased immediately (Auth. Abs. Mod.) after smoking the non-nicotine cigarettes,immediately, two, and four minutes after smoking the low-nicotine cigarettes, and immediately, two, four, andsix minutes 71.0290. Berkson, D. M., Stamler, J., Lindberg, after smoking the high-nicotine cigarettes. Smoking H. A., ciga- Miller, W. A., Stevens, E. L., Soyugenc, R., Tokich, T. rettes increased myocardial ischemia, causing J., an increase Stamler, R. Heart Rate: An Important Risk Factorfor in left ventricular A wave, reflected bya larger A wave ratio in the apexcardiogram. (Auth. Abs.) Coronary Mortality Ten-Year Experience of the Peoples Gas Co. Epidemiologic Study (1958-68). In: Jones, R. J. (F.ditor). Atherosclerosis. Proceedings of the Second International Symposium. New York, Springer-Verlag, 71-0288. Ayres, S. M., Giannelli, S. (Jr.), Mueller,H. 1970, pp. 382.389. Myocardial and Systemic Responses to Carboxyhemo- globin. Annals of the New York Academy of Sciences In a 174 (Art. 1):268-293, October 5, 1970. ten-year perspective epidemiologic study of middle-aged men of the Peoples Gas, Light andCoke Measurements of Company of Chicago, testing heart rates of 80 andgreater alveolar-capillarygas exchange, were found to be associated with sizeable increases in risk systemic hemodynamics, and myocardial metabolism of dying over the next ten years from allcauses, including were made in a series of human and canine studies before all cardiovascular-renal diseases, and after the administration of amounts of either 5 coronary heart disease, or 0.1 and sudden death. These associations were independentof percent carbon monoxide, sufficient to raisecarboxy- coexistent diseases, ECG abnormalities, and othermajor hemoglobin (COHB) saturation to between 5and 25 coronaryriskfactors percent. Arterial and mixed venous oxygen tensions (hypercholesterolemia, hyper- were tension, cigarette smoking, overweight). A faster heart decreased by administration of either concentration,and rate is apparently an independent coronary risk factor. changes could be identified with COHB saturationsbelow (Auth. Abs. Mod.) 5 percent. Cardiac output and minuteventilationin- creased when COHB was elevated by breathingthe higher concentration. The coronary arteriovenous oxygen differ- 714291. Breysse, P. A., Boyce, H. H. Usc of Expired ence was uniformly decreased and coronary blood flow AirCarbon Monoxide for CarboxyhemoglobinDeter- increased when COHB was raised to between5 and 10 minations in Evaluating Carbon Monoxide Exposures percent saturation with either gas mixture in the human Resulting From the Operation of Gasoline ForkLift studies. Certain patients withcoronary artery disease developed altered Trucks in Holds of Ships. American Industrial Hygiene lactate and pyruvate metabolism Association Journal 30(5):477-483, September-October following eleAtion of COHB suggestingmyocardial 1969. hypoxia. Signi.:14ant myocardial changeswere seen in patients with elevation of COHB above 6 percent COHB. Exposures of longshoremen to carbon monoxide from Tie canine preparation, in contrast,was notably more fork lift trucks used in holds of ships were evaluatedby resistant to COHB, and significant alterationswere not use of the expired air method for determining carboxy- observed until COHB saturation exceeded 25 percent. hemoglobin. Results indicated that if the net increase in Studies showing similar myocardial and systemichemo- dynamic effects of carbon monoxide in cigarette carboxyhemoglobin was considered, then the hazards smokers potential of utilizing gasoline driven fork lifts in the holds are reviewed. (Auth. Abs. Mod.) would be considered of low order of magnitude. Moderate to heavy cigarette smoking was probably as importanta factor in individual carbon monoxide adsorptionas being 71-0289. Bahl, A. L., Basu, T. K., Chugh,R. N. Preco- exposed to CO at the Threshold Limit Value (TLV). cious Ischende Heart Disease. Evaluation ofDifferent (Auth. Abs.) Risk Factors. Indian Journal of MedicalSciences 24(11):722-728, November 1970. 71-0292. Dalderup, L. M., Van Haard, W. B.,Keller, This study was conducted to identify and evaluatethe G.H.M., Zwartz, J. A., Visser, W., Schouten, F., De Metz, various possible risk factors in precociouscoronary heart 1' H. Sugar Consumption, Physical Activity, Smoking,and disease. Fifty-seven patients below 40years with a diag- Serum Composition in Men. Voeding 32(l):4162, nosis of coronary heart disease and 50 healthysubjects in January 15, 1971.

52 CARDIOVASCULAR DISEASES

The results of this pilot study point strongly to physi- 71-0294. Gupta, R. S., Madan, B. R. Effect of Ganglion cal activity as the factor playing a key role in the blood Blocking Agents on Spontaneous and Adrenaline-Induced lipid concentrations, the blood coagulation and the fibri- Ventricular Ectopic Tachycardia Following Coronary nolysis time. Lack of physical activity in combination Occlusion. Indian Journal of Experimental Biology with a high score for smoking, and for alcohol consump- 8(3):198-200, July 1970. tion in combination with smoking, must be considered to be a dangerous combination with regard to the risk of Antiarrhythmic effects of tetraethylammonium myocardial infarction and thrombosis. Smoking increases (TEA), hexamethonium (C6). and nicotine have been the risk especially by a distinct inhibition of the blood studied in conscious dogs on the first and third post- fibrinolysis activity, but also by elevating a number of the operative days after a 2-stage ligation of the anterior blood lipid fractions. An advisable amount of physical descending branch of the left coronary artery. The dosage activity has been estimated roughly to be at least 25 Cal/ of nicotine. 50 micrograms/kg, is within the range system- kg body weight. This means spending about an equal atically absorbed as a result of cigarette smoke inhalation. amount of calories for various daily activities and sports TEA and C6 suppressedthe spontaneous ventricular as one's basal metabolic rate. The exceptions to this rule ectopic tachycardia on the1st post-operative day and within the group are found almost exclusively among the adrenaline-induced exaggerated ectopic response on the smokers. The dietary composition did not play a large 3rd postoperative day; nicotine aggravated these arrhyth- role in the variation of the blood lipid levels. Neither the mias. The possible mechanism underlying antiarrhythmic sugar, not the fat content of the diet was important. only action of TEA and C6 and arrhythmogenic effect of nico- the total carbohydrate content showed more or less dis- tine appears to be mediated through theft influence on tinct inverse relations with the blood lipid levels. There is calcium ion transfer across the cardiac cell membrane. an obvious need to study the activity of a number of (Auth. Abs. Mod.) enzyme systems in relation to physical activity and smok- ing. From comparisons with data from the literature it is also clear, that acute and chronic effects of a higher sugar 71-0295. Haust, M. D., More, R. H. Spontaneous Lesions consumption are to be studied separately; a simple extrap- of the Aorta in the Rabbit. In: Roberts, J. D. (Jr.). olation of acute to chronic effects is impossible. For Straus, R. (Editors). Comparative Atherosclerosis. The epidemiological studies on cardiovascular diseases and Morphology of Spontaneous and Induced Atherosclerotic abnormally high blood lipid levels, the estimation of the Lesions in Animals and its Relation to Human Disease. energy spent per kg of body weight is expected to be very New York, Harper and Row, 1965, pp. 255-275. useful. The conventiona8/ recognized spontaneous lesions of the rabbit aorta are not of an atherosclerotic variety, and 71-0293. Dawber, T. R., Thomas. H. E. (Jr.) Prevention there is general agreement that they resemble somewhat of Myocardial Infarction. Progress in Cardiovascular Dis- the changes seen in Monckeberg's medical sclerosis. The eases 13(4):343-360, January 1971. lesions reported by Ophuls and Nuzum et al. were not found by others, and there is some doubt whether they The possible methods of preventing myocardial infarc- were, indeed, spontaneous. Even if lesions described by tion are discussed. The desirability of prevention in the Ssolowjew and Bragdon were observed by other investi- total problem of myocardial infarction is stressed. The gators. they could hardly pass as typical of the atheroscle- methods consist of the prevention of the underlying rotic process. Ssolowjew describes finely dispersed fat in coronary atherosclerosis, and the secondary prevention of the intercellular substances of the vessel.Itis not un- myocardial ischemia contributed by other factors than common to find such fine fat deposition in perfectly those presumedtorelatetoatherosclerosis. Inthe normal human aortas. The lesions described by Bragdon, primary prevention of coronary atherosclerosis the two if present, are transient and seem not to go on to develop- major risk factors are elevation of scrum lipids and of ment into an atherosclerotic focus. It is difficult to assess blood pressure. The benefits to be achieved by reduction the significance of the lesion referred to above as "poly- of elevation of both of these abnormalities are discussed. poid" and interpreted by Lopes de Faria as a healing Both require a long-term approach starting as early in life dissecting aneurysm, though it is reminiscent of a human as possible. The major methods of prevention or retarda- atherosclerotic plaque. Itis also difficult to make any tion of coronary ischemia irrespective of coronary artery statements in reference to the finding of microthrombi. disease involve discontinuance of cigarette-smoking and a More dataill be necessary before any significance can be program of increased physical activity. In addition, pre- attached to these observations. It may be stated in con- vention or correction of polycythemia, anemia or hyper- clusion that no spontaneous atherosclerotic lesions are coagulability should be included. The use of oxygen, in found in the rabbit aorta. higher percentage orathigher pressure than in the atmosphere, surgical intervention to improve the myo- cardial blood supply and pharmacologic agents to improve 71-0296. Kandaswamy, S. An Analysis of Coronary myocardial metabolism are also considered. Quantitation Diseasein150 Cases of Chest Pain. Antiseptic of the benefit of preventive programs is still impossible. 67(12):936.940, December 1970. Benefit from lowering blood lipids and blood pressure requires long-term therapy begun early in life. Discontinu- The incidence of coronary disease in 150 patients with ance of cigarette smoking and increasing the amount of chest pain is analyzed with special reference to such im- physical activity offer reasonable assurance of immediate portant etiological factors as excessive smoking, physical benefit. So also does correction of hematologic abnormal- inactivity, heredity, obesity, hypertension, diabetes and ities.Pharmacologic agents and surgeryto improve excessive fat intake. coronary blood flowstillrequire further evaluation. (Auth. Abs.)

53 CARDIOVASCULAR DISEASES

71-0297. Kannel, W. B. The Framingham Study and chronic obstructive bronchitis, but therewas evidence of Chronic Disease Prevention.Hospital Practice 5(3):78-94, March 1970. a continuous spectrum of hypertrophy with minor degrees being present at the earlier stages of chronicbron- chitis. Strong associations were also demonstrated Some of the principal coronary heart disease (CHD) be- tween right ventricular hypertrophy and such pathological findings of the Framingham study are reviewed. The conditions as coal workers' pneumoconiosis and study showed that the risk of death rises post- as living habits tuberculous fibrosis. There was no association between become more sedentary, but risk of angina orcoronary right ventricular hypertrophy and the extent of emphy- insufficiency is unrelated to lack of physical activity. sema in the lungs; even at advanced grades of emphysema, Angina risk rises progressively with weight, but risk of no right ventricular hypertrophy was noted, unless acause nonfatal myocardial infarction does not. The number of other than emphysema were present. Therewas some cigarettes smoked daily, not duration of habit, raises the evidence that certain conditions, for example carcinoma risk of CHD. The contribution of cigarette smoking of the lung, asthma, bronchiectasis with middle-lobe appears to be independent of blood pressure, vital capac- syndrome, late effect of extensive thoracic injury, ity or serum cholesterol value. At any level of ex- these fac- tensive organized pulmonary thrombosis, etc.,may have tors, smokers have an excess risk of CHD. The effect is been partly associated with right ventricular hypertrophy. transient, reversible, and noncumulative and thosewho (Auth. Abs.) give up the habit can expect to revert promptlyto the nonsmoking low risk. Living habits apparently unrelated to excess CHD risk include moderate amounts of alcohol 71-0300. Pernod, 1. Frequence et Etiologic de la Maladic and coffee, marital status, and family size. Biologic fac- Coronarienne. [Incidence and Etiology of Coronary Dis- tors incriminated include a variety of scrum lipids, hyper- ease.] Cahiers de Medecine 11(16):1431-1437, tension, diabetes and ECG abnormalities. Diminishedvital December 30,1970, French. capacity, cigarette smoking and diabetescarry an excess risk of stroke, especially if there is cardiac enlargement. The various factors which can influence the incidence of coronary disease (sex, age, geographic distribution, heredity, diabetes, cholesterol and disturbances of lipid 71-0298. Kradjian, R., Bowles, L. T., Edwards, W. S.Pe- metabolism, obesity, gout and uricemia, physical activity, ripheral Arterial DiseaseinCeylon.Surgery 69(4):523.525, April 1971. nervous stress, and tobacco) have been reviewed. Select data from the FraminghamAlbany Study and other A total of 54 patients (51 men and 3 women) with studies illustrate the role of tobacco in increasing the risk of the disease. Despite some minor disagreementin one peripheralarterialocclusivediseasewere studiedin Ceylon. There was a much earlier statistic or another, there is no disagreement regarding the average age of onset and role of the more important risk factors. Thus, although a more distal localization of the occlusive lesions thanare there is a lack of knowledge concerning the etiology of usually seen in patients of North America. AU the men coronary atherosclerosis, one can define the factors for studied were heavy smokers, most smokingBeedi, an the utilization of preventive measures. inexpensive Indian cigarette. The pathological lesions examined were often atherosclerotic in the larger arteries but usually thrombotic more peripherally. This was unlike 71-0301. Rissanen, V. T. Occurrence of Coronary Occlu- thromboangiitis obliterans (Buerger's disease) inthat there were no episodes of superficial phlebitis. sion in Cases of Coronary Death and Accidental Recent Death. In: Halonen, P. 1., Louhija, A. (Editors). Throm- pathological studies suggest the possibility thatheavy bosis and Coronary Heart Disease. First PaavoNurmi smoking can cause an accelerated coagulativetendency Symposium, Porvoo, Finland, 1969.Advances in Cardi- with deposition of fibrin on arterial walls withincorpora- ology4:99 -111, 1970. tion of this fibrin to develop atheroscleroticplaques in larger arteries and thrombotic occlusion ofsmaller arte- ries. (Auth. Abs.) The prevalence of occlusive coronary artery disease and coronary thrombosis was studied incases of acciden- tal death and sudden cardiac death in males. An obvious increase with age in the extent of occlusivecoronary dis- 71-0299. Outhred, K. G., McKenzie, H. 1.,White, K. H. Some Findings on the Post-Mortem Association ease was established in accidental deaths. The difference of Right in degree of occlusive coronary disease between cardiac Ventricular Wall Thickness and Chronic ObstructiveBron- deaths and accidental deaths was significant when esti- chitis, Pneumoconiosis, Emphysema andTuberculo- mated on the basis of the occurrence of marked stenosis, sis.Medical Journal of Australia2(21):950-954, November 21,1970. total occlusion and thrombosis, and on the basis of the 'obstructive score' describing the occurrence of stenutic In a post-mortem series from New South or occlusive lesions in the coronary arterial tree. A differ- Wales coal ence, although less distinct, was also demonstrated in the miners, averaged measurements of rightventricular wall items mentioned between cardiac deaths with and thicknesses were made, the thickness of thenon-septal portion having been measured at five levels. without a previous history of coronary heart disease. The These data obstructive score and the prevalence of total occlusion were correlated against assessed grades of chronicbron- were higher in cases of cardiac death showing recent or chitis derived from measurements of theReid index and the wall-lumen ratio in the old myocardial infarcts as compared to cardiac deaths same subjects. These gradings without detectable infarcts. (Auth Abs.) correlated well with documentedante-mortem symptoms and signs and with bronchitis gradings basedthereon. Not only was pronounced rightventricular hypert:ophy invariably present in moderate and 71-0302. Samaggia, S., Sovcrini, A., Zincati, G. L'Abitu- severe grades of dine al Fumo di Sigaretta nei Colpiti da Infarto del

57 S4 OTHER DISEASES AND CONDITIONS

Miocardio. (Cigarette Smoking Habits in Subjects With when three or four factorswerepresent, the incidence Myocardial Infarction.]Cardiologia Pratica1 (Supple- rose considerably. An attempt torelate the incidence of ment): I 20-124 , 1967, Italian. three different manifestations of coronary heart disease (myocardial infarction, angina pectoris and newECG The cigarette smoking habits of 237 subjects with findings) to increased numbers of risk factors was unsuc- have myocardial infarction were studied. Cigarette smoking cessful since Inc three manifestations should not was noted to be a frequent habit in subjects with coro- been combined into a common group whenassociations nary heart disease and patients who contract:td the disease with different factors were examined, but studied sepa- at an early age were as a rule heavy smokers. Cigarette rately. smoking was concluded to play an important role in causing coronary heart disease. (Auth. Abs. Mod.) 71-0304. Ziegler, E. Die Beziehungen zwischenkardio- vaskularer Sterblichkeit and Zuckerkonsum inder 71-0303. Tibblin, G. Risk Factors in Coronary Heart Dis- Schweiz. (The Relationship BetweenCardiovascular Switzer- ease.In: Ilalonen, P. 1., Louhija, A. (Editors). Throm- Mortality and Sugar Consumption in bosis and Coronary Heart Disease. First Paavo Nurmi land.]Schweizerische Rundschau fur Medizin Symposium, Porvoo, Finland, 1969.Advances in Cardi- 60(10):298-303, March 9, 1971, German. ology4:123-130,1970. The relation between cardiovascular mortality and two Various risk factors in coronary heart disease, in- food factors, sugar and fat, were investigated in thelight cluding age, blood lipids, blood pressure, blood sugar, of Swiss statistics of the years 1900 to 1968. Thedevelop- serum uric acid, hematocrit, obesity, smoking and physi- ment of atherosclerosis mortality of this periodshows an cal activity, as well as interactions between these factors, obvious parallelism with that of the sugar climate (K30), were examined in a group of 834 urban Swedish men, all not, however, with that of the fat consumptionand the born in 1913. Blood lipids, blood pressure, smoking and smoking of cigarettes.Betweenthe ischemic heart disease low physical activity were the most important risk factors and cerebral atherosclerosis mortality and the sugar and in these men. However, one or two of these factors fat consumption from 1942 to 1968, there aresignificant seldom produced a case of myocardial infarction. But correlations. (Auth. Abs.)

See also,71-0206, 71-0234, 71-0244, 71-0338

OTHER DISEASES AND CONDITIONS

4.5 lb. in gain 71-0305. Beal, V. A. Nutritional Studies During Preg- weight gain, with a mean difference of only from one pregnancy to another. (Auth. Abs.) nancy.Journal of the American Dietetic Association 58(4):321-326, April 1971.

Datawereanalyzed for ninety -five pregnancies in fifty -four women as part of a longitudinal study of the 71-0306. Bynum, T. E., Ruoff, P. A., Richert, J., Wolf, S. children.The women The Smoke Reflex in Rabbits. An Example of Autonomic growth and development of their Conditional were white, middleclass, and primarilyof northern Control of Cardiorespitatory Function. European extraction. All infants were live single births. Reflex5(4):233-240,October-December1970. The records of five women who delivered prematurely showed no unusual patterns. The women were generally This study was undertaken to elucidate aspects of well nourished prior to and during pregnancy,although autonomic behavior as reflected in the "smoke reflex" in rabbits. Allowing smoke to envelop the nostrils of a rabbit there were wide individual variations. No significant cone- lations were found between maternal intake of calories, resulted in prompt apnea, bradycardia, diminution of carbohydrate, fat, protein, or calcium and the length or peripheral pulse and elevation of systemic blood pressure. weight of the infant at birth. A significant correlation was Atropine and vagotomy, or both, mitigated the brady- found between caloric intake in the second trimester and cardia, but the combined effect of propranolol and vagot- total weight gain during pregnancy. Birth length wassig- omy was requiredto abolish bradycardia. Phenoxy- nificantlycorrelated with maternal preconceptional benzamine (d iben zy line)alone blocked only the weight and with weight gain in the third trimester. peripheral vasoconstriction and pressor response. The Smaller correlations were found between birth weight and combination of vagotomy, propranolol and phenoxy- maternal weight and weight gain. Women who were benzamine blocked all manifestations of the reflex with heavier preconceptionally and women with largeweight the exception of apnea. A classical concept holds that gains during pregnancy tended to bear infants who were responses of the autonomic nervous system must be either both longer and heavier. Birth size was not related to distinctly ad re ne rgic (sympathetic) or cholinergic parity. Women who smoked gave birth to infantswith (parasympathetic), and that visceral regulation is achieved by an antagonism between the two. This study introduces lower mean birth weights than did nonsmokers, despite in certain higher average caloric intakes and no significant difference contrary evidence and demonstrates that a patterned response that in length of gestation. A study of repeated pregnanciesin adaptive behavior thereis the same women revealed a high positive correlationin includes activation of discrete elements of both 58 " OTHER DISEASES AND CONDITIONS

cholinergic and adrenergic divisions, as well as inhibition than those with distal polyps for subsequent procedures of one component of the latter. (Auth. Abs.) should efficiently increase the yield of benign adenoma- 71-0307. Chisholm, I. A., Bronte-Stewart, J., Awduche, tous polyps, at half cost of similar studies in an unselected population. (Auth. Abs.) E. 0. Colour Vision in Tobacco Amblyopia.Acta Oph- thalmologica 48(6):I145-1156, 1971.

A defect of color discrimination isa consistent feature 71-0311. Kowalski, C. J. Relationship Between Smoking of tobacco amblyopia. In the untreated conditionthe de- and Calculus Deposition. Journal of Dental Research fect takes the form of an irregular depressionof color 50(1):101-104, January-February 1971. discrimination in most regions of thespectrum. Poor The chi-square test for association in contingency color discrimination was found to be related directlyto ta- poor visual acuity and increased age. Sixty patientswere bles is often used to analyze data gathered duringthe treated with parenteral hydroxocobalamin andcontinued course of dental /oral experimentation. A simple proce- smoking. Five patients stopped smokingas their only dure that makes such analyses more useful is described, form of therapy. When the disease was associated with and the method is applied in a study of the relationship between smoking and calculus deposition in 568 pernicious anemia, the rate of visual improvementwas non- slower than that when diabeteswas the associated con- smokers, 1,798 smokers of more than 10 grainsper day dition. When there was no associated disease,the rate of and 3.324 smokers of less than 10 grainsper day. The visual improvement with hydroxocobalaminwas as good results showed that the chances of having no calculus, as that obtained when smoking was stopped. (Auth. Abs.) supragingival calculus and subgingival calculus did not dif- fer in the two groups of smokers. Calculusformation was influenced by the fact of smoking rather than the amount smoked. The probability of being calculus-free 71-0308. Ciuca, A., Sanda, M. Fattori Sociali Dennvecc- was greater hiamento. (Social Factors of Aging.)Medicine Societe for nonsmokers than for either group of smokers,whereas 20(4):101-104, April 1970, Italian. the probabilities of supragingival and subgingival calculus among nonsmokers were less than for the average smoker. The psychological and social factors (family,work, Subgingival calculus was affected less by no smokingor consumption of alcohol and tobacco, standardof living, heavy smoking than the two other categories,no calculus and supragingival calculus. mental stress) which accelerate agingare reviewed and the means for preventing the negative action of these factors are discussed. (Auth. Abs.) 71-0312. Phillips, C. I., A inley, R. G., Van Peborgh.P., Watson-Williams, E. J., Bottomley, A. C. VitaminB12 71-0309. Cohen, M. M., Debas, H. T., Holubitsky,I. B., Content of Aqueous Humor. (Letter)Nature Harrison, R. C. Effect of Nausea on Human Gastric Secre- 217(5123):67-68, January 6, 1968. tory Responses, Digestive Diseases I6(2):156-159,Feb- ruary 1971. The vitamin Bi2 content of the aqueous humor of the eye was determined in samples from 16 patients having cataract extraction in order to verify if abnormally low In three healthy young adults, cigarette smokingwas found to have no significant effecton the pentagastrin- values of vitamin B12 in the aqueous humor could be stimulated submaximal plateau of acidor pepsin secre- found in patients suffering from tobacco amblyopia. The tion. When smoking was accompanied bynausea, the out- mean aqueous concentrations of vitamin B12 were 20.2 put of both acid (P <0 .0025) and pepsin (P <0.025)was Wad for the smokers and 34.3 mind for thenon- significantly inhibited. The conclusionwas reached that smokers. These observations may be relevant in the eluci- dation of the pathogenesis of tobacco amblyopia. nausea is a potent inhibitor of the gastricsecretory re- sponse in man. (Auth. Abs.)

71-0313. Procianoy, G., Maulaz, P. B., Schlee, J. C. Influ- 71-0310. Drexler, J. Asymptomatic Polyps ofthe Colon ends do Fumo Durante a Gestacao Sobreo Recem- and Rectum. 111. Proximal and Distal PolypRelation- Nascido. Resultados e Conclusoes da Observacao Humana ships. Archives of Internal Medicine127(3):466-469, e da Experimentacao Animal. (Influence of Smoking Dur- March 1971. ing Pregnancy on the Neonate. Results andConclusions on Human Observations and Animal Experiments.) Pe. Four hundred and fifty-six distal polypswere detected diatria Pratica 41(7/8):259-268, 1970, Portuguese. in 160 (53 percent) of 300 patientsover 45 years of age examined by routine proctosigmoidoscopyafter July I, On the basis of an investigation amongpregnant 1965. Sixty-five percent of these lesionswere multiple, 97 women and an experimental work on pregnant rats, smok- ing was concluded to have a negative effect percent were 5 mm or less in size, and 75percent were on the weight, height and size of the newborn. There located in the middle third segment of therectocolon were no histopa- visualized. Sixteen proximal polypswere revealed in 8 thologic changes in the newborn of therats. (Auth. Abs. Mod.) (3.8 percent) of 211 patients examined byroentgenogram of the colon. Half of these lesionswere less than 1 cm in size. Higher up polyps were roentgenologicallydemon- strated in patients with distal polyps almost twiceas fre- 71-0314. Speer, F. Passenger Smoking Effectson Bus quently as in those with normal results of endoscopy.A Drivers. (Letter) Archives of Environmental Health significantly higher incidence of both distal and proximal 22(4):512, April 1971. polyps was found in cigarette smokers and ex-smokers as compared with nonsmokers. Selecting smokers rather This letter-to-the-editor, in re.gard topassenger smok- ing effects on bus drivers, reports thata questionnaire

59 $6 BEHAVIORAL AND EDUCATIONAL RESEARCH

the survey of 71 nonallergic, nonsmoking men found that 76 45-55 years of age. The IgG scrum concentrations and percent suffered from such symptoms as eye irritation, response of lymphocytes to PHA were significantly lower cough, wheezing and headache when exposed to tobacco in the smokers than in the nonsmokers. The number of leukocytes was significantly greater in the smokers than in smoke. the nonsmokers. (Auth. Abs. Mod.)

71-0315. Thompson, J. H., Angulo. M., Spezia, C. A. Rat Gastric Secretion and Mucosal Serotonin Following 71-0317. Weiss, W. How Smoking Affects Hearing. Medi- Chronic Oral Nicotine Ingestion. Research Communica- cal Times 98(1 I ):84-89, November 1970. tions in Chemical Pathology and Pharmacology l(6):721 -732, November 1970. The health maintenance examinations of a consecutive series of 97 older male executives were reviewed for Gastric secretion and gastric inucosal serotonin were evidence of a relationship between smoking habits and measured in the basal state and following atropine. in hearing loss in the pure tone audiogram. Heavy cigarette two-hour pylorus- ligated Sprague-Dawley male rats after smokers had a higher prevalence of hearing loss than non- two weeks of exposure to nicotine in drinking water. smokers and light smokers. The loss was limited to low Gastric secretion was increased by chronic exposure to frequencies, 250 and 500 cycles per second, and to a mild nicotine. Atrophic (100 micrograms/kg) reduced gastric degree of abnormality. These findings are consistent with secretion equallyin control and nicotine treated rats. the hypothesis that cigarette smoking is associated with a Gastric mucosal serotonin, expressed either in micro- conductive hearing defect, most likely due to involvement grams/g mucosa, or micrograms /tissue, was significantly of the eustachian tube. (Auth. Abs.) reduced by nicotine exposure. Itis suggested that the increase in gastric secretion is related to depletion of mucosal scrotonin. (Auth. Abs.) 7141318. Wilson, J., LhincU, J. C.. Matthews, D. M. Plasm a-Cobalamins in Neuro-Ophthalmological Dis- eases. Lancet l(7693):259.261, February 6. 1971. 71-0316. Vos-Brat, LC., Rumke, P. lmmunoglobuline Concentraties, PHA Reacties van Lymfocyten In Vitro en Plasma-cyanocobalamin levels were found to be signifi- Enke le Antistof Titers van Gezondc Rokers. ilmmuno- cantly raised in Lcbcr's hereditary optic atrophy, domi- globulin Concentrations, Hemagglutinin (PHA) Responses nantly inherited optic atrophy, tobacco amblyopia. and of Lymphocytes In Vitro and Some Antibody Levels in sporadic cases of optic atrophy. The mean total vitamin- Healthy Smokers.]Jaarboek Kankeronderzoek en B 1 2 concentration in the normal non - smoker group was Kankerbestrijding 19:49-53. 1969, Dutch. 465 pg per ml. and similar mean concentrations were found in all groups except patients with Lcbcr's disease The possible influence of smoking on the immune (nonsmokers) or with West Indian amblyopia (both non- state was investigated in 75 heavy smokers (15 or more smokers and smokers). The levels may be evidence of cigarettes per day for 20 years). These were compared inborn metabolic errors of cynaidc detoxication, varying with 50 nonsmokers. All were male office employees, clinically and geneticallyaccordingtothe particular enzyme involved. (Auth. Abs. Mod.)

See also, 71-0188, 710212, 71.0223, 71-0224, 714231, 710239, 710242, 71-0248, 710321, 71-0325

BEHAVIORAL AND EDUCATIONAL RESEARCH

71-0319. Anderson, J. P. Smoking in Postgraduate Medi- it should convey to the patient, the physician's conviction cal Centres. (Letter)British Medical Journal that smoking is hazardous. The values of antismoking 1(5748):558, March 6, 1971. clinics, the banning of smoking and sales of cigarettes in hospitals, and the nonsmoking physician arc discussed. Questionnaires sent to all known postgraduate medical centers in England and Wales in 1967 and again in 1969 show how many allow smoking in meetings and the low 71-0321. Bender, W., Go then, M., Malorny G., Sebbesse, priority accorded to reconsideration of their policies on P. Wirkungsbild niedriger Kohlenoxid-Konzentrationen smoking in meetings, during the 18 months between the beim Menschen. (Effects of Low Carbon Monoxide Con- two questionnaires. centrations in Man.]Archiv fur Toxikologie 27(2):142.158, 1971, German.

714320. Ball, K. Cigarette Smoking and the Responsibil- In experiments on healthy volunteers 19 to 34 years ity of the Hospital Physician. British Journal of Hospital of age seated quietly in a closed chamber of 1.5 m3 capac- Medicine 4(6):865-866, December 1970. ity continuously circulated with a mixture of air and CO, the uptake and psychological effects of carbon monoxide Hospital physicians have the responsibility to help during and after exposure were investigated. After 8 hours their patients stop smoking, to control smoking in hospi- of breathing 100 ppm CO, a concentration of 93 ppm was tals and to encourage the reduction of cigarette smoking measured in expiratory alveolar air, demonstrating that in the community. In helping their patients to quit smok- diffusion equilibrium in the organism had not yet been ing, each physician should develop his own technique, but attained. The highest concentration of CO-Hb measured

60 57 BEHAVIORAL AND EDUCATIONAL RESEARCH

under these experimental conditions was 11.6 percent. It The effect of nicotine and total alkaloidsextracted was calculated by applying the law of mass action that from smoke on the avoidance behavior of only within a limited range of CO concentrations is there rats under extinction procedure has been measured inan experiment an approximate linear relation between the CO concentra- extended over a period of three months. There tion in expired air and the CO-Hb content of blood. Any was no significant difference between the two substances,with conclusions as to the CO-lib content of blood drawn from both inhibiting the extinction of avoidance the known CO concentration of expired air assuming response to a approximately the same degree. Significance against the linear correlation between the two over a greater range of control was achieved with all treatments, the effect being concentrations are bound to be burdened with consider- significantly greater with the dose of 0.2 mg/kg than with able error, since in reality the relationship between the the two doses of 0.1 or 0.05 mg/kg. (Auth. Abs.) two quantities is an exponential one. On the basis oftests carried out on a random sample of 42 students, itcould be shown that carbon monoxide inspired in concentration 71-0325. Eastwood, M. R., Trevelyan, M. H. Smokingand of 100 ppm for 2 1/2 hours resulted ina statistically Neurotic Illness.Lancet1(7690):107408, January 16, significant diminution of visual perception, manualdex- 1971. terity, ability to learn and perform certain intellectual tasks. At this time, the measured CO concentration in During a health screening survey of 1471 middle-aged alveolar air was 55 ppm and the CO-Hb levelwas 7.2 individuals from a South-East London percent. Subjective symptoms were generally absent. group practice, each individual completed a questionnaire which included Smokers and nonsmokers showed no discernablediffer- ences in regards to their psychological susceptibility by items related to psychiatric state and smoking. The smok- ing habits of 124 individuals with confirmed psychiatric 100 ppm CO. The observed effects cannot be satisfacto- disorders were compared with those of a demographically rily explained, at least in our present state of knowledge, matched group which was free from psychiatric illness. on the basis of hypoxia alone. (A u th. Abs.) No significant differences were found between thetwo groups for the proportion who smoked, amount smoked 71-0322. Coe, R. M., Brehm, H. P. Smoking per day, or duration of smoking for either sex. There was Habits of no significant correlation between the amount smoked Physicians and Preventive Care Practices.HSMHA Health Reports86(3):217-221, March 1971. per day and psychiatric severity. This study therefore gives no support to the hypothesis that smoking habitsare related to neurotic illness. (Auth. Abs.) A nationwide sample of 1,591 general practitioners and internists was stratified by location of practice,year of graduation from medical school, andtype of practice, in order to study the influence their smoking 714326. Fodor, J. T., Glass, L. H. Curriculum Develop- habits had ment and Implementation of Smoking ResearchA Lon- on preventive care practices. Young physiciansmore often than older ones believed it was their responsibility gitudinal Study.Journal of School Health to set 41(4):199-202. April 1971. the example for patients by not smoking andthat talking with patients about smoking was valuable. About seven of During the four -year study, extensive clinical tests ten physicians claimed they routinely asked all patients if they smoked, while six of ten advised their patients were completed which indicated significant immediate who effects of cigarette smoking on healthy young males and smoked to stop. Younger physicians, especiallyinternists, and those with a strong orientation to preventive medi- females. In addition, subjects participating in the clinical phase of the project completed written questionnaires. cine, significantly more often inquired routinely about Significant differences between smokers and nonsmokers smoking or advised patients to stop. In general, physicians were observed in terms of knowledge, attitudes, and who smoked advised their patients less oftento stop smoking than did nonsmoking physicians. practices. An educational program which incorporated findings on the immediate effects of smokingwas devel- oped and implemented at the sixth grade level. Significant differences in knowledge were observed between experi- 71 -0323. Dilley, J. W. Smokingon Campus.Journal of mental and control groups. An educationalprogram also the American College Health Association19(4):230-234, April 1971. was developed for the eighth grade level. (Auth. Abs. Mod.) The smoking habits of 43,172 college students from 50 colleges and universities were studied.Data obtained with relation to sex, incidence, field of 71 -0327. Frith, C. D. The Effect of Varying the Nicotine study, social Content of Cigarettes on Human Smoking Behavior. environment, dosage, concern about harmful effects, Psy- and chopharmacologia19(2):188-192, January 20, 1971. cessation of smoking arc reported and comparedwith results from previous studies in similar areas. The respon- Nine subjects were given cigarettes to smoke contain- sibility of an educational institution with regardto the health habits of the college community is discussed. ing three different amounts of nicotine. Itwas found that the larger the content of nicotine in the cigarettes offered the smaller was the numbcr smoked during the eight-hour period. A linear relationship between nicotine 71-0324. Driscoll, P., Battig, K. The Effect of content Nicotine and time to smoke a single cigarette was found such and Total Alkaloids Extracted From CigaretteSmoke on that Avoidance Behavior in Rats Under Extinction Proce- the more nicotine there was in a cigarette, thelonger a tubject took to smoke it. (Auth. Abs.) dure.Psychopharmacologia18(3): 305 -3 13, November 24, 1970.

61 58 BEHAVIORAL AND EDUCATIONAL RESEARCH

71-0328. Frith, C. D. Smoking Behavior and Its Relation nervous unrest and over-activity of contemporaryinternal to the Smoker's Immediate Experience. British Journal uneasiness. Among the stimulating factors of tobacco of Social and Clinical Psychology 10(1):73-78, February smoking are the possibilities of using the hands, of suck- 1971. ing and playing with fire, and the fascination of the whole smoking ritual. Among the various methods of giving up The hypothesis that smoking behavior can be deter- smoking, psychotherapy is particularly important. It has mined by the smoker's characteristic level of arousal is been shown to be the most successful method and it can tested by means of a questionnaire in which situations be effectively supplemented by drug therapy, especially inducive of high and low arousal arc described. The with psychodrugs. Ninety-one heavy smokers were treated sample consisted of 59 men and 39 women aged between with Tofranil; most cases began treatment in a hospital. 18 and 50 and representing a wide range of occupations. Sixteen of them stopped smoking completely; in 41 the In general, it appeared that people had a greater desire to amount of smoking was reduced to less than 1/3 of the smoke in low-arousal situations. This is consistent with original consumption. (Auth. Abs. Mod.) nicotine acting as a stimulant. The finding that heavy smokers have a desire for a cigarette in any situation was not unexpected, but is of importance since this effect will 71-0331. Mitkov, V., Shekerova, N., Vasileva, D. Nevro- tend to disguise any differential patterns of smoking tieheskay aiNevrozopodobnaya Zabolevayemost' behavior that may exist. When the data were examined in Rabochikh i Sluzhashehikh Tabachnoy Promyshlennosti v more detail, evidence appeared for the existence of two G. Plovdive. [Neurotic and Neurotic-Like Morbidity in extremes of smoking behavior. The men tended to have Manual and White-Collar Workers in the Tobacco Industry the highest desire for a cigarette in situations inducing inPlovdiv.]Folia Medica(Plovdiv)11(6):397404, boredom and tiredness, while the women had their high- 1969, Russian. est desire in stress inducing situations. Detailed neurological and somatic investigations of 935 employees in the tobacco factories in Plovdiv, rep- 71-0329. Levitt, E. E. Reasons for Smoking and Not resenting 20 percent of the total number of employees, Smoking Given by School Children. Journal of School revealed that 43.85 percent of the persons investigated Health 41(2):101.105, February 1971. suffer from neuroses and neurotic-like conditions. The highest morbidity is found among the workers directly A questionnaire study was made of 51,507 Indianapo- engaged in the manufacture of the tobacco, followed by lis school children, grades 5 through 12, to determine the clerical and other employees of the auxiliary depart- their reasons for smoking or not smoking. Emotional im- ments. The percentage of morbidity is higher among provement and habituation given as reasons for smoking women (47.04 percent) than among men (25.71 percent) showed an increasing trend throughout the grades. Smok- and this difference is observed in all age groups. Regarding ing for pleasure declined slowly from a 5th grade high and factors such as age, general length of service, and length of rose again through the 12th grade. Peer influence asa' service in the manufacture of tobacco, the latter has the reason for smoking increased through the elementary more pronounced connection with the indicesof morbid- grades to an 8th grade peak and then declined to a 12th ity. Among the causesfor neurotic morbidity, the grade low.. To impress others, to -imitate adults and to patients attribute the greatest significance to domestic imitate siblings all slowly decreased from early to later factors. More than half (59 percent) of the neurotic and grades. Among the reasons for not smoking, health neurotic-likepatients have not sought medical help. demonstrated a high-low-high curvilinear trend across the (Auth. Abs. Mod.) grades, while not pleasurable, esthetic reasons, lack of desire, negative effect on performance, undesirable reac- tion from smoking, peer influence, and personal illness 71-0332. Modern Medicine. 34,627 Physicians Take Part increased from the low to high grades. Expensiveness and in Smoking Survey. Modern Medicine 38(26):47,49, the attitude that smoking is senseless behavior also in- December 28, 1970. creased over the grades. Parental influence and undesir- able effects slowly declined as nonsmoking factors over The third Modern Medicine smoking survey, based on the school years. One out of ten nonsmokers (15 percent responses from 34,627 physicians, reports a steady gain elementary and 2 percent high school children) reported over the past six years for those intent on alteringthe uses that they did not smoke because they were not old of tobacco products. Responses from two previous enough. Less than one percent of nonsmokers were surveys arc comparedstatistically with those of the deterred by school health classes or health warnings on present one indicating, for example, that there are more cigarette packs. However, 66 percent of nonsmokers were nonsmoking physicians and more altering their smoking deterred by health considerations. The results are com- habits away from cigarette smoking now than previously pared with those of similar studies. reported. Increased counseling efforts, more optimism regarding the physician's ability to dissuade patients from smoking, and a greater success rate are reported. Of the 71-0330. Luban-Plozza, B. Das Rauehen and die Moglich- prime techniques employed for changing the public's keiten der RaucherEntwohnung. [Smoking and the smoking habits, physicians rate educational programs Possibilities of Giving It Up.] Munchener Medizinische first, followed by smoking clinics and tobacco substitutes. Wochenschrift 112(51):2322-2327, December 18, 1970, German. 71-0333. Newman, I. M. Peer Pressure Hypothesis for Tobacco may be chewed and, in a powder form, Adolescent Cigarette Smoking. School Health Review snuffed, but cigarette smoking has become its most 1:15-18, April 1970. important form. It appears to correspond best to the

62 59 BEHAVIORAL AND EDUCATIONAL RESEARCH

The friendship patterns of 80 ninth grade students, 40 about 15 permit of those who have more than one ciga- smokers and 40 nonsmokers of both sexes, were exam- rette avoid becoming regular smokers. The matter is ined to determine conformity of smoking behavior within largely settled by the age of 20: if a person is each group. For both smokers and nonsmokers, a non- a signifi- smoker at this age, he is unlikely to take it up. Established cant relationship existed between smoking behavior and smoking is primarily maintained by dependence friendship choice. This tendency toward homogeneity on the was pharmacological effects of nicotine, which are predomi- most pronounced for female nonsmokers who were a nantly stimulant but may also be sedative. Eventually, mutually exclusive group in their friendship selections. when sonic of the ill effects of smoking on health These findings, usingindirect sociometric techniques, are confirm earlier findings using direct questions already being experienced, most smokers try to stop, but about only about 15 percent succeed before the age of 60. Ciga- friends' smoking behavior, and indicate, especially for rette smoking is clearly a habit that is easily acquired but female nonsmokers, that the degree of conformity within difficult to break. In the prevailing social climate, of those peer groups is even greater than originally realized. The who smoke more than a single cigarette during adoles- function of the peer group and the possibleuse of peer group pressure to support nonsmoking behavior cene, some 70 percent continue smoking for the next 40 are dis- years. (Auth. Abs.) cussed.

71-0337. Scharfenberg, G., Benndorf, S., Kempe, G., 71-P334. O'Rourke, A., Wilson-Davis, K. Smokingand School Chidren. Journal of the Royal College of W:nkelvoss, E. Ante und Rauchen. Ergebnisse einer General Practitioners 20(101):354.360, December Erhebung der Rauchergewoluiheiten und der Stellungzur 1970. Raucherentwohnung bei Arzten des Bezirkes Magdeburg. [Doctors and Smoking. Results of an Investigation of the A survey of the smoking habits of 4,502 Dublin school Smoking Habits and of the Attitudes on Smoking Detoxi- children is reported. Important factors suchas age at first fication of Doctors in the Magdeburg District.] smoke, parental influence as reflected by their Deutsche habits, G esundheitswesen 25(48):2296 -2300, November 26, their approval, and their knowledge, and thesignificance 1970, German. of social class are statistically analyzed. Otherfactors, including advertising, peer influence, and differencesin Via the Department of Health and Social Affairs at the habits according to sex are also discussed. An educational Council of the District of Magdeburg, the general medical health program developed by The Royal College of Gen- practitioners of this district were anonymously interro- eral Practitioners in which the general practioner plays a gated by means of a margin-punching card on their smok- direct role as an educator in the schoolsand in which ing habits and views on the health-injuring effect of smoking is treated within the concept of positive healthis described. tobacco smoking, on the methods hitherto applied with regard to the antinicotine campaign, on their personal engagement in smokers' abstention cures as wellas on their possible willingness to participate in the combating 71-0335. Panminerva Mcdica. Campaign Against Smoking of nicotine abuse. Four hundred and seventy-six physi- Promoted by the Ministry of Health, Panminerva Medica cians replied in an evaluative way. We recorded 12(12):474, December 1970. clear differences between smokers and nonsmokers,as to the manner of replying. These differences permit the assump- As part of its antismoking campaign, the Italian Health tion that smoking physicians appear to be somewhat Ministry has sent a circular to provincialdoctors asking inhibited and prejudiced with regard to their readinessto for their cooperation with education officialsin discour- aging smoking among school children. recognize the health-injuring effect of smoking andto cooperate in the field of smokers' abstention cures.

71-0336. Russell, M.A.H. Cigarette Smoking: Natural 71-0338. Thomas, C. B., Fargo, R., Enslein, K. Personal- History of a Dependence Disorder. British Journalof Medical Psychology 44(1):1-16, May 1971. ity Characteristics of Medical Students as Reflected by the Strong Vocational Interest Test With Special Refer- A case is made for regarding cigarette smoking ence to Smoking Habits. Johns Hopkins Medical Journal as a 127(6):323.335, December 1970. dependence disorderthatisstatisticallylinked with dependence on alcohol and other drugs. The dependence- producing potential of smoking is currently The Strong Vocational Interest Blank (SVIB)was greater than administered to 383 Johns Hopkins medical students in that of alcohol and barbiturates in thatmost smokers are dependent smokers, whereas a majority seven consecutive classes graduating in 1958-1964 to are able to use determine whether personality differences measured in alcohol and barbiturates intermittently and sensibly.It is only the exceptional two percent who smoke occasionally young adulthood would predict which subjects develop and intermittently who are truly non-dependent hypertension or coronary disease in later life. Various smokers. genetic, psycho-social and physiological characteristics Furthermore, dependence on smoking can no longer be were also recorded, smoking habits among them. The regarded as 'merely psychological% most cigarette smokers probably fulfill the criteria for physiological vocational interests of the medical studentswere found to dependence! generally resemble those of Strong's criterion on nicotine, namely tolerance and physical withdrawal group of physicians. In medical school, heavy smokers had signifi- effects. The onset of smoking is determined by the inter- action of social and psychological factors during cantly different SVIB scores from those of nonsmokers adoles- for a number of single occupational variables. A discrimi- cence. It takes no more than three or four casual ciga- nant function analysis showed a highly significant differ- rettes in this sensitive period virtually to ensure evolution ence between the heavy smoker and nonsmoker groups. to regular dependent smoking within a fewyears. Only The SVIB scores of light smokers resembled those of

63 60 TOBACCO ECONOMICS

nonsmokers more closely than those of heavy smokers. Of 81 women who graduated from medical school When single SVIB variables were compared, light smokers between 1948 and 1958, 69 were in active practice in shared some of the main occupational interests of the 1967. Over one-quarter had attained specialty certifica- heavy smokers, but had distinctive differences as well. tion: 21 percent held appointments as assistant professor Pipe smokers were significantly different from non- or above. In general, the women had good gradesin smokers in regard to another set of single occupational medical school (better than their male classmates). Nearly variables. Whentheircurrent smoking habits were 78 percent of these graduates had married. Marital status reported in 1968, less than a third of the original group of and familysize were closely related to career. Being heavy smokers were found to have stopped smoking. married, especially at an early age, is associated with a less Former students who had stopped smoking more closely successful career, as is having an increasing number of resembled nonsmokers in their vocational interests while children. The most successful women, the "professors" in medical school than did those who continued to group, were more likely to be single, to be regular ciga- smoke. rette smokers and to have lower scores on "habits of nervous tension" than their colleagues. In these two latter respects they were similar to their male colleagues in 71-0339. Wakefield, J. Advertising and Smoking.Inter- medical school. The specialty of pediatrics contained the national JournalofHealth Education8(3):118-122, largest proportion of nonsmoking women. 66.7 percent, 1970. and very few regular smokers, 16.7 percent. In other specialty groups, about 42 percent of the physicians were This paper presents a number of facts about expendi- regular smokers. For these women physicians, smoking ture on the advertising of tobacco products and what was not significantly correlated with nervous tension. changes there have been over the past six years in the Almost halfofthemarried women had physician- United Kingdom. This i3 followed by some information husbands. Those who married physicians had less conspic- on the trends in smoking behavior among men and uous careers and had more children than the average, women over the same period. The complex situation within each of the professional categories. The women which it brings out leads the author to ponder on the who were daughters of managers and proprietors had the many factors which affect health behavior and make it so best grades and the most prominent careers. Daughters of difficult to evaluate health education attempts. (Auth. physicians seemed to have low professional ambitions, Abs.) but, on the other hand, were most likely to be in practice. It is suggested that part of the reason women medical graduates do not realize their full potential in later careers 71-0340. Westling-Wikstrand, H., Monk, M. A., Thomas, lies in the views and practices of society and medical C. B. Some Characteristics Related to the Career Status of institutions. (A u th . Abs. Mod.) Women Physicians.Johns Hopkins Medical Journal 127(5):213-286, November 1970.

See also,71-0197,71-0314,71-0349

TOBACCO ECONOMICS

71-0341. Swomley, J. A. The Cigarette Epidemic.Con- advertising, efforts to control it and the broadcast and necticut Health Bulletin85(1):11-22, January 1971. tobacco industries' reaction to control are discussed along with the antismoking efforts of health agencies on radio Included in this general review is an array of statistics and TV and the increasing national effort to combat on the effects of smoking, who smokes cigarettes, ciga- smoking. Antismoking activitiesin Connecticut are rette uonsumption, the cigarette tax and its effect on emphasized. cigarette sales, and cigarettes and the economy. Cigarette

BILLS AND LEGISLATION

71 -0342. Egsmose, A. T. Prioriteringsproblemer og reviewed. It is known today that it has a definitely harm- Tobalcsrygning. (Priority Problems and Tobacco Smok- ful effect. Measured in deaths, lost working days, sick ing.]Ugeskrift for Laegerl32(37):1748 -1749, Septem- days, and disablement, the cost to society is considerable. ber 10, 1970, Danish. It would, therefore, be a rational move for our decision- makers to give a high priority to the control of this health Investment in the health sector, especially the hospi- hazard. It is suggested that 03 percent of the government tal-services, has grown to such an extent that increased tobacco duties, almost U.S. $1.5 million, should be interest in prophylactic measure: has now become a released for a control program which has been roughly necessity. In this context tobacco smoking has been outlined. (Auth. Abs.)

64 61 SMOKING CESSATION METHODS

71-0343. Roisman, A.Z. Nonsmokers Have Rights, to a clean and healthy environment. An attempt is made Too. Bulletin National Tuberculosis and Respiratory to explain how the tobacco industry, using massive adver- Disease Association 57(4):10-13, April 1971. tising campaigns and persuasive lobbyists. has brought about public acceptance of the right to smoke. Consumer The hypothesis that the so-called right to smoke is pressure groups are recommended as a means for non- equal if not superior to the right to be free from smoke is smokers to assscrt their rights. examined in terms of Constitutional rights and the right

See also, 71-0235

SMOKING CESSATION METHODS

71-0344. Fredrickson, D. T. The Primary Physicianin assessed by taking account of supplementary observa- Office Management of Smoking Problems.Chest 59(4):414-417, April 1971. tions, including a content analysis of the partners' conver- sations during meetings. The most plausible mediating fac- tor appears to be the increase in interpersonal attraction Smoking is viewed as a habit anda habit as behavior produced by daily contact, which makes for increased learned through systematic training. Becomingan ex- valuation of the clinic group and internalization of the smoker involves unlearning the smoking habitand norms conveyed by the consultant leader. (Auth. Abs.) replacing it with a newly learned habit, nonsmoking. Motivating the smoker to quit through personalrelevance and how the physician can help the smokerhasten the 71-0346. Lichtenstein. E. How to Quit Smoking. Psy. process of deciding to stop smoking are discussed. chology Today 4(8):42-45, January 1971.

A satiation method to aid the habitual smoker to quit 71-0345. Janis, I. L., Hoffman, D. Facilitating Effects of is described. The technique is based on aversive condi- Daily Contact Between Partners Who Makea Decision to tioning brought about by a combination of rapid smok- Cut Down on Smoking. Journal of Personalityand ing, at 6-second intervals, and smoke blown into the Social Psychology 17(l):25-35, January 1971. smoker's face from a machine. All but one of 58 hard- core smokers stopped smoking after treatment, and after This field experiment was conducted ina smoking clinic with 30 adults who volunteered six months, 34 of the 58 were still not smoking. Other to attend five types of cessation techniques are reviewed including over- weekly meetings with a consultant. Pairs of subjects were dosage, electric shock, behavior modification, positive assigned to one of three equivalent experimentalgroups: (a) high-contact partners, who social reinforcement, stimulus control, group therapy, were asked to phone each drama, and gradual reduction vs. "cold turkey" methods. other daily; (b) low-contact partners, whospoke with each other only at clinic meetings; (c) controls,who had a different partner at each meeting. At the last clinic ses- 71-0347. Luban-Plozza, B. Nicotine et Hygiene de Vie. sion, the high-contact partners showedmore positive [Nicotine and a Healthful Life.] effects than the other two Medecine et Hygiene groups on measures indicating 29(949):176-179, February 3, 1971, French. that they developed (a) more unfavorableattitudes toward smoking (p < .01), (b) more favorable attitudes Following some introductory remarks concerning the toward the clinic (p <.05) and toward the partner (p < absolute and relative harmful effects of smoking as well as .05). and (c) fewer withdrawal symptoms of anxiety after the psychological reasons for smoking at an early age, cutting down on smoking (p < .05). Follow-up a interviews distinctionis made among the nicotineaddicts, the indicated that during the subsequentyear the high- pleasure smokers, and the habitual smokers. The detoxifi- contact partners continued to smoke fewer cigarettes (p < cation methods distinguish treatment without medica- .01) than subjects in the other twogroups, almost all of tion making use of will power and psychotherapy among whom reverted to their former smoking habits. The high- other techniques. Medical therapy uses especially psycho- contact partners reported, however, that theyhad discon- tropic drugs or products containing Lobelin. A question- tinued contacting each other by 4 weeksafter the final naireis of help in investigating motivational factors. clinic session. Alternative explanatoryhypotheses are (Auth. Abs. Mod.) See also, 71-0337

65 62 GENERAL

71-0348. Barrett, H. S. Some Reminiscences Concerning without filter by 6.3 mm (from 19.3 to 25.6 mm). (Auth. the Contributions of the State Department of Health to Abs.) the Smoking and Health Problem. Connecticut Health Bulletin 85(1):5-10, January 1971. 71 -0351. Schurer, D. A New Time-Regulating Mechanism A brief historical commentary on the policies, pro- fora Pipe-Smoking Machine.Beitrage zurTabak- grams, committees, and activities of the StateDepartment forschung 5(5):229-230, November 1970. of Health and its concern with the smoking and health problem in Connecticut reviews the role a public health A pipe-smoking machine was constructed whichsimu- service plays in helping to identify, define, and warn lates pipe-smoking. A photo-electric cell and aperforated against the health hazards of cigarette smoking. endless belt were used for the time-regulation. The repro. ducibility of the puff and interval duration was fair;that of the crude and dry condensate of two typesof tobacco 71-0349. Marrone, R. L., Merksamer, M. A., Salzberg, P. smoked inthis machinerequires more investigation. M. A Short Duration Group Treatment of Smoking (Auth. Abs.) Behavior by Stimulus Saturation. Behavior Research and Therapy 8(4):34 7-35 2, November 1970. 71 -0352. Timm, J. Einige Trendanalysen zumProblem Deutsch- The effectiveness of short-duration stimulus saturation des Cigarettenrauchens in der Bundesrepublik of cigarette smoking was tested on 32 subjects who land fur die Jahn: 1961-1969. [Several TrendAnalyses wanted to quit smoking. Subjects chain-smoked for either on the Problem of CigaretteSmoking in the German 20 hours (group Et) or 10 hours (group E2). Total Federal Republic for 1961-1969.)Beitrage zur Tab abstinence was the main dependent measure. Both groups forschung 5(4):193.197, A ugust 1970, German. experienced relatively equal success on a short-term basis. Long-term abstinence was noted for group E1 only. Sixty On the basis of numerous research results and data on percent of the El subjects were not smoking four months the development of condensate contents ofGerman ciga. smoked length of after treatment. (Auth. Abs. Mod.) rettes, their share of the market, the cigarettes in laboratory tests as opposed to the average smoker, the per capita consumption of cigarettesin the 71-0350. Schulz, W., Seehofer, F. Uber die Lange von Federal Republic of Germany and the trendsof the smokers' share, an estimate has been prepared inthe Cigarettenstumineln in der Bundesrepublik Deutschland of im Jalure 1968. [Length of Cigarette Butts in the Federal Federal Republic on the yearly per capita consumption The 1968.3Beltrage zur Tabak- smoke condensates covering the years 196 1-1969. German Republic in the year forschung 5(4):198 -200, August 1970, German. value for 1961 amounts to 40.2 g, whereas for 1969, 31.9 g have been obtained. This meansthat the The length of the butts left by the smokers was ascer- consumption of cigarette condensates in theFederal approximately 40,000 cigarettebutts Republic has decreased during the last years. At anearly tained from that the con- gathered in 1968 in the whole of the Federal Republic of constant share of smokers it can be seen Germany and West Berlin. In comparison with an exami- sumption of smoke condensates per smoker had decreased by about 20 percent during the years between1961 and nation made in 1959, it could be seen that the length of (Auth. the butts of filter cigarettes increased by 8.5 mm (from 1969, despite an increased cigarette consumption. 22.1 to 30.6 mm) and the length of the butts of cigarettes Abs.)

See also, 71-0341

66 63 CHEMISTRY, PHARMACOLOGY ANDTOXICOLOGY

71-0353. Ankicr, S. I., Brit tain, R. T., Jack,D. Investiga- tion of Central Cholinergic Mechanisms 71-0355. Astrup, P., Kjeldsen, K., Wanstrup, 1. Effectsof in the Conscious Carbon Monoxide Exposure on the Arterial Walls. Mouse.British Journal of Pharmacology42( I ):127-136, In: May 1911. Coburn, R. F. (Editor). Biological Effects ofCarbon Monoxide.Annals of the New York Academy of Sciences 174(Art. l):294.300, October 5, 1970. An investigation of central cholinoceptorsinthe mouse has been made by injecting cholinomimetic dugs Published version of70-0305. into the cerebral ventricles and seeing howtheir effects were modified by prior administration ofatropine-like substances and other drugs. Carbacholor oxotremorine injected in small doses intracerebroventricularly 71-0356. Astrup, P.Intraery throcy tic2,3-Diphospho- into con- glycerate and Carbon Monoxide Exposure. scious mice caused hypothermia,gross tremor and a vari- In: Coburn, R. F. (Editor). Biological Effects of CarbonMonoxide. ety of parasympathomimetic effects includinglachryma- tion and salivation. Acetylcholine injected in Annals of the New York Academy of Sciencesl74(Art. this way was 1):252 -254, October 5, 1970. active only in much larger doses. Methacholineand pilo- carpine also caused a variety of parasympathomimetic A review of studies on the 2,3-diphosphoglycerate effects after inuacerebroventricular injectionbut virtually no hypothermia or tremor. Nicotine injected intracerebro- (2,3 DPG) content of red blood cells and itsrelation to CO exposure shows that exposure to CO ventricularly caused mild hypothermia,fine tremor but results in de- creased 2,3DPG content,in no parasympathomimetic effects.Atropine-like dittos, increasedhemoglobin affinity to oxygen, and in displacement of theoxyhemo- tricyclic antidepressants and amphetamineantagonized thehypothermia induced by globin dissociation curve to the left.Hypoxia increases intracerebroventrieular 2,3 DPG content,decreases hemoglobin carbachol or oxotremorine. The sites ofaction of the affinityto atropine-like drugs are in the brain; those of the oxygen, and displaces the oxyhemoglobin dissociation tricyclic curve to the right. Exposure to oxygen inhalations antidepressants and amphetamineare in the periphery or to high atmospheric pressure in a highpressure chamber has probably on heat generating p-adrenoceptormechanisms. It is concluded that the atropine sensitive the same effect as exposure to CO. Small changes in blood cholinoceptors pH can change 2,3DPG concentration. in the brain vary in their sensitivitiesto cholinomimetic drugs, other than acetylcholine, andmay exist in isorecep- tor forms. Peripheral atropine sensitive cholinoceptors may also exist in isoreceptor forms. (Auth. Abs.) 71-0357. Badakov, S., Ivancev, V. RecherchesExperi- mentales sur le Microclimat des Chtunbres deFermenta- tion du Tabac. I. Changements MorphologiquesDans les 71-0354. Appleton, R. A., Enzcll, C. Organes Intemes etle Systeme Nerveux des Lapins. R., Kimland, B. [Experimental Research on the Microclimate of Tobacco Chemistry. 3: UnsaturatedHydrocarbon Consti- Tobacco tuents of Greek Tobacco.Beitrage zur Tabakforschung Fermentation Chambers. I. Morphological Changes inthe 5(6):266.274, December 1970. Internal Organs and Nervous System of Rabbits.]Folia Medico(Plovdiv) 12(1):25-31, 1969, French. Tobacco from Series, Greece, has beenstudied with Morphologic changes originating in the internalorgans respect to the content of unsaturated hydrocarbons.The isolation of these constituents involved and the nervous systems of rabbits exposedto the action as a key step dis- of toxic substances extracted from the tillation with the aid of a new techniqueusing carbon fermentation of dioxide as carrier gas and total condensation tobacco were studied. The most significant dystrophic of this and and hemodynamic changes were observed in the distillate at liquid nitrogentemperature. In addition animals dur- to the main constituent, neophytadiene, the ing the acute experiment and in the laterphases of the unsaturated subacute experiment. Lesions of the central hydrocarbon fraction was shown to containa series of nervous aromatic compounds. These were examined system were found, particularly of the trunkregion, by means of cerebral cortex and the anterior layer of the spinal gas chromatography on capillary columns and alsoby gas cord. chromatography in combination with Peripheral nerves suffered various dystrophiclesions. The mass spectrometry. myelinic fibers were more seriously affected. In all Fractions were examined before and afterelimination of cases, smaller amounts of accompanying olefinic important changes were observed in the axial sheaths of material with the optic nerves. These morphologic changes the aid of osmium !dioxide. The aromaticconstituents resulted from the complex action of all the toxic substancesin were found to be alkylated benzene andnaphthalene derivatives, of which many have been which methyl alcohol and nicotine probablyplay a identified unambig primary role. uously. The vast majority of these havenot previously been encountered in tobacco. Severalhave, however, been detected in smoke and the present results therefore show 71-0358. Beard, R. R., Grandstaff. N. Carbon that these compounds arc not necessarilyformed solely in Monoxide the pyrolysis process. (Auth. Abs.) Exposure and Cerebral Function. In: Coburn, R. F. (Editor). Biological Effects of Carbon Monoxide. Annals

64 67 CHEMISTRY. PHARMACOLOGY AND TOXICOLOGY

of the New York Academy of SciencesI 74(Art. diethylamine, and me thylprOpylamine - - varied within 0:385-395, October 5, 1970. plant tissue and among Nicutinana spp. In burley tobacco the stein tissue had the highest content of these amines Various studies on the cerebral effects of small doses and the leaf midrib the lowest. Leaf latnina, roots and of carbon monoxide (CO) from air pollution and cigarette seed were intermediate in amine content. Among Nicu smoking as well as under laboratory conditions are re- tiara spp. there was considerable difference in total amine viewed. CO has been shown to significantly degrade audi- content as well as among the ratios of the amine fractions torysignaldiscrimination, brightness-difference measured. Amine content of tissue was positively ..orre- discrimination, time estimation and visual acuity. No lted with nitrogen content of tissue and was altered by demonstrable effects of CO on driving ability, critical the drying process of tissue prior to analysis. The amines flicker fusion frequency, oxygen transport or enzyme were not present as free amines or salts but weredetected systems have been reported. only following steam distillation from a basic medium. (Auth. Abs.)

71-0359. Brown, D. A., Halliwell, J. V., Scholfield. C. N. Uptake of Nicotine and Extracellular Space Markers by 71-0362. Cano, Catalin. L. Badre. R., Dumas. C.. Isolated Rat Ganglia in Relation to Receptor Activa- Viala, A., Guillerme. R. Determination de la Nicotine par tion.British Journal of Pharmacology 42( I ): 100-113, Chromatographie en Phase Gazeuse.II.Applications. May 1971. [Determination of Nicotine by Gas-Phase Chromatogra- phy. II. Applications. Armies Pharmaceutiques Fran. Results of an experiment using isolated rat ganglia wises 28(11):633-640. November 1970. French. incubated in nicotine solution indicate: nicotine is con- centrated in ganglion cells to a level far exceeding that in Nicotine was measured by gas-phase chromatography the extracellular fluid; the concentration in sympathetic in the air and in the urine of smokers and nonsmokers in ganglion cells exceeded that in nodose ganglion cells; and an enclosed but regenerated atmosphere in closedcircuit this difference reflects in part an i :,creased uptake of nico- and supplied with oxygen. The atmospheric concentration /m3. In tineinto sympathetic ganglioncells duringnicotine- of the alkaloid varied from 15 to 35 micrograms induced depolarization. There exists a relatively rapid smokers, urinary elimination (0.35 to 1.60 mg/24 h) concentrating process for nicotine in cells of the sympa- depended on the subject himself, the nature of the thetic ganglion. resulting in a substantial intracellular- tobacco and the presence or absence of a filter on the extracellular concentration gradient. This uptake process cigarette consumed, It appeared that the regeneration of has essentiallytwo components: (I)a component the air had a certain influence in the:absorption of the observed in the absence of depolarization by nicotine alkaloid. In nonsmokers exposed to the smoking atmo- which leads to a mean intracellular concentration about sphere, the urinary excretion of nicotine was from 22 to six times that in the extracellular fluid, and which may be 70 micrograms/24 h. These results show that the quantity termed the 'resting uptake'; and (2) an additional uptake of nicotine absorbed by nonsmokers is a function of the linked in some manner with the effect of nicotine upon amount of the alkaloid in the air and point out the impor- the receptors, serving to increase the overall intracellular tance of having air purification in smoking environments. concentration by a further 25 percent (and perhaps by considerably more in the responsive cells themselves). which may be designated 'activation uptake'. 71.0363. Casarett. L. J. Toxicology: The Respiratory Tract. Annual Review of Pharmacology 11:425-446. 1971. 71-0360. Bruni, A. Effect of Tobacco Smoke Poisoning on Phagocy tosis. Complete Englishtranslationof A detailed review of the research in pubnonary toxi- "Influenza dell'Avvelenamento da Fumo di Tabacco sulla cology is presented. Highlighted in this review are effects Fagocitosi", Sperimentale 85:523 - 543, 1931. of the pulmonary toxicant dose on human health, and the development of pulmonary dysfunction and progressive The defensive mechanism, phagocytosis, was studied pathologic change from inhaled toxicants. particularly the in medium-size rabbits subjected to tobacco-smoke poi- contribution of smoking to emphysema. Emphasis is given soning. The effects of both acute poisoning, where 4 or 5 to the influence of pollutant gases on susceptibility to cigarettes were smoked one after another, and chronic infection and the functional potency of the alveolar poisoning, where one cigarette was smoked daily over a macrophage, particularly carbon monoxide on alveolar period varying from 15 to 49 days, were investigated. cells, and to the noncellular components of lung tissues. Results showed that under both acute and chronic poison- Also discussed are early lung changes, the deposition and ing phagocytosis was considerably reduced; thatthe clearance of particles, the alveolar response, and the mix- content of substances with opsonk power in the blood tures of toxicants. especially particulate. in the atmo- scrum did not undergo modification; and that phagoey tic sphere. activity was adversely affected. In conclusion, the reduc- tion of phagocytosis was linked to the immediate effect of tobacco smoke on the leukocytes. 71-0364. Chan, E. W., Ball. J. K. Polycyclic Aromatic Hydrocarbons Covalent Binding to DNA and Effects on Template Function. Biochimica etBiophytica Acta 71-0361. Bush, L. Principal Alipathic Secondary Amines 238(1):46-49, April 29. 1971. of Burley Tobacco. Beitrage :ur Tabakforschung 5(6):275 -278, December 1970. Exposure of solutions of DNA containing intercalated molecules of benz(a)pyrene or pyrene to 7-irradiation Quantity and distribution of the principal aliphatic resulted in very extensive covalent binding of these hydro- secondary amines-- dimethylamine, methylethylamine, carbons to DNA. The ex tent of binding for benz(a)pyrene

68 65 CHEMISTRY, PHARMACOLOGY ANDTOXICOLOGY

was I molecule for every 100 DNA nucleotides andfor 71-0367. Debas, H. T., Cohen, M. M., Holubitsky,I. B., pyrene was 1:270 DNA nucleotides. It was also found Harrison, R. C. Effect of Cigarette Smoking that in vitro transcription was inhibited whenDNA con- on Human taining covalentty bound benz(a)pyrene Gastric Secretory Responses. Gut 12(2):93-96,February was used as 1971. template for Escherichia cod DNA dependent RNA poly- merase. (Auth. Abs.) The effect of smoking three cigarettesover a one-hour period on the pentagastrin-stimulated submaximalplateau 71-0365. Chopra, N. M., Domanski, of acid and pepsin secretion was observed in 12healthy I., Osborne, N. B. human volunteers comprising men and Systematic Studies on the Breakdown of p,p'-DDTin women and Tobacco Smokes.Be itrage zur Tabakforschung smokers and nonsmokers. No significant overall changein 5(4):167-174, August 1970. secretion was observed. In one subject, however, acid secretion was significantly inhibited (P <0.01) andin one The report deals with the isolation and individual significant late stimulation (P < 0.01)of both identification acid and pepsin was observed. (Auth. Abs.) of the degradation products of the pyrolysisof DDT in a nitrogen atmosphere and the pyrolytic degradationof DDT intimately mixed with tobacco. The formation of 71-0368. Dinman, B. D., Eaton, J. W., Brewer, G. TDE, bis(p-chloropheny °methane, methylchloride and J. dichlorostilbenes indicates that hydrogenation Effects of Carbon Monoxide on DPG Concentrationsin is one of the Erythrocyte. the most important reactions taking place In: Coburn, R. F. (Editor). Biological in the smoking Effects of Carbon Monoxide. Annals of the New of tobacco, presumably in the burningzone. The forma- York tion of dichlorocarbene and uichloromethyl Academy of Sciences 174(Art. 1):246-251, October 5, radicals 1970. suggests that these are some of the primary alkylating agents in tobacco smoke and that methyl chlorideis really a secondary alkylating agent. Both humans and rats were exposed to varyingdoses of carbon monoxide (CO) to determine its effectson 71-0366. Coburn, R. F. (Editor) Biological 2,3 -diphosphoglycerate (DPG) concentrations inthe Effects of erythrocyte. Results showed that changes in DPG levels Carbon Monoxide. Annals of the NewYork Academy of Sciences 174(Art. 1):1-430, October 5, 1970. were inversely related to peak carboxyhemoglobincon- centrations. Possible mechanisms which couldaccount for These conference papers point out that although the increased DPG levels found in both humans andrats the exposed to the lower CO doses are discussed. world CO production is increasing andnow totals approx- imately 175 million tons peryear, "background" CO concentrations (in the troposphere and in air above 71-0369. Dogon, 1. L., Amdur, B. H., Bell, K. remote areas in the Pacific Ocean) are apparentlynot in- Observa- creasing. Ocean CO concentrations tions on the Diurnal Variation of Some InorganicCon- seem to be much stituents of Human Parotid Saliva greater than expected from consideration of CO solubility in Smokers and and air CO concentrations and it is Non - Smokers. Archives of Oral Biology 16(1):95-105, now thought that the January 1971. oceans may be the largest natural source of CO. Motor vehicle exhaust contributes about 70percent of CO pro- duced from all sources. Measurements of Stimulated parotid secretion (5-ml volumes)was col- blood carboxy- lected by means of a modified Carlson-Crittenden hemoglobin (COHb) percent saturation showthat signifi- device cant numbers of people have blood COHb levels from 25 healthy subjects (18-45 yr of age)at 4 hr inter- which vals over a 24-hr period. By uniform stimulation, the exceed levels that have been associated withCO toxicity flow in acute experiments on man and animals. rates of each subject were kept within 0.2 ml/min/gland There is con- for the 6 collections ranging from 0.42-0.56 ml/min/ vincing evidence that acute absorption of COgiving COHb gland. The subjects were divided into 13 smokersand 12 levels as low as 3 to 5 percent saturationmay cause a nonsmokers. Ca, Mg, Na, K, SCN- and CIwere determined subtle effect on the CNS. The negative findingsreported by others who have studied effects of on each sample. The thiocyanate concentrationswere an equivalent CO significantly higher in smokers than nonsmokers exposure on mental performance are apparently relatedto (p < differences in the testing situation. Two studies 0.001), decreasing in both groups during thesleeping support hours (p = 0.02). Chloride concentrations the concept that CO toxicity is dueto binding with hemo- were similar in smokers and nonsmokers, but increased during globin and a resultant decrease inoxygen tension in pe- sleeping ripheral capillaries and tissues. However, hours (p = 0.05). Calcium was markedly lower insmokers other studies (p = 0.001) but showed no diurnal variation. offer evidence that CO bindingto nonhemoglobin hemo- Potassium protein is a mechanism of CO toxicity in increased in the smoking compared to the nonsmoking man. Both man group, but it also showed no diurnal variation. Magnesium and animals can adapt to CO effectsthrough such mechanisms as erythropoiesis. A 2,3-diphosphoglycerate- showed no statistically significant change withsmoking status or time. Sodium concentrationswere not signifi- mediated shift in the oxyhemoglobin dissociationcurve appears not to be a major mechanism of adaptation cantly affected by smoking status, but showeda tendency to CO to increase during sleep. The nicotine action explains the hypoxia. Endogenous CO productioncauses an increase in the body CO stores sufficient difference between smokers' and nonsmokers'potassium to elevate blood COHb to salivary levels. The diurnal patterns are probably levels of about 4 percent saturation inpatients with rapid related rates of hemoglobin turnover. The same hemoproteins to metabolic variation. (Auth. Abs. Mod.) which bind body CO appear to beprecursors of endo- genous CO. 71-0370. Donzelli, F. Effect of Tobacco Smoke Poisoning on Agglutinins.Complete Englishtranslationof 69

66 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

"Influenza sulk Agglutinine delrAvvelenamento da Funto studied. The quantitative evaluation of the values ob- di Tobacco",Giontale di Batteriologia e Immunologia tained is only possible with all reserve as the method 11:1012 -1018, 1933. contains a large number of sources of errors. No correla- tion between the alkylating activity and biological activity The experiments showed that acute poisoning from (determined by mouse skin painting) of the different tobacco smoke in immunized animals results in a lowering smoke condensates and fractions of smoke condensate of the agglutinating titer of the blood serum. This lower- could be found. It appeared remarkable that an alkylating ing was only transient and within 24 to 48 hours the activity could be found in the vapor phase condensate of agglutinating power. returned to its original titer. The smoke. (Auth. Abs. Mod.) maximum reduction was usually reached within 6 hours afterthe poisoning, and appeared most markedly in animals which were chronically poisoned with tobacco 71.0374.Ehnenhorst.IL,Rolle. W. Zigarettenrauch- smoke. During immunization, the animals poisoned with kondensate fur Tierversuche. 1. Herstellung and routine- tobacco smoke produced the agglutinating antitoxins with massige Kontrolle. [Cigarette Smoke Condensates for remarkable delay, and at the end of the immunization Animal Tests. 1. Preparation and Routine Control.)In: period, the titer of the agglutinating power of their serum Weber. K. H. (Editor).Zur Methodik der Untersuchung was decidedly lower titan that of the controls. von Rauchkondensaten int Tierversuch.Hamburg. Wizen- sehaftliche Forschungsstelle im Verband der Cigaretten, industrie. 1969, pp. 57-60, German. 71-0371. DuBois, A. 13. Establishment of "Threshold" CO ExposureLevels.In: Coburn, R. F. (Editor). Biological A method for the preparation of cigarette smoke Effects of Carbon Monoxide.Annals of the New York condensate for animal experiments is described. Cigarette Academy of Sciences174(Art. 1):425-428, October 5. smoke is precipitated in cold traps at 80° C. The con- 1970. densate is dissolved in acetone and the obtained solution is evaporated under reduced pressure. The residue is dis- This paper discusses carbon monoxide (CO) levels solved in acetone according to the wanted concentration already established for special groups for limited duration, of condensate solution and can ue applied to the skin of how CO levels to be proposed for continuous exposure of mice by dropper. Condensate solutions prepared by the the population at large must differ from those presently described method contain a substantial portion of the existing for exposure of special groups, whether a thresh- semi-volatiles of cigarette smoke. (Auth. Abs.) old exists for CO exposure, and steps remaining to be taken toward establishing air quality standards for CO. 71-0375. Elmenhorst. F1., Fluke, Zigarettenrauch- kondensate fur Tierversuche. 2. Ein neues, schonendes 71-0372. Elmenhorst, H., Frahm, 13. Fluoreszenzmes- Herstellungsverfahren, bei dem fluchtige lnhaltsstoffe des sungen an Zigarettenrauchkondensaten. [Measurement of Rauches in der Losung erhalten bleiben. [Cigarette Smoke Fluorescene in Cigarette Smoke Condensate.)In: Weber, Condensates for Animal Tests. 2. A New Practical Method K. H. (Editor). Zur Methodik der Untersuchung eon of Preparation to Preserve the Volatile Components of the Rauchkondensaten in:Tierversuch.Hamburg, Wis.sen- Smoke in the Solution.)In: Weber. K. II. (Editor). Zur schaftliche Forschungsstelle im Verband der Cigaretten- Methodik der Untersuchung von Rauchkondensaten im industrie, 1969, pp. 72-76, German. Tierversuch.Hamburg. Wissensehaftliche Forschungsstelle im Verband der Cigaretten'mdustrie, 1969, pp. 61-65, The total fluorescence of cigarette smoke condensate German. from 13 different cigarettes was investigated to study the possible correlation between the total fluorescence and A method of preparing solutions of cigarette smoke the biological activity of the different smoke condensates. condensate is described. The method allows the preserva- No unequivocal correlation could be found. Miller and tion of volatile components of smoke in the solution. The Leonard found that the reduction of biological activity in smoke is precipitated in a cold trap at 80°Cand is smoke condensate, due to the addition of sodium nitrate dissolved with acetone at low temperatures. The maxi to cigarette tobacco, corresponded to a reduction of mum con tentration of the solutions is between 40 and50 fluorescence in condensates. The results show that the percent of dry condensate. The newprocedureis of correlation found by Miller and Leonard cannot be advantage compared withthe previouslyemployed generalized. (Auth. Abs. Mod.) method of evaporating and resolving the smoke conden- sate. Changes in the composition of condensates. occur- ring possibly by high temperatures during evaporation, are 71-0373. Elmenhotst, H., Harke, Uber die alkyl- prevented. Volatile substances distilling over together ierende Wirkung des Zigarettenrauches. [The Alkylating with solvents and water vapors are preserved. Secondary Effect of Cigarette Smoke.)In: Weber, K. H. (Editor). reactions by increased temperature during distillation, the Zur Methodik der Untersuchung von Rauchkondensaten consequences of which cannot be approximately esti- im Tierversuch.Ilamburg, Wissenschaftliche Forschungs- mated yet, are likely to be prevented by the new method. stelle im Verband der Cigarettenindustrie,1969, pp. (Auth. Abs.) 77-84, German. The method for the quantitative estimation of the 71 -0376. Frcour,P.,Coudray,P.,Fontan, M.E.C. alkylating activity of cigarette smoke condensate as used Approche Pour une Lune Contre!Intoxication Taba- by Stedman and Miller was tested. The alkylating activity gique. Donnees Epidemiologiques suetin Groupe of cigarette smoke condensate, some fractions of smoke d'Adultes des Deux Sexes. [An Approach for the Fight condensate, and the so-called vapor phase condensate by Against Tobacco Poisoning. Epidemiologic Data on a conversion through 4-(4-nitrobenzyl)pyridine were Group of Adults of Both Sexes.)Bulletin de l'Academie

70 67 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

Nationde de Medecine I54(24):633-649. October 13, 71-0378. Guertzenstein, P. G. Stimulation by Nicotine of 1970, French. a Vasodilator Area on the Floor of the Fourth Ventri- cle. Journal of Physiology 214(11:5P-6P. April 1971. This study was undertaken to determine the impor- tance of the tobacco consumption phenomena in a large Nicotine, in doses of 5 to 20 micrograms, applied to city. In Bordeaux. France, the smoking habits of 2490 the vasodilater area on the floor of the fourth ventricle in adults (30-70 years old) were investigated from 1963 to anesthetized cats produced a fall in arterial blood pres- 1967. Results indicated that 1099 men (83.2 percent) sure. The response was not greatly augmented during were smokers of which 90.3 percent smoked only ciga- occlusion of the common carotids, was not abolished by rettes and 59.4 percent inhaled. When compared with intravenous atropine. and was obtained only when the other countries, French smokers were average with only nicotine was applied on to or just below the surface of the 30 percent smoking more than a pack a day. However, the floor of the ventricle. Results showed that the nicotine total quantity of cigarettes smoked by each subject during acted on the nerve cells and, therefore, suggested a relay his lifetime was relatively important since more than 40 station in the depressor reflex arc of the afferent fibers of percent of the smokers smoked more than 150.000 ciga- the vagus and or sinus nerves near the obex close to the rettes which is the equivalent of 20 cigarettes a day for a surface of the fourth ventricle. period of 20 to 40 years. Forty-five percent of the smokers indulged for more than 30 years. Although 80 percent started smoking before 21 years of age, the study 71-0379. Hanks, T. G. Human Performance of a Psycho- of smoking relativeto age showed statisticallythat motor Test as a Function of Exposure to Carbon Monox- tobacco consumption was quite light in the beginning and ide.In: Coburn, R. F. (Editor). Biological Effects of again after 60 years of age. Cessation occurred in 290 Carbon Monoxide. Annals of the New York Academy of (26.9 percent) at varying ages after a variable period of Sciences I 74 (A rt. I ):421-424, October 5, 1970. consumption. Finally, military service intervened in 60 percent of the cases either as a star tiag factor or as an Psychomotor control function and carbon monoxide aggravating factor. (CO) were investigated under conditions of human ex- posure to low levels of CO. Nonsmoking, healthy young male college students were exposed to levels of 0, 25, 50. 71-0377. Goldsmith. J. R. Contribution of Motor Vehicle 75 and 100 ppm of CO on each of two series of runs. Exhaust, Industry, and Cigarette Smoking to Community Breath samples were measured for CO content before and Carbon Monoxide Exposures.In: Coburn, R. F. (Edi- at half-hourintervalsfor 41/2 hours during exposure. tor). Biological Effects of Carbon Monoxide. Annals of immediately following psychomotor testing. No effect on the New York Academy of Sciences 174(Ar I. 1 ) :122-134, performance of the psychomotor control was found at- October 5,1970. tributable to CO exposure. Exposure to carbon monoxide (CO) in cigarette smok- ing, in connection with certain occupations, in house- 71-0380. Harke, H.-P., Schuller, D., Drews, C.-J. Ziga- holds, particularly from heating and cooking, and in the rettenrauchkondensate fur Tierversuche.3.Unter- general community where motor vehicle exhaust is the suchungen der flunchtigen Inhaltsstoffe der Rauch - primary source is examined with respect to the propor- kondensatlosungen.[Cigarette Smoke Condensate for tion of people affected, the magnitude of short- and long- Animal Tests. 3. Investigations of the Volatile Compo- term exposure in relation to the possibility of illness, and nents of Solutions of Smoke Condensates.]In: Weber, the time-course of exposure in relation to the possible K. H. (Editor). Zur Methodik der Untersuchung von hazards. Depending on age and sex, cigarette smoking RauchkondensateninnTierversuch. Hamburg, Wissen- affects from 40 to 60 percent of all adults. COexposure schaftliche Forschungsstelle im Verband der Cigaretten- in cigarette smoke can produce up to 15 percent carboxy- industrie, 1969, pp. 66-71, German. hemoglobin (COHb). The time course is inherently inter- mittent. Within smoking categories there is an apparent Investigations by gas chromatography and mass spec- decrease in COHb with age. Pipe and cigar smokers in the trometry reveal that tobacco smoke solutions, used for U.S. have much less exposure to CO than cigarette biological experiments, contain considerable parts of the smokers. The usual effect of occupational exposure to CO volatile components of smoke condensate if the pro- causes increases of less than 10 percent COHb. The usual cedure of evaporation was avoided during preparation. pattern of work permits a substantial recovery if the work These substances are almost completely lost if so-called is intermittent. At least 750,000 people probably have dry condensate is used for the preparation of the solu- occasional occupational exposure to CO. In nouschold tions. (Auth. Abs.) exposure to CO, the subject is usally unaware of the risk, the exposure can range from less than 2 percent toan amount sufficient to cause death, the exposure is often 71-0381. Haynes, J. L.. Glauser, S. C. Comments on over a number of hours, and the exposure is inadequately Glauser Et Al's Article. (Letter) Archives of Environ- evaluated. Tens of millions of people are exposed to mental Health 22(3):409. March 1971. motor vehicle exhaust resulting in COHb levels of less than 2 percent, but exceptional circumstances could lead A study by Glauser et al entitled "Metabolic Changes to acute illness. The time course is unpredictable and Associated With the Cessation of Cigarette Smoking" is largely depends on meteorological conditions, but ex- criticized for not showing a definitive association between posures are generally elevated over periods of several the onset of statistically significant metabolic changes hours sufficient enough to produce an appreciable COHb because of the lack of dietary controls. Many of the rise. metabolic changes may have been affected by abrupt

71 68 CHEMISTRY. PHARMACOLOGY AND TOXICOLOGY

changes in dietary habits which often accompany cessa- demonstrated between oxidant and mortality. (Auth. tion of smoking. Clauses replys that he had only intended Abs.) his study to determine whether metabolic changes oc- curred upon cessation of smoking and thatit seems unlikely that the observedchangeswould allbe due 71-0385. Hoffmann. D., Mazzola. V. ChemicalStudies on Cigarcite simply to a change in dietary habits. Tobacco Smoke. Xl. Dibenzofurans in Smoke.Beitragezur Tahakforschung5(4):183.188, August 1970. 71-0382. Henderson. E. G., Hancock. J. C. Nicotine- Induced Depolarization and Stimulation of Potassium A method was des eloped for the isolation ofdibenzo- Efflux in Striated Muscle.Journal of Pharmacology and furan (DBE) and its four methyl derivatives fromcigarette Experimental Therapeutics177(2):377-388, May 1971. smoke. The mainstream smoke of an 85-mm U.S. non- filter cigarette contained 106 ng of dibenzofuran, 40 ng The influence of nicotine on potassium (42K) ex- of 1-methyldibenzoluran. 100 ng of 2- and 3-methyl changein denervated frog sartorius and nit extensor dibenzofurans. and 52 rig of 4-methyldibenzofuran. The digitorum fungus muscles was examined. Nicotine identification of DBE and its four methyl derivatives in (0.005-0.2 mM) did not alter the uptake of 4 2 K in any of cigarette smoke represents theirfirst isolation from a the muscles tested. Efflux was significantly increased dur- respiratory environment. ing the first one to five minutes of nicotine exposure and returned to normal monotonically within an hour in both types of denervated muscle as well as the innervated frog 71-0386. Holland, R.A.B. Reaction Rates of Carbon sartorius muscle. After removal of nicotine, there was a Monoxide and Hemoglobin.in: Coburn. R. E. (Editor). long period (>1.0 hour) during which42K efflux was Biological Effects of Carbon Monoxide.Annals of the decreased 20 to 50 percent below control values. The New York Academy of Sciences174(Art. I):154-171, time course of 42 K efflux stimulation paralleled the time October 5. 1970. course of muscle cell membrane deplorization. Both the nicotine-induced depolarization and stimulation of 42K Equations are given for carbon monoxide's reactions efflux were blocked byprioradministrationof d- with reduced hemoglobin, for its replacement of oxygen tubocurarine and, therefore, were probably initiated by from oxyhemoglobin, andforitsdissociation from an interaction of nicotine with chemo-sensitive sites on carboxyhemoglobin. The relationshipof thekinetic the muscle cells. The decreased rate of 42K efflux after constants to the equilibrium conditionsis discussed. nicotine removal was not blocked when d- tubocurarine Values are given for the rate constants for the various was added immediately after exposure to nicotine. Con- reactions of carbon monoxide with hemoglobin in a duction in sartorius muscle cells was not blocked by low number of mammalian species, and new figures for the concentrations ofnicotine (<0.06 m61) andactitNi velocity constant of the dissociation of carbon monoxide potentials recorded during the peak of depolarization from saturated hemoglobinarepresented. The question of were followed by a "late positive aftespotential" oflong whether hemoglobin is functionally a tetramer or a dimes duration (>150 msec). The magnitude of the late positive is briefly discussed. (Auth. Abs. Mod.) afterpotential was increased by reducing the potassium concentration of the bathing medium. (Auth. Abs.) 71-0387. Jenkins, R. W. (Jr.), Newman, R. IL, Carpenter, R. D., Osdene, T. S. Cigarette Smoke FormationStudies, 71-0383. Hengy, H.. Thirion, J. The Determination of 1. Distribution and Mainstream Products FromAdded Malathion Residues in Tobacco and Tobacco Smoke Con- "C-Dotriacontane-16,17.Beitrage zur Tabakforschung densate.Beitrage :ur Tabakforschung5(4),175-178, 5(6):295 -298, December 1970. August 1970. The distribution of 14C-dotriacontane-I6,17 and its A method was developed to determine Malathion in combustion and pyrolytic products in cigarette smoke is tobacco and in smoke condensate at levels of 0.05 ppm described. Twenty-one percent of the activity is found in and above. A study on the Malathion content of leaf the mainstream smoke, 49 percent is found in theside- tobacco, cigarette tobacco, and the transfer rate from stream smoke, and 30 percent is found in the butt. Of the cigarettes into the main-stream smoke was made. The mainstream activity, 95 percent is in unchanged dotri- analysis revealed that the air-cured tobacco contained 0.1 contanc. The transfer of "C-dotriacontane to main- ppm of the pesticide, white the flue-cured samples and stream smoke is linear throughout the smoking of the cigarettes contained less than 0,05 ppm. The transfer cigarette, as shown by puff-by-puff data, Hypotheses to studies indicated that approximately 91 to 92 percent of explain the results are presented. (Auth. Abs.) Malathion is lost during the smoking of cigarettes. (Auth. Abs.) 71 -0388. Jenkins, R. W. (Jr.). Newman, R. H., Chavis. M. K. Cigarette Smoke Formation Studies, II. Smoke Distri- 71 -0384. Hester, A. C Goldsmith, J. R. Carbon Monox- bution and Mainstream Pyrolytic Composition of Added ide:Association of Community Air Pollution With I 4C- Menthol (U).Beitrage zur Tabakforschung Mortality.Science172(3980):265.267, April 16, 1971. 5(6):299-301, December 1970.

Regression analysis of daily mortality in Los Angeles The distribution of 14C- menthol (U) and its combus- County shows thatthereisa significant association tion and pyrolytic products in cigarette smoke is des- between community carbon monoxide concentrations cribed. The mainstream smoke contains 28.9 percent of and mortality. Cyclic variation and maximum temper- the total activity with 44.3 percent in the sidestream ature were the main contributors. No association was smoke and26.9percentinthebutt. The major

72 69 CHEMISTRY. PHARMACOLOGY ANDTOXICOLOGY

"C-menthol smoke product in themainstream smoke is in humans and about 2.2 in sheep, dogs andrabbits. The unchanged menthol (98.9 percent). A puff-by-puffplot of placental exchange of CO is limited by diffusion.and the menthol delivery is presented. The results obtainedare exchange rate is useful in quantitating explained hypothetically. (Auth. Abs.) placental respira- tory function. The placental CO diffusing capacityis about 0.54 ml/ (min X mm Hg X kg fetalwt) for sheep and dogs. The half time for placental exchange 71-0389. Keeri-Szanto, M., Pomeroy. J. R. is about Atmospheric two hours. About 60 percent of the resistanceto diffu- Pollution and Pentazocine Metabolism.Lancet sionis by the placental membrane, whereas 1(77061:947-949. May 8. 1971. about 20 percent of the resistance is due to the maternal andfetal Study of the use of pentazocine for the intracellular chemical reaction rates. In the reportedcases supplementa- of carbon monoxide poisoning. (COHb)F tion of nitrous-oxide relaxant anesthesia in forty-one was a function of (COHb)m and the duration of placentalexchange of patients revealedthata significant correlationexists CO. Among the infants surviving maternal COpoisoning. between high drug requirements and urbanliving as well all but one showed either neurologicalor pathological as smoking. The excess drug requirement resided in the evidence of brain damage. Smoking during need for higher maintenance doses rather than pregnancy in different results in average levels of ( COHb)M of 2.0-8.3 priming doses for the subgroups. Changes in percent. the rate of Mean ( COHb)F varies from 2.4-7.6 pentazocine disposal have been tentatively linked percent. Maternal with smoking has been reported to be associatedwith de- ambient or self-induced atmospheric pollution,and it is creased infant weight, increased number ofabortions. suggested that similar differences are likelyto occur with stillbirths, and deaths during the neonatal andpostneo- other drugs and in other therapeutic settings.(Auth. Abs.) natal periods. Although these may result fromexcessive exposure of the fetus to CO, they may also result from decreased maternal food intake, effect of nicotine 71-0390. Lowther, P. 3.. Commins, B. T. Cigarette or Smok- other factors in tobacco smoke on the uteroplacentalcir- ing and Exposure to Carbon Monoxide.In: Coburn, R. culation or fetus, or some as yet unrecognizedfactor in F. (Editor). Biologcal Effects of CarbonMonoxide. smoking or in the mother who smokes. Animalstudies Annals of theNew York Academy of Sciences174(Art. l):135-147, October 5. 1970. suggest that CO per se is not the sole etiologic agent causing these effects. Some theoretical considerationsof the effects of COHb on fetal oxygenation A brici review is made of efforts to are presented. assess the relative Elevated COHb is associated with: contributions of air pollution and cigarette smoking a shift to the left of to the oxyhemoglobin saturationcurve with a decrease in blood carboxyhemoglobin (COHb) levels. Results ofCO sampling of London air showed consistent CO Pso: the lowering of P0 2 in the venous blood draining concentra- fetal tissues. and an increased ratio of carboxymyoglobin tions over an 18-month period which increased with time to COHb in myocardium and skeletal muscle. Finally, it is during the working daY, reachinga peak around 6 pm, not possible at present to separate the effects of COper se and which were in rough agreement withthose reported from hypoxia on the fetus. There is ample evidencethat for other large cities. Field surveys of COHblevels in both the decreased availability of 02 resulting fromelevations smokers and nonsmokers under variousconditions of of COHb is probably injurious to fetal exposure to city pollution showed that smoking had tissues. To what a extent CO per se is harmful remains to be determined. greater effect on C011b levels than street pollution.A (Auth. Abs. Mod.) study demonstrating that CO could belost from the blood in smokers and in subjects experimentallygassed with CO despite exposure to traffic is briefly described. 71.0392. Lunn, J. N. Smoking.Midwires Chronicle 84:59, February 1971. 71-0391. Longo, L. D. Carbon Monoxide in the Pregnant Experiments in which cigarettes and pipeswere artifi- Mother and Fetus and Its Exchange Acrossthe Pla- cially smoked in various concentrations centa.In: Coburn, R. F. (Editor). Biological Effects of of trichloro- ethylene showed no breakdown into . Carbon Monoxide. Therefore, Annals of the New York Academy of smoking prohibitions for women receiving Sciences174(Art. 1):313-341, October 5, 1970. trichloro- ethylene analgesia for delivery for 24 hoursfollowing delivery are not justified. The carboxyhemoglobin concentration in theblood of normal nonsmoking pregnant women ( COHb)M is slightly increased over that of nonpregnant women. The steady 71.0393. Markiewicz, K. Biemi Palacze. 0 Szkodliwosci state (COHb),j is a function not only of the endogenous Biernie Wdychanego Dymu z Papierosow PalonychPrzez CO production of the mother, the concentrationof CO in bmych. (Passive Smoking. Harmfulness of PassiveInhala- inspired air, the alveolar ventilation and thepulmonary tion or Smoke From Cigarettes Smoked by Others.]Pot- CO diffusing capacity, but also of theendogenous CO ski Tygodnik Lekarski production of the fetus and the 25(52):2041-2042, December 28. rate of CO exchange 1970, Polish. across the placenta. Endogenous production of CO is about 0.92 (± 0.11) ml/hr duringpregnancy. as compared The deleterious effect of the smokeron passive with 0.62 (± 0.06) ml/hr during the progestationalphase smokers is of the menstrual cycle and 0.32 (± 0.04) briefly discussed. The nonsmoker inthe ml/hr during the presence of cigarette smokers, especially in closed estrogenic phase. The COHb in humanfetal blood spaces (COHb)F isalso a or those that are not too well ventilated, is forcedto function of the above factors. inhale all kinds of compounds and materials. The (COHb)p/(C011b)misdependent upon the relative cigarette affinities of maternal and fetal blood for 02 ejects particles between 0.2 and 2 microns in sizewhich and the rela- are inhaled. Inside the cigarette, temperatures of 700° tive affinities of both bloods for COas compared with 02. to 1050 °C are reached and under insufficient admittanceof During the steady state, (COHb)p/(COHb)mis about 1.1 air, carbon monoxide is created. This is easilyascertained

73 70 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY by a determination of the carboxyhemoglobin in the exposure was blocked by iodoacetate treatment.The CO tolerance of the newly hatched chick appears to bedepen- blood of the nonsmoker. The smoke from 20 cigarettes, require- either smoked by one person consecutively or by several dent in part on the ability to reduce its energy persons simultaneously creates 300 to 500 mgnicotine in ments through a reduction in metabolismand to provide anaerobic a closed space. This is 6 to 10 times thelethal dose. Most for its reduced energy requirements through of the nicotine is burned, but the air in a closed space glycolysis. (Auth. Abs.) after a period of occupancy by smokers contains between 3 and 5.3 mg nicotine/m3. The effect of the smoker upon the nonsmoker becomes especially bad in restaurants, as 71-0397. Meszaros, J. The Effect of Somerholinomi- there the nonsmoker flushes down the compounds into metic Drugs on Presynaptic Inhibition in theLateral the intestinal tract with the saliva. Geniculate Nucleus. Neuropharmacology10(1):67-76, January 1971.

71-0394. Martin, J. C., Becker, R. F. The Effects of Nico- The effects of nicotine, physostigmine and pilocarpine optic tract terminals, tineAdministration In Utero Upon Activity in the on the excitability of intrageniculate Rat. Psychonomic Science 19(1):59.60,1970. amplitude of orthodromic lateral geniculate responses and the presynaptic inhibition evoked in the lateralgeniculate Holtzman male rat offspring whose mothers were in- nucleus by stimulation of the reticular formation orthe jected twice daily throughout gestation with 3.0 mg/kg visual cortex werestudied. Nicotine decreasedor nicotine differed little from saline-injected control off- abolished the presynaptic inhibition, with a simultaneous spring on activity measures in the wheel. Offspring whose increase in the resting excitability of presynaptic optic mothers were injected with the same dose of nicotine tractterminals.Similareffects were observedafter throughout gestation and the nursing period and offspring physostigmine. Pilocarpine did not have any significant whose mothers received a four percent hypoxic episode effect on the presynap tic inhibition or on theresting throughout gestation were significantly more active than excitability of optic tract fibers. The results were inter- the control saline group. Differences were more extreme preted as indicating that N-cholincrgic mechanisms take during the second week of testing than during the first. part in the presynaptic inhibitory activityof the lateral (Auth. Abs.) geniculate nucleus. (Auth. Abs.)

71-0395. McFarland, R. A. The Effects of Exposure to 71-0398. Mikulka, P.,O'Donnell, R.,Heinig,P., Small Quantities of Carbon Monoxide on Vision.In: Theodore. J. The Effect of Carbon Monoxide on Human Coburn, R. F. (Editor). Biological Effects of Carbon Performance.In: Coburn. R. F. (Editor). Biological Monoxide. Annals of the New York Academy of Sciences Effects of Carbon Monoxide. Annals of the NewYork 174(Art. 0:301-312, October 5,1970. Academy of Sciences I74(Art. 0:409-420, October 5, 1970. Results of experiments on theeffects of small amounts of CO on visual !reception are reviewed and Ten nonsmoking, male students were used as subjects related to the effects oft and altitude on vision. The to determine the effects of CO onrelatively simple visual functions tested were visual acuity at low levels of applied performancetasks. Time estimating ability, illumination, dark adaptation, differentialbrightness psychomotortracking performance, and ataxia were sensitivity, and critical flicker fusion. Results show that measured. Results showed that exposure to a CO-level of visual perception is impeded with increased altitude (i.e., 125 ppm produced no effect on time estimation, no decreasing amounts of 02 inhaled), age, and increased decrement in tracking performance. and no effect on the amounts of carboxyhemoglobin in the blood. Italso abilities measured by the ataxia battery. showed that CO aggravated the effects of altitude and that the detrimental effects of CO on visual function lags behind the elimination of CO from the blood. 71-0399. National Research Council. Division of Medical Sciences. Committee on Effects of Atmospheric Contami- nants on Human Health and Welfare. Effectsof Chronic 71-0396. McGrath, J. J., Jaeger, J. Effect of lodoacetate Exposure to Lcw Levels of Carbon Monoxide on Human on the Carbon Monoxide Tolerance of theChick- Respir- Health, Behavior, and Performance. National Academy ation Physiology 12(1):71-76, April 1971. of SciencesNational Academy of Engineering, Washing- ton, D.C., 1969, 66 pp. Chicks 0-3 weeks old were exposed to1 percent carbon monoxide (CO) in air in a metabolic chamber at The importance of CO in the ambient air liesprinci- 35°C. Survival time as a function of age was determined pally in its ability to combine with hemoglobin (Hb). The and is defined as that period of exposure at which 50 portion of Hb present in the form of carboxyhemoglobin percent of the animals lived. Body temperatures were (COHb) cannot combine with oxygen or carry oxygen monitored throughout the experiment by means of a from the lungs to body tissues Although otherferro- rectal probe and an electric thermometer. Newly hatched proteins can combine with CO at very high partial pres- birds were more resistant to CO and lived in excess of 30 suresof CO, such reactions play no role in theeffects of minutes. Survival times decreased rapidly with age and low-level CO exposures on man. The CO-Hb reaction is reached 4 minutes by day 8, an age associated with the reversible, so that reduced CO exposure will eventually onset of homeothermy in chicks. There was alinear rela- make Hb available for oxygen tansport. A normal person tionship between survival time and decrease in rectal breathing air devoid of CO has about 0.4 percent COHb in temperature. The youngest birds underwent the greatest his blood. The amount by which the COHb concentration decrease in rectal temperature in response to CO and sur- increases above this background level depends on the vived the longest. The increased initial tolerance to CO ambient CO level and on whether a steady state has been

71 CHEMISTRY. PHARM ACOLOGY AND TOXICOLOGY

reached, which can take 12 hours or more. Tests have in the isolated spontaneously beating right atrium of shown that COHb levels as low as two the percent above the guinea pig. Intracellularly recorded action potentials from background level can significantly impair mental perform- these cells showed that the actions of MeN A-343 ance. probably through CO interference with oxygen were similar to those of acetylecholine. The negativechrono- delivery to brain tissue. No CO threshold has been found. tropic effect of MeN A -341 was prevented by but its existence has not been ruled out. Man atropine can adapt to but was not modified by hexamethoniumor nicotine. increased CO levels in the ambient air, at the cost of some Tetrudotusin, in concentrations sufficient to block im- reserve capacity for oxygenation, through such mechan- pulse conduction in vagal neurons. did notoppose the isms as increased 1lb concentration in the blood, increased cardiac slowing produced by MeN A-343. suggesting cardiac output, possibly increased capillary blood that volume. the latter agent was acting at a site distal to vagal and perhapsslightly ganglion increased volume of pulmonary cells. Nicotine-induced depression of pacemaker activity ventilation. The consequences of low levels of CO would was similarly unaffected by tetrodotoxin although itwas probably be accentuated when there is less than normal prevented by :AM A-343. In addition, nicotine retained oxygen in alveolar air, as in emphysema: when there is its sympathomimetic activity in the tissue hypoxia of a fetus because of limited blood flow presence of tetro- to dotoxin and restored action potentials to hearts poisoned the placenta: and when there is tissue hypoxia ofother by this agent. probably by release of catecholaminesfrom organs with limited blood flow, such as the digits in intracardiac nerve terminals. (Auth. Abs.) peripheral vascular disease or the myocardium incoronary vascular disease. Evidence from epidemiologicstudies indicates a slight increase in mortality among myocardial 71-0402. Rathkamp, G.. Hoffmann. D. Chemical infarct patients if the ambient CO level is sustained Studies above on Tobacco Smoke. )U11. Inhibition of the Pyrosyntheses 10 ppm. Exposures to increased CO concentrations for of Several Selective Smoke Constituents. Beitrage short periods (I-2 hours) are innocuous unless :ur or until the Tabakforschung 5(0:302-306. December 1970. cumulative effect is such that the blood COHb levelhas been raised appreciably. From 4 to 6 hoursare required Earlierstudies demonstrated to get halfway to a new plateau of blood COHb after that polynuclear aro- a matic hydrocarbons (PAH) are selectively reducedin the change in ambient CO concentration. It is the COHblevel, smoke of alkali nitrate rich tobaccos. It ratherthanthe CO concentration was hypothesized. breathedat any therefore, that in the burning cone of a tobacco product. moment, that counts. One-pack-a-day smokers have blood the non-volatilized organic compounds COHb levels of approximately 5 percent. Theoretically arepartially pyrolyzed to CH-radicals that may combine witheach the CO in cigarette smoke could, independently ofother other and form, among others, the thermodynamically smoke constituents, produce some adverse health effects. favored PAH. Since there is in the burningcone of nitrate rich tobaccos an excess of thermically activatednitrogen oxides. it was assumed that thesemay react as scavengers 71-0400. O'Donnell, R. D., Alikulka, P.,Ileinig,P.. for CH-radicals and, with it. partially inhibit thePAH Theodore. 1. Low Level Carbon Monoxide Exposureand pyrusynthesis. This study was designed to challengethe Human Psychomotor Performance. Toxicologyand above working hypothesis. For the experiments cigarettes Applied Pharmacology l8(3):593 -602, March 1971. were used to which were added various amounts of KNO3 (0. 2.5, 5.0, 7.0, and 8.0 percent). As expected, the yields The effects of 5 concentrations of carbon monoxide of nitromethane, nitroethane. and nitrobenzenein the exposure on time estimation, tracking, and ataxiawere studied in 10 humans. The tracking task required smoke increased with the increase of nitrate inthe to- the bacco and the yields of phenanthrene. benz(a)anthracene, subjects to keep a needle display dial from going off scale and benzo(a)pyrene decreased. The concentrationof by manipulating a control stick. Levels of COused were naphthalene was only to a minor degree reduced withthe 0,c0,125, 200. and 250 ppm, yieldingmean car- increase of nitrates in the tobacco. One explanationfor boxyhemoglobin levels from 0.96 to 12.37percent in a this observation could be that naphthalenes 3-hr exposure. No significant symptoms are primarily were reported by formed from specific tobaco terpenes, the subjects, and no ability to detect the as suggested in the presence of CO literature. As was expected, the smoke yields of N-unsub- was noted. No overall trend toward poorer estimates of a stituted and Ahalkylated indolcs were relatively 10-sec interval occurred as a function of CO uptake, little and affected by the increase in the nitrate tracking performance did not deteriorate content, since these over the course agents are predominantly formed from tryptophan. of the exposures to CO. There wasa suggestion that sub- jects inhaling CO showed a different overallpattern of tracking performance over time than control subjects.It is concluded 71-0403. Ray. A. M., Rockwell. T. H. An Exploratory that the present data do notsupport the Study of Automobile Driving Performance Under hypothesis that low level carbon monoxide the In- exposure of fluenceof LowLevels of Carboxyhemoglobin. In: humans resultsin performance decrement. Additional Coburn, R. I'. investig.ation is required to define the lower limit (Editor). Biological Effects of Carbon and Monoxide. Annals of the New York Academy of Sciences extent of such exposure and to resolve conflicting views on this issue. (Auth. Abs.) 174(Art. 1):396-408. October 5, 1970.

Three nonsmoking, male subjects were studied ina live highway environment to observe the changes in driving 71-0401. Pappano, A. 1., Rembish, R. A. Negative Chro performance rlicited by COHb blood levels of 20percent notropic Effects of McN A-343 sad Nicotine in Isolated and lower. Results showed tha Guinea-Pig Atria: Insensitivity to Blockade by Tetrodo- . COW) levels below 10 toxin. percent had a detrimental effer. on driving performance Journal of Pharmacology and Experimental and that a brief exposure to a high CO concentration Therapeutics 177(1):40-47. April 1971. may resultin performance decrement lasting many hours. Other adverse effects observed were increases in AIM A-343 reduced the firirg rate of pacemaker cells response time to taillight intensities, relative velocities, andnormal 75 72 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

driving velocity; and decreases in abilityto maintain Synthesis inRat Liver.FEBS Letters 14(3):170.174, distances and to estimate time. April 30, 1971. This study was conducted to determine if chronic ad- 71-0404. Reckzeh, G., Dontenwill, W. Vetsuchstier. ministration of nicotine to rats, with doses that produce Versuchstierhaltungand Tiervetsuch.[Experimental induction of microsomal enzymes. would lead to an in- Animals, Their Maintenance and Testing.]In: Weber. K. creased synthesis of nonhistone nuclear proteins. Nico- H. (Editor).Zur Methodik der Untersuchung von Rauch tine effects were compared to those of inducing doses of kondensaten im Tierversuch.Hamburg, Wissenschaftliche phenobarbital. Male rats weighing 70-80 g were injected Forschungsstelle im Verband der Cigarettenindustrie, intraperitoneally with phenobarbital t75 nig/kg) prior to 1969, pp. 1-56, German. pLIse labeling for 40 min with an intraperitoneal 'dose (200 microcuries) of leucinc-4.5-311 t58.2 curies/niniole). Results of animal experiments are obtained by ex- or treated chronically with nicotine in the drinking water amining and comparing reactions of treated animals and in concentrations of 5 mg/kg /day for 7 days followed by untreated controls. The pattern and the intensity of the a 40 minute pulse dose ofleucine-311 (340 microcuries). reactions depend upon the genetic characteristics of the There was an increase in the incorporation of labeled animal strains and can be influenced by physico-chemical, kucine into the total nunhistonc nuclear protein fraction social and microbiological changes of the environment as in the nicotine- treated rats. An absorbancy tracing of an well as by differences in nutrition. Examples are pre- electrophoretic run of hepatic nuclear proteins showed no sentedforthe interrelation between zndogenous and difference between the absurbancy profile of the proteins exogenous factors and the results obtained in such experi- extracted from nicotine-treated and control rats. The ments. For all experimental work with animals, closely radioactivity contained in the major peaks was generally controlled and standardized conditions are strongly rec- higher in the nicotine-treated samples, but when the ratio ommended in order to obtain results which are com- counts per minute for the treated and control animals parable and reproducible. (Auth. Abs.) were plotted from the radioactivity contained in the gels. there was an apparent selectivity to the labeling pattern. For nicotine, the most pronounced peak was 34 nun from 71-0405. Richard, J.L., Lelouch, J.. Claude, J.R., the origin, while phenobarbital showed a peak approxi Schwartz, D. Lipidemie, Consommation de Tabac et mately 10-12 mm down the gels. Corpulence. Etude dune PopulationMasculine Activede 7.972 Sujets. (Lipidemia, Tobacco Consumption and Corpulence. Study of an Active Male Population of' 7,972 71-0408. Sricus. A. G. Irrigation Experiments on Oriental Subjects.]Archives des Maladies chiCoeur et des Tobacco.Beitrage zurTabakforschung 5(61:259-261. Vaisseaux11(3, Supplement 3):71-87, 1969, French. December 1970.

The correlation between tobacco and lipidemia was Irrigation experiments were conducted at the Tobacco studied in a Parisian population (7,972 subjects). A posi- Institute of Drama and the Tobacco Research Station of tive link was observed between tobaccoandblood choles- Xanthi on aromatic and on neutral (baba-Koulak) to- terol. However, this was a weak link which appeared only bacco. Roth tobacco types benefited highly from a when body weight was taken into consideration. There moderate water supply from 40-80 m per stremina. was no correlation after the age of 50. A correlation be- Yield was increased by about 20-30 percent and quality tween tobacco and blood triglycerides was noted in cer- was also significantly improved. Nicotine content was tain isolated age groups but was not affected by taking reduced in a proportion of 5.10 percent. In the aromatic body weight into consideration. These results agree with types, topping and close spacing gave significantly higher those generally reported in population studies and suggest yield per stremma. The nicotine level was higher with that the link between tobaccoandblood fats is very weak topping and lower with close spacing. (Auth. Abs.) and cannot account for the risk of atherosclerosis in rela- tion with tobacco smoking. (Auth. Abs. Mod.) 71-0409. Steffens. G. L., Alphin. J. G.. Ford. 7.. T. "Ripening" Tobacco With the Ethylene-Releasing Agent 71-0406. Rondia, D. Abaissement de rActivite de la 2-Chloroethylphosphonic Acid.Beitrage Tahak. Benzopyrene-Hydroxylase HepatiqueIn VivoAprea In- Jorschung5(6):262-265. December 1970. halation d'Oxyde de Carbone. (Reduction in the Activity of Hepatic Benzopyrene HydroxylaseIn VivoAfter In- Treatment offluc-curcdtobacco with the ethylene halation of Carbon Monoxide.]Comptes Rendus Heb- releasing agent2-chlorethylphosphonicacid (CEPA) domadaires des Seances de l'Academie des Sciences; D: caused mature leaves to lose their green color and turn Sciences Natural/es 271(6):617-619, August10. 1970, yellow. The treated leaves appeared to go through a French. partial "yellowing" or "coloring" phase prior to harvest. Treated leaves at harvest contained greater amounts of The inhalation of carbon monoxide at concentrations reducing sugars and lower levels of starch. relative to of 60 to 100 volumes per million in air for 120 hours comparable untreated leaves. At the end of the curing reduces the hepatic benzopyrene hydroxybse activity in process, comparisons between treated and untreated leaf the rat by 10 to 25 percent. This modification of activity showed that only small differences existed in total nitro- is slow in stablizing itself. gen, total alkaloids, starch, and reducing sugars. Statisti- cally. protein of leaf treated with CEPA was significantly lower as compared to untreated leaf. For all yellowing 71-0407. Ruddon, R. W., Rainey, C. H. Comparison on times, dollar values per hundred weight of cured leaf from Effects Phenobarbital and Nicotine on Nuclear Protein treated plants were higher than from untreated plants, but

76 73 CHEMISTRY.PHARMACOLOGY AND TOXICOLOGY

the average weight per leaf from treated plants was lower. performance. Exposup to relatively high levels of CO During the curing proces: leaf treated with CEPA can (460 and 575 mg/m) for 168 days had no affecton probably be subjected to shorter periods of yellowingor animal survivability, growth rates. or clinical chemistry. coloring than untreated leaf. If further work with "ripen- and failed to produce pathologic changes in the CNS. The ing" chemicals such as CEPA show that they can be used most prominent effect due to CO was the marked eryth- to hasten yellowing or ripen tobacco successfully, as well rocytosis seen during chronic exposure. No performance as to reduce the time required for curing the crop, econ- decrements were observed in either the rhesus monkeys omic advantages are likely to accrue. It is to be hoped up to CO levels of 440 mg/m3 or in humans during three that such chemicals may help reduce the labor and invest- hours of exposures of 50 to 250 ppm CO. Itwas con- ment required for crop production, and at the same time cluded that if CO at these levels had an initial adverse improve crop quality. (Auth. Abs.) effect, adaptive processt3s must take place early during exposures, and the compensatory changes override the initial CO effect. 71-0410. Stupid, M., Boulcy, G. Physiological and Bio- chemical Effects on Rats and Mice Exposed to Small Con- centrations of Carbon Monoxide for Long Periods.In: 71-0413. Tobacco Research Council. Review of Activities, Coburn, R. F. (Editor). BiologicalEffects of Carbon 1967-69. Tobacco Research Council. London. 1970 60 Monoxide. Annals of the New York Academy of Sciences pp. 174(Art. I ):342-368, October 5,1970. Research activities directed by the Tobacco Research Pathogen-free rats and mice were exposed, five days Council in the field of smoking and health are reviewed. per week, to 50 ppm of CO for periods extending from The largest effort was directed to the closely related fields three months to two years. During the first three months. of chemical research and biological testing. Bio-assay fecundation, reproduction, growth, CO2 emission, work was primarily concerned with the possible roles of weights and water percentages of different organs. hemo- cigarette smoking in lung cancer and was based on the globinemia, protidemia, lipemia, calcemia, magnescmia, working hypothesis that cigarette smoke affects theres- serum transaminases, hematological data, experimental piratory epithelium by direct contact. Further progress Serratia marcescens infection and immunization and also was made in narrowing down the fractions of smoke Guerin's grafted tumor's evolution were not modified. condensate which are mainly responsible for carcino- Cholesterolemia, heart pulserates, ECG tracings and genicity as measured by a series of tests on the skin of avoidance conditioning appeared to be slightly altered at mice. A series of studies was conducted to provide infor- the beginning of exposure. During the two-yearexposure, mation about personal, environmental and other factors mortality and aging processes such as nephrosis, aortic in the diseases associated with smoking, and cover not calcification, spontaneous tumors, were not modified by only lung cancer but also bronchitis and heart disease, and 50 ppm of CO. As could be seen from experiments with tc a less extent, some other conditions. Some information three groups of animals (in a 50-ppm CO chamber, ina has been obtained about the characteristics of men and chamber with no CO, and outside the chambers), putting women in high risk groups. Another series of projects was rats into an enclosure affects body growth, heart rate, directed toward understanding the motives for smoking in ECG patterns, and avoidance conditioning. In general, terms of a complex interaction of subjective psychological that proves the importance of ecological factors (confine- factors and objective pharmacological effects. ment. odors, noise, humidity, temperature), in such long- term exposure to very small doses of CO. (Auth. Abs.) 71-0414, Townes. B. 1., Sheen, S. J. Changes of Alkaloid Composition During Curing in Three Isogenic Burley 71-0411. Tamura, T., Inoue, H., lids, T., Ono. H. Studies Tobaccos and Their F1 Hybrids. Beitrage zur Tabak- on the Antidotal Action of Drugs. Part I. Vitamin C and forschung 5(6):279-289, December 1970. Its Antidotal Effect Against Alcoholic and Nicotine Poisoning. Journal of NihonUnirersity School of Quantitative changes of nicotine, nomicotine, ana- Dentistry 11:149-151,1969. basine (including anatabine), and total alkaloids in the juvenile leaves and roots of Nicotiana tabacurnof. Burley Vitamin C (400 mg/kg) and in combination with 21 (11N) and its isogenic lines selected for nictonecon- glucose-eysteine were tested for their antidotal effect version (C), and low total alkaloids (LN) were studied against acetaldehyde (10 mg/kg) and nicotine (31 nil/kg) during air-curing simulation. In the leaf. the C linecon- in DD strain male mice. The combination of vitamin C tained less total alkaloids but more nornicotinc than the with glucose.cysteine showed a greater antidotal effect HN line, suggesting that some may have been converted to against both nicotine and acetaldehyde than vitamin C nomicotine during leaf growth. The conversion phenom- alone. enon was not observed in the root. The root tissues of the LN line showed a high rate of nicotine decomposition at the inception of curing. On the basis of F1 results, both 71..0412. Theodore, J., O'Donnell, R. D., Back, K. C. total alkaloids and nicotine conversion are governed by Toxicological Evaluation of Carbon Monoxide in Humans dominant factors. An intermediate nornicotine/nicotine and Other Mammalian Species. Journal of Occupational ratio for the cured leaves of the LN and C hybrids indi- Medicine 13(5):242-255, May 1971. cated the presence of converter modifiers in the LN line. In the C line and its hybrids the decrease of nicotine This study was concerned with the effects ofcon- content mainly occurred at the beginning of curing, tinous long-term (CO) carbon monoxide exposureon whereas the nornicotine increase appeared after the eighth various animal species and, in particular, on the lever day of curing. The amount of anabasinc was increased in pressing performance of rhesus monkeys; and the effects the leaf but was decreased in the roots by curing. (Auth. of short-term low-level CO exposure on human tracking Abs.)

77 74 CHEMISTRY. PHARMACOLOGY AND TOXICOLOGY

71-0415. Van Duuren, B. L., Blazej, T., Goldschmidt, B. smoke condensate,the alkylating effect of cigarette M., Katz, C.. Melehionne, S.. Sivak, A. Cocarcinogcnesis smoke condensate, and the mathematical aspects of the Studies on Mouse Skin and Inhibition of Tumor Induc- planning and evaluation of experiments in cancer re- tion.Journal of the A'ational Cancer Institute search. 46(5):1039-1044, May 1971.

Various tobacco leaf and tobacco smoke components 71-0418. WHO Chronicle.Public Health Aspects of and related synthetic compounds were tested for co- Climate in Cities. WHO Chronicle 25(4):I61-167. April carcinogenic activity on mouse skin by simultaneous and 1971. repeated application with benzo(a)pyrene. The potent tumor-promoting agent, phorbol myristatc acetate, was The problems of urban climatology and the related also tested and showed pronounced cocarcinogcnic activ- ones of air pollution and its effects on human health are ity. Linalyl oleate and linalyl acetate showed weak co- discussed. Highlighted are the effects of motor vehicle carcinogenic activity. Linalyl burate and the three corres- pollutants, including sulfur dioxide, ozone, lead, and ponding esters of borneol showed no cocarcinogcnic activ- carbon monoxide. Special emphasis is given to carbon ity. Administration of phenol, rutin, and morin resulted monoxide, which in traffic exhaust fumes can lead to in a decreased tumor yield and/or delayed tumor appear- blood earboxyhemoglobin concentrations of 3.4 percent. ance when compared to benzo(a)pyrene administered Although evidence shows that no psychomotor effects are alone. (Auth. Abs.) produced. synergistic effects may occur in subjects under stress or under the influence of central nervous system depressants. Carcinogenic polycyclic compounds have also 71-0416. Vich, V. Otrava Kyslichikcm Uhelnatym. [Car- been found in some particulate emissions from diesel and bon Monoxide Poisoning.]Pracovni Lekarstvi petrol engines. and it is believed that motor vehicle ex- 22(7):255 -258, September 1970, Czech. haust may contribute to the occurrence of lung cancer. Nevertheless, its role is small in comparison with that of Highlights of carbon monoxide poisoning with refer- cigarette smoking. ence to tobacco smoke are presented in this literature review. The clinical picture shows disturbances of various reflexes as well as altered respiration, often of the 71-0419, Wohlrab, H., Ogunmola, G. B. Carbon Monoxide Cheyne-Stokes type, and a high assayof carboxy- Binding Studies of Cytochrome a3 Hemes in Intact Rat hemoglobin. The pathogenesis involves the development Liver Mitochondria. Biochemistry10(7):1103 -1106. of a number of symptoms, such as secondary hypoxemia March 30, 1971. in the myocardium, and hyperglycemia as the saccharide metabolism becomes disturbed. Thereis, however, an Cytoehromc a3 of intact rat liver mitochondria has adaptation mechanism which goes into action in cases of been titrated anacrobically with carbon monoxide. A new chronic carbon monoxide poisoning as in the cast of technique has been used which allows titrations to be smokers. Other symptoms include anoxia and ischemie completed in less than 10 min. The equilibrium constant malacias, necroses and comatoses. Thc causal treatment (A) between cytochrome a3 and carbon monoxide was strives to restore the hemoglobin and to dissipate the found to be (2.15 ± 0.3) X 106hil with a Hill coefficient carboxyhemoglobin, as in the cast of insufflation of (n) of 1.1 ±0.1. Both of these values are not affected by a oxygen, or by hyperbaric oxidation. Thc symptomatic variation in pH from 6.1 to 7.8 and by the presence of treatment is directed against anoxia. Brain afflictions due uncoupling concentrations of uncouplers. The results to carbon monoxide poisoning are numerous and they are demonstrate that there is no functional interaction be- often seen in heavy smokers. These symptoms, which may tween reduced a3 proteins. Thc lack of effect of the very not atfirst be attributed to carbon monoxide from tightly bound uncoupler molecules on the IC suggests that smoke, include somnolence, disorientation, and motor the binding site of the uncouplcr is not on the a3 protein. and psychic disturbances. Carbon monoxide poisoning is When adenosinetriphosphateisaddedto anaerobic diagnosed on the basis of certain symptoms. such as coupled mitochondria in the presence of N,N,N ;Pr-tetra- pyramidic irritation phenomena leading to an asymmetric methyl.p-phenylenediamine, ascorbate, and succinate,the Babinski reflex, accompanied by miosis and bradycardia. ICchangesto (1.1 ± 0.1) X 106 le while the n value remains unchanged. The fact that carbon monoxide is an uncharged molecule and does not respond to potential 71-0417. Weber, K. H. (Editor) Zur Methodik der Unter- and proton gradients set up by the adenosine triphosphatc suchung von Rauchkondensaten im Tierversuch. [The and that the IC between CO and a3 is independent of pH, Method of Investigation of Smoke Condensates in Animal demonstrates an energy-linked structural change in the a3 Experiments.]Hamburg, Wissenschaftliche Forschungs- which is not due to a pH change resulting from a proton stclle im Verband der Cigarettenindustric, 1969, 119 pp.. gradient set up by ATP across the inner mitochondria! German. membrane and which results in a reduced affinity for car- bon monoxide. Thc reduction of 02 by a3 consists of two The publication consists of seven separate reports deal- basic processes: (1) a pH-independent binding of 02 to a3 ing with the preparation of the smoke and the testing of and (2) a pH- dependent oxidation of a3 by 02. A lower cigarette smoke constituents in laboratory animals. Thc limit for the favorable free-energy change associated with reports include data on the maintenance of laboratory the rust process was estimated to be 560 mV. (Auth. animals, the measurement of fluorescence in cigarette Abs.) smoke condensate, the alkylating effect of cigarette See also, 71.0453, 71-0467, 71-0511, 71-0512, 71-0513, 71-0527

78 75 MORTALITY AND MORBIDITY

71-0420. Journal of the American Osteopathic Associa- difference in rates for respiratory cancer between those tion. The Relationship Between Smoking and Health: A maximally and minimally exposed was fivefold and. Review.Journal of the American Osteopathic Asso- though perhaps exaggerated. was apparently determined ciation70(7):720-726, March 1971. by accumulated dust exposure and duration of employ- ment. A random sample of over 1.000 current employees Highlighted in this review are a chronological summary showed little or no relationship, after allowing for age. of those studies linking smoking to human diseases, the between smoking habits and either dust exposure or dura- Surgeon General's 1964 Report on Smoking and Health. tion of employment. the establishmentof the National Clearinghouse on Smoking and Health, the law requiring that all cigarettes packages bear a warning label, and in 1971, the ban of 71-0422. Ochsner. A. The Health Menace of Tobacco. cigarette advertising on television and radio. American Scientist59(2):246-252, March-April 1971.

The link between tobacco and lung cancer and other 71-0421. McDonald, J. C., McDonald, A. D., Gibbs, G. W. equallyseriousconditions causedoraggravated by Siemiatycki, J., Rossiter, C. Mortality in the Cluysotile tobacco are discussed, including other cancers, vascular Asbestos Mines and Mills of Quebec.Archives of Enri- deterioration, pulmonary disease, reproductive disorders, ronmental Health22(6):677-686, June 1971. ulcers, disabling illness and premature deaths, and econ- omic loss. Of 11,788 persons born between 1891 and 1920 em- ployed in the Quebec asbestos mining industry, 88.4 per- cent were traced. Of these, 2,457 (23.6 percent) had died. 71.0423. Schuman, L. M. The Benefits of Cessation of Exposure indexes for each worker were calculated from Smoking.Chest59(4):421427, April 1971. job dust levels and duration of employment. The overall mortality was lower than expected for the population of Various studies are cited to compare morbidity and Quebec but in the highest dust category, comprising 5 mortality statistics among smokers. ex-smokers and non- percent of the cohort, the age-standardized rate was 20 smokers forseveral chronic diseases, including lung percent higher than in other groups. Respiratory, cardio- cancer, other cancers, coronary heart disease, cardio- vascular, and malignant diseaseinequal ptoportions vascular diseases and bronchopulmonary diseases. Ces- accounted for the excess. There were 101 deaths from sation of smoking is shown to significantly reverse a respiratory cancer including three. from malignant meso- number of these disease processes and arrest others. thelioma, an estimated excess of about 15 deaths. The See also,71-0384, 71-0427, 71-0503

NEOPLASTIC DISEASES

71-0424. Bignon, J., Goni, J., Bonnaud, G., Jaurand, scanning electron microscope, that assists in identifying C., Dufour, G., Pinchon, M. C. Incidence of Pulmonary the central fiber of the ferruginous bodies is described. Ferruginous Bodies in France.Environmental Research 3(5/6):430442, December 1970. 71-0425. Bock, F. G. Tumor-Promoting Activity of A method of chemical digestion and microfiltration of Tobacco Extracts.Journal of the Indian Medical Pro- lung tissue has shown that ferruginous bodies, with a fession17(3):7561-7564, Jane 1970. transparent central fiber or invlsible core, were present in the lungs of all cases in a series of 100 French people, Commercial cigarette tobaccos are a potent source of aged 13 and over, both Parisians and country dwellers. tumor-producing activity, the activity depending on the The number of ferruginous bodies, counted in respect to presence of at least two agents, one of which has a large their frequency per cm of lung, increased with age and in molecular weight and the other a small molecular weight. Parisians. While no significant relationship was found with Inasmuch as extracts of commercial English cigarettes either sex or occupational history, a greater frequency of were active, the activity does not depend on the additives ferruginous bodies was found in cases with primary lung used during the manufacture of American cigarettes. On cancer than with other diseases. Eleven of 12 primary the other hand, fresh leaves of several tobacco strains that lung cancer cases were smokers, whereas only 6 had over were raised ina.field without chemical insecticides or 100 ferruginous bodies/cm3 of lung. There were fewer suckering agents yielded extracts which were only very smokers among cases without primary lung cancer and the weakly active. The higher activity of commercial cigarette number of ferrunginous bodies was less, even in patients tobacco is possibly due to increased quantities of the with obstructive lung disease. A new method, using the component of large molecular weight which in turn may be a tobacco pigment.

76 79 NEOPLASTIC DISEASES

71-0426. Bors, G.. Kisbenedek, L. A Dohanyzas Szerepe a nonfiltercigarettes. 24 (group II) and 38 (group h) Holyagdaganatok Keletkezeseben. [The Role of Smoking smoked twice as many cigarettes as the other 12 (group in the Development of Tumors of the Bladder.]Magyar L). By day #375. none of the N dogs, 2 1 dogs, 2 L dogs, Onkologia 1-1(4):230.232, 1970, Hungarian. 12 II dogs and 12 h dogs had died. Several of the H and h dogs but none of the other dogs died of cor pulmonale. The results show that smoking is not one of the special Starting on day 476 all surviving N, F, L and tI dogs causes of bladder tumor, but rather a cocarcinogenic fac- were sacrificed and lung sections were examined micro- tor to be taken into consideration. Papillomatous patients scopically. The lung parenchyma of the nonsmoking dogs should not smoke since the statistical data slum that (group N) was normal while pulmonary histopathological smoking has an unfavorable effect with respect to the changes (fibrosis. emphysema. etc.) were found inall development of bladder tumors and an also promote the smoking dogs. Greatest changes were found in the lungs relapse of papillomas. of dogs smoking nonfilter cigarettes most heavily. Non- invasive bronchioloalveolar tumors were found in dogs of all five groups. Invasive bronchioloalveolar tumors were 71-0427. Doll, R.. Morgan. L. G.. Speizer, E. E. Cancers found only in dogs smoking nonfilter cigarettes most of the Lung and Nasal Sinuses in Nickel Workers. British heavily (groups II and hl: m 2 of 12 group h and H dogs, Journal of Cancer 24(4):623 -632, December 1970. respectively. which died, and 8 of 12 H dogs which were sacrificed. One tumor extended to the pleura and four Men employed in a nickel refinery in South Wales tumors extended into the pleura. Early invasive squamous were investigated to determine whether the specific risks cell carcinoma was found in bronchi of 2 of 12 group H of developing carcinoma of the bronchi and nasal sinuses. dogs which were sacrificed. The findings strongly suggest which had been associated with the refining of nickel. are that smoking cigarettes with an efficient filter will pro- still present. The data obtained were also used to compare duce less damage to the human lung parenchyma than the effect of age at exposure on susceptibility to cancer smoking identical cigarettes without filters. It was con induction and to determine the rate of change of mortal cluded that the smoking of a large number of nonfilter ity after exposure to a carcinogenic agent had ceased. cigarettes daily for over two years can lead to the develop- Eight hundred and forty five men were studied who had ment of invasive bronchioloalveolar tumorsin male been employed in the industry for at least 5 years and beagle dogs. (Auth. Abs.) whose first employment was in or before April 1944. Altogether 482 of the men had died: 113 from lung cancer and 39 from nasal cancer. In men employed before 71-0429. IlurIburt, J. F.. Schulson, N. G. Study of Asbes- 1925, deaths from lung cancer varied from about 5 to 10 tos Workers in British Columbia. British Columbia Medi- times the numbers that would have been expected from cal Journal 13(3):58,67163. March 1971. the corresponding national mortality rates, while the deaths from nasal cancer varied from about 100 to 909 Thirty-three asbestos insulationworkers were times the expected numbers. Among men first employed examined with a view to assessingthe incidence of in 1925 or after there were 8 deaths from lung cancer asbestos-related pulmonary disease in British Columbia. against 6.2 expected and no deaths from nasal cancer. The Results were largely negative. revealing no cases of asbes- death rate from causes other than cancer was similar to tosis, pleural plaques. or malignancy. Eight subjects had that experienced by men in the same geographical area chronic bronchitis andthree others were asthmatics. irrespect;ve of their date of first employment. Suscepti- Sputum sample smears from five subjects showed the bility to the induction of nasal cancer increased with age presence of asbestos birdies. Lung function test results at first exposure, but susceptibility to the induction of showed that just under 40 percent of the subjects had lung cancer varied irregularly. The trends in susceptibility reduced FEVI's and over 20 percent had reduced vital showed some similarity to the trends in the national mor- capacities. Only one worker had an abnormal diffusing tality among men employed at similar ages. It is suggested capacity. Smoking histories indicated that of 29 onetime that susceptibility to cancer induction is determined by regular cigarette smokers. 19 had stopped smoking, a the amount of previous exposure to other agents. The risk majority within the past five years. Reasons given for of developing nasal cancer persisted with little change 15 stopping indicated a high degree of awareness among to 42 years after the carcinogen was eliminated whereas these men of the dangers of smoking and working with the risk of developing. lung cancer decreased. If the effects asbestos, a combination carrying a greatly increased risk of cigarette smoking and the specific occupational hazard of bronchogenic carcinoma. interact, the reduction in the risk of in cancer could be due to the differential elimination of heavy cigarette smokers. (Auth. Abs. Mod.) 71-0430. Lancet. Smoking and Cancers of the Bladder and Kidney. (Editorial) Lancet 1(7700):6351636, March 27, 1971. 71.0428. Hammond. E. C., Auerbach. O._ Kirman, D.. Garfinkel, L. Effects of Cigarette Smoking on Dogs. Ca The question of whether the finding of an association 21(2):78.94, March-April 1971. between exposure to an agent and the risk of occurrence of a particular disease in a retrospective study can estab- Tracheostomy was performed on 97 male beagle dogs. lish a cause-andeffect relationship is discussed in view of All but 8 (group N) were trained to smoke cigarettes over what some pertinent research publications have so far the first 56 days through tubing from a to reported concerning the relationship of smoking and can- the tracheostoma. Two died and one was withdrawn dur cers of the bladder and kidney. The need for evidence ing this period. The remaining 86 dogs trained to smoke from prospective studies and the elucidation of the causal were divided into groups on day From then on, 12 mechanism is emphasized. (group F) dogs smoked filter-tip cigarettes and the other 74 smoked nonfilter cigarettes. Of the dogs smoking

80 77 NEOPLASTIC DISEASES

71-0431. Misfeld, J., Timm, J. Mathematische Aspekte the basis that the study was unpublished and therefore der Planung and Auswertung von Experimentenzur unassailable for many months after thepress conference. Krebsforschung. Dargestellt am Beispiel der Untersuchung Some misleading accounts of the study have alsobeen von Zigarettenrauchkondensaten. (Mathematical Aspects quoted by persons using the pre-publication versionof the of the Planning and Evaluation of Experiments in Cancer study. The delay in publication gave the Tobacco Insti- Research. Presented Using the Investigation of Cigarette tute an opportunity to try and discredit what may bea Smoke Concentrates as an Example.) In: Weber, K. H. significant contribution to the cigarette-cancer issue.The (Editor). Zrr Methodik der Untersuchung con Rauch- controversyindicatesthat publication should, where kondensaten irn Tierversuch. Ilamburg, Wissenschaftliche possible, preceed excessive publicity. Forschungsstelle im Verband der Cigarettenindustrie, 1969, pp. 85-119, German. 71-0434. Rimington, J. Smoking, Chronic Bronchitis, and The mathematical-statistical methods are explained Lung Cancer.British Medical Journal 2(5758):373-375. using the animal experiment testing of cigarette smoke May 15,1971. condensate on mouse skin. The methods are useful for the solution of other theoretical and practical problems of A follow-up was carried out on 21,579 male this type. mass radiography volunteers aged at least 40 who had been the subject of an earlier investigation in which their smoking habits and sputum production were recorded andthe 71-0432. Nagrath, S. P., Hazra, D. K., Lahiri, B., Kishore, prevalence of lung cancer was determined after chest X- B., Kumar, R. Primary Carcinoma of Lung: Clinico- ray examination. During the follow-up period, whichwas Pathological Study of 35 Cases. Indian Journal of Chest a minimum of 36 months and a maximum of 56 months, Diseases 1 2(1/2): 15-25, January-April 1970. 64 new cases of lung cancer were identified bycross checking records with the registers of the regionalcancer Of 25,346 consecutive radiological examinations of registration bureau. A significantly higher incidence of patients attending the Tuberculosis Clinic S. N. Hospital, lung cdhcer was found in those with chronic bronchitis Agra, India, during the period 1950-1959, 35 cases of than in those without this disease. In the smokingcate- histologically proved primary carcinoma of the lungwere gories. cigarette smokers with chronic bronchitishad a detected and studied. These cases ranged in age from 13 higher incidence than those without it, and this relation- to 70 years with a male to female ratio of 4:1. All of the ship was maintainedirrespective of age and amount squamous carcinoma cases, 71.4 .percent of the undif- smoked. It is concluded that persons who smokerun a ferentiated carcinoma cases and 33 percent of the adeno- higher risk of chronic bronchitis than nonsmokersand carcinoma cases gave a positive history of heavy smoking. those who develop bronchitis run a higher risk of develop- Of 23 smokers, 17 were bidi smokers. Commonsymp- ing lung cancer. (Auth. Abs.) toms and signs and the relative value of various investiga- tions in proving the diagnosis of bronchogenic carcinoma are discussed. The importance of a high clinical index of 71-0435. Sufi, K., Goldman, H. M., Wells,H. Carcino- suspicion for this disease is stressed. genic Effect of a Dimethyl Sulphoxide Extract of Betel Nut on the Mucosa of the Hamster Buccal Pouch. Nature 230(5293):383 -384, April 9, 1971. 71-0433. Nature. Premature Puff for Smoking Bea- gles. Nature 2300296J:547-548, April 30, 1971. The occurrence of leukoplakia and tumorswas studied in the buccal pouches of 9-week-old male. golden Syrian The controversy concerning the Hammond-Auerbach hamsters after chronic topical application of dimethyl study on the effects of cigarette smoking in beagles is sulfoxide (DMSO) extracts of betel nut, and of betelnut reviewed. The study was first presented at a press confer- and tobacco mixture. Results showed that betelnut ex- ence arranged by the American Cancer Society (ACS) iti tracts caused tumors in 38 percent and leukoplakia in 90 February 1970 and an article on the study appeared in percent of the hamsters; the betel nut and tobacco mix- the Medical World News. The study was offered for pub- ture caused tumors in 76 percent and leukoplakia in 85 lication in the New England Journal of Medicine but was percent; tobacco extracts caused leukoplakia in 66per- rejected because so much of its substance had previously cent, but no tumors; and the control solution (100 appeared in the Medical World News. It was then offered percent DMSO) produced neither tumors nor leukoplakia. to the Journal of the American Medical Association but The contention that lime salts are the carcinogenwas not because the journal's referees called for revisions des- supported by the results since lime saltswere not added cribed as "quite fundamental", the authors decidedto to the extracts. Nor was tobacco considereda carcinogen; submit the paper to the Archives of Environmental Health however, tobacco does contain materials whichcan en- where it was published in December 1970 with only hance the carcinogenic actions of substances in betelnut. minor revisions. Between the pre-publication conference Possibly a carcinogenic action of the tobaccoextract and publication a battle raged between the ACS and the could have been demonstrated in a longer experimentor Tobacco Institute; the latter taking issue with the ACSon if a more potent extract had been used.

See also, 714)413,71-0415, 71-0421, 71.0422, 71-0462,71-0514

81 78 NON-NEOPLASTIC RESPIRATORY DISEASES

71-0436. Coudray, P., Sense, M., Freour, P. Recherche 1.7. Although there was no obvious relationship between Epidemiologique sir les Bronchites Chroniques et les mucous gland volume and the volume of lung parenchyma Insuffisances Respiratoires. Etude de Prevalence Dans un involved in emphysema, the mean percentage bronchial Echantillon de Femmes de 30 a 70 Ans. lEpidemiologic mucous gland volume was significantly larger in the cases Study of Chronic Bronchitis and RespiratoryInsuffi- with emphysema as compared with those cases without ciency. Prevalence in a Sample of Women 30 to 70 Years emphysema. The findings indicate not so much that of Age.]Revue de Tuherculose el de Pneunto logie emphysema is due to chronic bronchitis but that both are 33(6):769 -780, September-October 1969, French. influenced by smoking. However, smoking seems to play a much more clear cut role in the etiology of emphysema. In an examination of an urban female population (2000 subjects) in Bordeaux, France, aged from 30 to 70 years, aimed at determining the importance of broncho- 71-0439. Falk, C. A Btiscoe, W. A. Alpha, -Antitrypsin respiratory syndromes, 12.23 percent indicated relatively Deficiencyin Chronic Obstructive Pulmonary Disease. important syndromes and 17.53 percent showed slight (Editorial) Annals of Internal Medicine 72(3):427-429, syndromes. Age and smoking habits augni;nted the fre- March 1970. quency of incidence. A past history of allergies and pleurisy with the appearance of severe dyspnea was very Clinical and serologic observations show a definite important. The female population was almost equally association betweenhomozygous alpha rantitrypsin affected as a sample of males of the same type when the deficiency and chronic obstructive pulmonary disease. It influence of tobacco predominant in males was not con- has been postulated that proteolytic enzymes arc continu- sidered. A greater incidence was observed in this popula- ally released into the pulmonary patenchyma by alveolar tion than in one of female Parisian employees. The figures macrophages or other phagocytic cells and that alpha,- indicate a higher incidence of chronic bronchitis when an titry psin from serumnormallyinactivatesthese compared with those from other countries. enzymes before they can digest the alveolar septa. Pro- gressive damage to bronchial and alveolar structures may result from an alpharantitrypsin deficiency. Inhaled irri- 71-0437. Diamond, L, Lipscomb, W., Johnson, R. Acute tants (cigarette smoke and other air pollutants) or chronic Pulmonary Effects of Smoking a Reference Ciga- bronchopulmonary infection are likely to increase the rette.Toxicology and Applied Pharmacology rate of enzyme release, and the observed association of 18(3):638 -648, March 1971. thesefactors with emphysema isconsistent with an enzymatic mechanism of injury. Although scrum alpha,- The acute pulmonary effects of smoking a reference antitrypsin deficiency has been found in only a minority cigaretteof known, standard composition have been of patients, the possibility of an enzymatic mechanism of studied in 30 subjects grouped according to their smoking tissue destruction must be considered even inthose habits. The results of selected ventilatory function tests patients with normal scrum alpharantitrypsin levels. The did not change significantly after smoking. Inspiratory question of whether the diverse clinical and pathologic and expiratory lung airflow resistance was estimated manifestations of the disease originate primarily from before and after smoking by transiently occluding the destruction of alveolar septa or from inflammatory and subject's airway during tidal breathing, measuring the obstructive bronchial lesions, or whether the primary site transairway pressure at the instant of interruption and of pathology differs in the type A emphysematous patient relating the latter pressure to the rate of airflow recorded or type 11 chronic bronchitic patient, has not been re- immediately prior to interruption. Control pulmonary solved. However, the clinical picture of disease association resistance values obtained just prior to snicking were with alphavantitrypsin deficiency is sufficiently varied highest in the group of heavy smokers and in this group that a pathogenic role of protcolytic enzymes must be smoking produced a significant decrease in expiratory considered in both varieties of chronic obstructive pul- resistance to airflow. In nonsmokers inhalation of ciga- monary disease. rette smoke resulted in a significant increase in expiratory resistance, but the site of the reduction in airway caliber was not determined. (Auth. Abs.) 71-0440. Fallat, R., Powell, M., Kueppers. F.. Nadel, J. B., Murray, J. Chronic Obstructive Pulmonary Disease With Intermediate Alpha, -Antitrypsin Deficiency. Chest 71-0438. Dunnill, M. S., Ryder, R. A Quantitative Study 59(5, Supplement 1:20S-22S, May 1971. of the Relationship Between Chronic Bronchitis, Emphy- sema and Smoking. Chest 59(5, Supplement):35S-365, Clinical, physiologic and radioisotopic studies of 12 May 1971. homozygotes and 56 heterozygotes (including 9 and 28 smokers, respectively) with alpha rantitrypsin deficiency The lungs of 353 patients at autopsy were examined showed that heterozygotes often develop obstructive lung using the point counting technique to estimate the per- disease similar to that in homozygotes, but with later centage bronchial mucous gland volume and the percent- onset and less severity, and that smoking may be an aggra- age volume of emphysema in the lung parenchyma. In the vating factor in heterozygotes. It was concluded that air- 179 cases in which a smoking history was available, the way obstruction,scatteredperfusion defects and mean percentage volume of bronchial mucous glands was decreased ventilation of the lung bases are common fea- 17.6 in the 106 smokers and 14.5 in the 73 nonsmokers. tures in both groups with alpharantitrypsin deficiency, The mean percentage volume of parenchyma involved and that these findings are more frequent and more severe with emphysema in smokers was 10.8 and in nonsmokers, in homozygotes and cigarette smokers.

79

82 '0* NON NEOPLASTIC RESPIRATORY DISFASLS

71-0441, I olifiliCt.I., %ivy, P. Puumon et Tabac. [The 71-0444. Higgins. 1.T.T., Higgins, M. W.. GilsonJ. C., Lung and Tub a cco.]Postmon et le Coeur Campbell. II_ Waters. W. F., Ferris. 0. G. Smoking and 26491: 1 109.1 125. 1 970, f witch, Chronic Rs..pirator Disease: Finding in Surveys Carried Out in1957 and 1966 in Stavelcy in Derbyshire, Eng. In dealing with tobacco lung. various lesions can be land. Chest 59(5, Supplement):345-35S, May 1971. grouped experimentally and clinically. Chronically toxic lungs with specificpneumoconiosis in which chronic A nine year fullowup survey of chronic respiratory bronchitis. sclerosis, and bullous emphysema predominate diseases to one conducted in 1957 was undertaken to are studied. The most common is a scleruus bullugenic investigate the changes in lung function over the years. form with a generally apical origin. susceptible to spon- and the rate of development or remission of symptoms in taneous idiopathicpneutnothurax complications. The relation to smoking habits. Among the four occupational effect of smoke on infra- alveolar tension intervenes in the groups studied. three were engaged in dusty jobs, such as origin or evolution of the bullre, their apical location, and mining and foundry work. The results of this second sur- their possible dehiscence. The majority of spontaneous vey of HU males (ages 25.74) showed, over the nine year idiopathic pneumothorax cases observed after 25 years period, a consistent relationship of smoking to persistent :elate to alveolar tubaccoism. The disparity in observed cough and sputum; however. inconsistencies were found disorders at equal consumption is difficult to explain within the age groups in regard to lung function due outside of the fact of a hypersensibility to tobacco agres- partly to the confounding occupational effect. A high sion. Tobacco lung may be fatal due to respiratory insuf- proportion of smokers developed symptoms, while the ficiency or carcinogenesis. More than ever before, there is majority of nonsmokers and ex-smokers were relieved of a greater general tobacco-caused intoxication due to ciga- them. The proportion of smokers who died from all rettes and smoke inhalation. causes was almost double that of the nonsmokers. There was a progressive increase (ages 55164) in the proportion who died with:t 1) an increase in the prevalence of 71.0442. Cati. V. Etude Epidemiologique des Broncho- symptoms reported in 1957; (2) an increase in breathless pathies Non Specifiques. [Epidemiologic Study of Non- ness grade; and (3) a decrease in FIN. Specific Brunchopathies.)Bronches20(5):313-330. September-October 1970. French. 71-0445.Islam. NI. S., Datta, P. K., Mitra, I). K., Chakra. The questionnaire survey undertaken confirms that bony, NI. K. Changes of Ventilatory Function Amongst nonspecific bronchopathy can justifiably be called a Smokers and Non-Smokers. Indian Journal of Physiol "social disease" because it affects a large proportion of og and Pharmacology 1401:165.173, July 1970. the general population: about one person in eight mani- fests some symptom of bronchial irritation, symptoms The effects of cigarette smoking on lung functions of ulna two-thirds of the time indicate chronic bronchitis. 32 male Indians. la smokers and 14 nonsmokers, were The frequency of the syndromes augments significantly observed. Observations were made on the same subjects with age, and males are more often affected. In the total once in 1963164 and then again in 1969 and the relative population, smokers are affected four times more often deterioration in lung function of the two groups during than nonsmokers. In young subjects. the use of tobacco this period was compared. The lung function tests in- dominates the bronchial etiology; in older subjects, al- cluded forced vital capacity (INC), forced expiratory though bronchopathy increases sensibly in smokers, it volume for one second (FEV Lo sec) and mean maximal also increases in nonsmokers and, other dirtpathogenic expiratory flow between 50.75 percent (INN1EF50.75 per. factors are found to intervene. Air pollution doubles the cent). The lung term effects of smoking showed a reduc- risk of bronchitis but when comparing the two irritating tionin both INC and FEV1.0 sec over a period of 5 factors, smoking is found to be predominant. The princi- years. The reduction in INC was more than FEVi0t..0 pal task in the prophylaxis of nonspecific bronehopathy, among the smokers, whereas the reduction of FEV in which the progressive evolution towards respiratory was more than the INC among the nonsmokers. Diurnal insufficiency is well-known, should be directed at purifi- variation in lung functions showed greater declines of cation of inspired air which includes the cessation of FVC, FEV1.0 sec and MMEF50.75percent in smokers smoking. than those in nonsmokers; the declines in FEV1.0sec and M MFF 50 _75percent were more in comparison to FVC within the smoker group. The immediate effect of smok 71-0443. Guenter, C. A.. Welch, M. II., Ferguson, S., ing a cigarette wasas slight decrease in FEV1.0sec atad'd Henderson, L., liammarsten. J. F. AlphaAntitrypsin both of which tended to return I. Deficiency: Heterozygosity,IntermediateLevels, and pre-smoking values after10 minutes of smoking and Pulmonary Disease. Chest 59(5, Supple me nt ):16S-I 7S, almost returned to that level in another 20 minutes. There May 1971. was no significant change in FVC after smoking. This study attempted to correlate the prevalence of pulmonary disease and antitrypsin levels in three different 71-0446.Jancik, E.Quelques Donnees et Correlations populations. Spirograms and scrum trypsin inhibitory Provenant dune Etude Epidemiologique stir ('Incidence capacity were correlated from studies of families, rural des Symptomes Cuacteristiques des Maladies Respire - populations, and hospital patients. The results did not wires Chroniques Non Specifiques. [Some Facts and support the hypothesis that intermediate scrum antitryp Correlations From an Epidemiologic Study on the Inci- sin deficiency or the heterozygous deficiency state pre- dence of Symptoms Characteristic to Chronic Non- dispose to obstructive lung disease. Specific Lung Diseases.]Revue de Tuberculose et de Pneumologie 34(5):749.752, July-August 1970, French. 83 XI 80 NON NEOPLASTIC RESPIRATORY DISEASES

Additional facts and correlations which complement a 71.0450. Kucevvicz. J. Chronic Nonspecific Respiratory previously published 4:nide:Wok.* study of chionic non. Diseases in the City of Cracow. VIII. Fisher's Discrimi specific lung diseases are reported. A significant correla- nant Function in the Analysis of the Influence of Smok- tion was found between the number of cigarettes smoked ing on Prevalence of Symptoms. Epidemiological Review per day and the presence of cough and expectoration dur- 23(1/21:159-165.1969. ing three months per year. A negative correlation of daily consumption with age indicated that younger men smoke The applicability of Fishers discriminant function more cigarettes per day than older men. In five age analysis to determine the 'elation between three charac- groups. 4044. 4549, etc. up to 60-64; the percentage of teristics of smokers and disease symptoms was tested. A subjects with dyspnea increased with age in nonsmokers questionnaire was designed to provide information about from 4.12 percent, in smokers consuming 25 cigarettes three characteristics: period of smoking in years ape at per day or more. from 10-24 percent, and in ex-smokers. timeof starting smoking. and number of cigarettes from 7-25 percent. Differences in nonsmokers and heavy smoked daily recently. The influence of each factor on smokers (including ex-smokers) clearly indicate that the the occurrence of symptoms of chronic bronchitis was quantity of tobacco consumed is a factor linked to analyzed indicating that the numbei of cigarettes smoked dyspnea independent of age. Other correlations reported daily had the greatest influence. From an interview of 8U concern air pollution and occupations. radiological signs "present smokers", 50 percent reported cough :Indio' and characteristic symptoms of chronic nonspecific lung phlegm production. diseases. and the probable influence of hereditary or genetic factors on said diseases. 710451. Wow, P.. Dumitriu, M.. Ghise, O.. Comanescu, C. Cercetari Epidemiologice Privind Bronsita Cronica la 7141447. Kaatzsch, 11. The Influence of Smoking on the un Lot dinPopulatia Generala a Orasului Bucuresti. Ventilatory Disturbance in Bronchitis. Complete English [Epidemiological Studies on Chronic Bronchitisina translationofMediziniscise 64(47):2 i 96-2199. Sample of the General Population of Bucha- November 21,1969. rest.]MedicinaIntertia22(9): I 123-1134 September 1970, Romanian. SeeAbstract 70-0133. Research was conducted on the occurrence and distil. bution of chronic bronchitis from May 1968 to May 1969 71.4)448. KaUqvist, I., Taube, A.. Olafasson, 0. Peak Ex- on a sample of the urban population of Bucharest. The piratory Flow in Healthy Persons Aged 45165 simple consisted of 380 men and 620 women. ages 30-69. Years.Scandinavian Journal of Respiratory Diseases The largest number of chronic bronchitic cases was found 51(3):177-187,1970. in the 284 subjects of the 60169 age group. The ratio of bronchitics to the total population was studied and elks- The peak expiratory flow (PEE) test was included in a logical factors were considered to determine if smoking health survey in a Swedish industrial town to obtain PEI' was a direct. or at least a predisposing factor in chronic values which could be used as predicted normal readings. bronchitis. The incidence of chronic bronchitis was 17.3 Since the conditions of the study did not permit a full percent of the total population studied. Of this group 42 analysis of the effects of cigarette smoking, an unknown percent of the men and 31 percent of the women who number of asymptomatic smokers were included in the smoked had the disease. In ex-smokers. 30.5 percent of "normal" group. However, the PEI' readings showed no the men and 4.7 percent of the women had chronic discernible difference between asymptomatic smokers and bronchitis. The critical age for chronic bronchitis was the total "normal" series. The results showed a strong 4049 for men nd 60169 for women. correlation between PEE and sex, age and body height.

71-0452. Pavia, D.. Thomson. M. L.. Pocock. S. J. Evi- 7141449. Komitzer, M., Demeester, M. La Symptomatolo- dence for Temporary Slowing of Mucociliary Clearance in gie Respiratoire en Epidemiologie. Resultats de l'Enquete the Lung Caused by Tobacco Smoking. Nature Effeetuee Dans une Banque BruxeUoise, (Respiratory 231(5301):325-326.Juni:4.1971. Symptomatology inEpidemiology. Results From a Survey Effected in a Bank in Brussels.]Acta 71thercu Twenty-two volunteers (ages 64-92). of whom 19 were losea Pneumologica Belgica61(5/6 ):48 I -506. Septem- cigarette smokers and 2 pipe mnokers, were studied to ber-December 1970, French. determine the acute effects of smoking on mucociliary clearance. Ventilatory capacity tests revealed eight sub- The prevalence of respiratory symptoms related to jects with mild restrictive impairment and two with air- chronic respiratory diseases was studied in a population of way obstruction. Subjects were asked to smoke iron. .wo 539 male bank clerks aged from 40 to 59 in Brussels. The to live cigarettes consecutively with no time constraint. study included the use of a peak flow meter and a ques- The rate of mucociliary clearance was determined by tionnaire covering such symptoms as cough, expectora- gamma ray counting at frequent intervals following inhal lions, and as well as each individual's ation of tracerparticles. In comparing the effects of smoking history and habits. Data collected indicating a smoking on the clearance curves, subjects with restrictive relationship between respiratory symptoms. peak expira- impairment had a larger difference than the normal group. tory flow measurements, and smoking habits are statisti- Student's t tests on the clearance slopes of subjects before cally presented. Cigarette smoking seems to be related to and duri!eg smoking showed significant slope changes in 4 certain symptoms of chronic bronchitis as well as to of 12 normals and in 6 of 8 restrictive subjects. Of these reduced peak flow. ten sotijects. nine were cigarette smokers and the other a NON NEOPLASTIC RESPIRATORY DISEASES

pipe smoker. The average product of tobacco consump- inhaling and exhaling, were also quite useful in the detec- tion and the time of smoking was 109 g-min for the 10 tion of these diseases. subjects who showed a significant slope change as com- pared to 58 g-min for the 12 subjects with a non-signifi- cant slope change. 71-0456. Randowa. D., Niewiadontska, S., Paslawska- Prus. J., Mos, R., Rzeszu tko. 11., Wozniak. J. Obraz Epide- miologicznyPrzewleklychNicswoistych Chorob Pluc 71-0453. Pavlik. I., Cermakova.Z.Early Skin Reaction Ludnosci Jednigo Rcjonu Miasta Wroclawia. (Epidemio- Against Tobacco ExtractinRespiratory System Dis- logical Picture of Chronic Nonspecific Lung Diseases in ease. Complete English translationof "Casna Kozni One District of the Cityof Wroclaw.'Gnrlicai Reakee na Tabakovy Exuakt u Chorob Dychadel", Chorobyflue 38(7):585.594, 1970, Polish. Rozhledy vTuberkulose a v Nemocech Plicnich 24(9):629-635, 1964. The incidence and occurrence of chronic, nonspecific pulmonary diseases in one district of Wroclaw, Poland. A totalof 834 patients, both smokers and non- were investigated. A total of 1466 persons (823 women smokers, suffering from bronchial asthma and chronic and 643 men) over age 40 were examined (47 percent of inflammatory disorders of the respiratory passages wcrc the population of the survey). Methodology for study studied. Investigation revealed a highly significant in- included mass miniature radiography, spirometry. and creased frequency of positive skin tests against tobacco questionnaire techniques. Chronic bronchitis was found in extractin smokers, regardless of whether asthma was I Ipercent of the women and in 21 percent of the men present or absent. These results favor the hypothesis that examined. The higher percentage in men is accounted for allergization participates not only in the origin of bron- by their habit of smoking tobacco and its products. chial asthma in smokers, but in the origin of chronic bron- Dyspnca and a decreased vital capacity, as shown by chitis as well. Results obtained by other researchers spirometric examination. were more often observed in provide evidence for the participation of allergization in women than in men, but this is thought to be due to the origin of sonic other disorders, also connected with obesity in women. Emphysema was diagnosed by X-ray in smoking. In this way allergy assumes the position of a 2 percent of the women and in 4 percent of the men true connecting link between a great number of diseases, tested. The statistical evaluation showed that it was ciga- connected stochastically with smoking. rette smoking which brought about a greater incidence of the various diseases. Smoking as such. for example pipe smoking in men, could not always be clearly identified 71-0454. Peabody, II. D. (Jr.), Wilson, J. K. Epidemio- statistically as the causative agent. This in part is accoun- logic Factors in Etiology of Chronic Respiratory Dis- ted for by the methods of statistical interpretation. ease.Chest59(5, Supplemcnt):3 IS-32S, May 1971.

A statistical analysis of potential risk factors leading to 71-0457. Saha, N. C., Jain, S. K. Chronic Obstructive obstructive pulmonary disease has been made on 251 men Lung Disease in Delhi. A Comparative Study.Indian from the San Diego Fire Department examined yearly for Journal of Chest Diseases12(1/2):40-51, January-April nine years. Results of pulmonary function evaluation and 1970. correlation with risk factors have been presented. In des- cending order of severity the factors appear to be ciga- Using a standardized questionnaire and laboratory rette smoking, history of pulmonary infection, death of investigations in non-specific lung disease in Delhi. clinico- one or both parents, history of allergy, family history of physiologic observations were compared with similar respiratory abnormalities and occupational hazard prior observations previouslyreported from London and to employment with the San Diego Fire Department. Chicago. Thcrc were close similarities in the clinical. Thcrc was no significant difference between the levels of radiological and physiological features of the disease in pulmonary function and the degree of present occupa- the three groups. but certain differences were also ob- tional exposure. (Auth. Abs. Mod.) served. Sixteen percent of the Delhi patients were non- smokers whereas almost all of the London and Chicago groups were smokers. Delhi patients had more productive 71.0455. Prcgowski, W., Brysiewicz, K., Cesarz-Fronczyk, cough, slightly less severe degree of airway obstruction M., Kordecka, J.,Leszcbinski,B., Lukjan, Z., Sado- and emphysema, less severe degree of blood gas distur- kicrska, H. La Bronehite Chronique Parini les Ouvriers bances, and less frequent incidcncc of acute chest infec- (rune Usine Textile. Depistage Clinique et Radiologique. tion with pyogcnic organisms. [Chronic Bronchitis Among Textile Workers. Clinical and Radiological Detection.]Revue de la Tuberculose et de Pneumologie34(5):753-755, July-August 1970, French. 71-0458. Sanders, C. L., Jackson, T. A., Adcc, R. R., Powers, G. J., Wchncr, A. P. Distribution of Inhaled Metal In a study of 1,047 textile factory workers in Bialy- Oxide Particles in Pulmonary Alveoli.Archives of Inter- stok, Poland, the incidence of chronic bronchitis was nal Medicine127(6):1085 -1089, June 1971. found to be dependent upon working condition (the degree of dust pollution) and work location. This inci- The phagocytic response of alveolar cells is a signifi- dence was greater in cigarette smokers. In addition to cant factor in determining the pulmonary distribution and clinical detection, radiological detection methods per- fate of inhaled, insoluble particles. The type I alveolar mitted finding not only previously unknown tuberculosis epithelium and alveolar macrophage readily phagocytized cases and cancer cases at an early stage of development, inhaled nickel monoxide and chromic oxide particles with but also advanced bronchitis, emphysema, and bronchicc- 80 perccnt and 91percent,respectively, of alveolar tasis. Radiological plates taken in profile position while deposits being found in macrophages and 0.5 percent and

85 82 NON -NEOPLASTIC RESPIRATORY DISEASES

4.2 percent, respectively, being localized in type I alveolar Striking alterations in both collagen fibrils and base- cpitheliunt. Type II alveolar epithelium did not exhibit ment membranes were revealed with the electron micro- any phagocytic activity. Fewer NiO particles were found scope in the lungs of rats exposed to subacute levels of in macrophages, and more were found free in alveolar nitrogen dioxide. Collagen fibrils underlying the terminal lumens following exposure to cigarette smoke, indicating bronchiole in control rats increase slightly in size with an inhibition of phagocytosis of inhaled particles by ciga- age, and may appear stellate in cross section during old rette smoke. (Auth. Abs.) age. In marked contrast. young animals exposed to 17 ± 2 ppm for three months develop very large fibrils up to 15 times the normal diameter. The same response was ob- 71-0459. Seely, J. E., Zuskin, E., Bouhuys, A. Cigarette served in animals exposed to 2 ± I ppm for two or more Smoking; Objective Evidence for Lung Damage in Teen- years. The basement membrane under the epithelium of Apts.ScienceI 72(3984):74I-743, May 14, 1971. the terminal bronchiole also becomes greatly thickened. These alterations are seen after exposure to NO2 at Iligh school students with one to five years' smoking subacute levels that endure neither edema nor significant experience have excessive cough, sputum production, and destruction of cells but cause viable tissue to undergo shortness of breath. When maximum expiratory flow is metabolic alterations reflected by the changes described. plotted against maximum expired volume, the curves of Similar responses in dogs due to cigarette smoking have nonsmokers and smokers differ in shape. The smokers been reported. (Auth. Abs. Mod.) have lower flow rates at mid-vital capacity and at lower lung volumes. This probably reflects small airway obstruc- tion in the smokers. (Auth. Abs.) 71-0462. Sterling, T. D. Comment on Smoking Dogs. (Letter)Archives of Environmental Health 22(5):631632, May 1971. 71-0460, Snider, G, L., Doctor, L., Demas, T. A., Shaw, A. R. Obstructive Airway Disease in Patients With Treated The experiment described in the article by Ilumniond. Pulmonary Tuberculosis,American Review of Respira- Auerbach, et al, "Effects of Cigarette Smoking on Dogs." tory DiseaseI 03(5):625-640, May 1971. is criticized for having allowed the lungs of the dogs to be infused with unfiltered air drawn directly through holes in Data were collected just before medically approved the trachea andsobypassingtheusualprotective sanitorium discharge from 1,403 patients with pulmonary mechanisms which remove dust and other impurities that tuberculosis using a questionnaire, the hospital chart, a reportedly have caused changes in lung tissue. including spirogram, and a rating of chest roentgenograms. Pul- true metastatic cancers. In addition, there were no con- monary tuberculosis was moderately advanced atdis- trolssubjectedto comparable treatment but without charge in 52 percent of patients and far advanced in 21 exposure to cigarette smoke. percent; 87.5 percent of patients had no tubercle bacilli in their sputum cultures for more than two months before the study. Approximately 75 percent of men and more 71-0463, Velican, C. Cercctari Privind Mechanismele than 40 perccntof women were currentcigarette Aparitici Emfizemului Pulmonar la Tabagici. [Mechanisms smokers. Airway obstruction, defined as diminution of of Pulmonary Emphysema in Heavy Smokers.]Sista si forced expiratory volume in one second to less than 70 Caccia"( de Medkina Interim11(6):455-468, 1970, perccnt of vital capacity, was found in 62 pi' ;cent of Romanian. white men, 37 percent of nonwhite men, 3f percent of white women, and17 percent of nonwhite women. The macromolccular organization of the surfactant, Cough, expectoration, severe dyspnea, and wheezing dur- the ground substance,the basal membranes and the ing most days and nights paralleled spiromctric evidence rcticulin, collagen and elastic fibers in the alveolar walls is of airway obstruction and were also more prevalent in progressively altered by the action of chronic heavy smok- whites than nonwhites. Airway obstruction was present ing, though the lung continues to show for a long time an more often in men than in women but in both sexes was apparently normal aspect to usual techniques. Periodic less prevalent in the younger, smoking patients association of lower air passage infections enhances the with less severe tuberculosis. The addition of any one severity and extent of these alterations precipitating the factor such as older age, more smoking, or more severe occurrence of lesions that can be revealed by hcmatoxylin tuberculosis caused a twofold or greater increase in preva- and eosin staining. The action of tobacco smoke deter- lence of airway obstruction; the increase was least for mines in a first stage an increase of intermolecular bonds, heavier smoking. The coincidence of any two of these this process of "tanning" in tiro decreasing the elasticity factors resulted in a quadrupling of the prevalence of air- and extensibility of the alveolar wall which thus breaks way obstruction. Addition of the third characteristic had more easily on various functional demands. Secondary little further effect. The nonwhites were younger, smoked infections lead to release of lysosomal enzymes from infil- fewer cigarettes per day, and had less extensive residual tration cells as well as to enzymes elaborated by micro- changes intheir :adiographs. The lower prevalence of organisms. There results a predominance of degrading residual respiratory symptoms and airway obstruction was __processes favoring the rupture of alveolar walls and the therefore not attributed to race. (Auth. Abs.) occurrence of emphysema. Particular stress is laid on the presence of a correlation between the number of inflam- matory cells in the alveolar wall and the intensity of the 71-0461. Stephens, R. J., Freeman, G., Evans, M. J. Ultra- degenerative processes that may be detected in these structural Changes in Connective Tissue In Lungs of Rats structures. (Auth. Abs.) Exposed to NO2,Archives of Internal Medicine 127(5):873-883, May 1971.

86 83 CARDIOVASCULAR DISEASES

71-0464. Voisin, C. Les Facteurs Eticlogiques Dans b should be the tight against nicotinism and air pollution. Bronchite Chroniqueet L'Emphyseme Pulmonaire. lAuth. Abs.) [Etiologic Factors in Chronic Bronchitis and Pulmonary Emphysema.]Rerue de Medecine 111371:2175-2179, October 29. 1970. French. 71-0465. Willichnsen, L. Harmful ClinicalEffects of Smoking. Smoking andthe Upper Respiratory Pas- A large number of factors are responsible for chronic sages. Complete Englishtranslationof "Medicinska bronchitis and emphysema. The effects of these factors Skadeverkningar av Rokning. Rokning och Ovriga Luft overlap making it difficult to assess the relative responsi- sag ssjukdomar", Social.MedicinskTidskrift2(Special bility of each. However, investigations into the epidemiol- No.):73-77, February 1971. ogy of these disorders carried out over the past few years have established the determining role of nicotinism and The effects of tobacco smoking on the lungs can be air pollution, and to a lesser degree that of substances of a divided into an acute effect that primarily involves spasms professional nature. These exogenous factors are all the of the air passages and changes in surface tension of the more dangerous when they exercise their effects on a alveoli, and a chronic effectthatinvolves changes in constitution predisposed, by endogenous factors: allergy, mucous production in the air passages and an increased genetic disorders, chronic infections of the respiratory tendency toward infection. These changes lead to im- tract. The knowledge of these facts is the indispensable paired pulmonary function and an increased tendency to basis for effective prevention of chronic bronchitis and chronic bronchitis as shown by a number of epidemio- emphysema. The dominant feature inthis prophylaxis logical studies.

See also. 71-0413, 71-0121, 71-0429, 71-0434

CARDIOVASCULAR DISEASES

71-0466. Ander, S., Tibblin, G., Wilhelmsen, L. Points in 71-0468. Astrup, P.,Kjeldsen, K., Wanstrup, J. The the Matter of Giving Up Smoking. Who Stops Smoking Effects of Exposure to Carbon Monoxide, Hypoxia and After Acute Myocardial Infarct? Complete English trans- Hyperoxia on the Development of Experimental Athero- lation of "Synpunktcr pa Rokavvanjning. Vem Slutar matosis in Rabbits.In: Jones, R. J. (Editor). Athcro Roka lifter Akut Hjartinfarkt ? ", Social.Medicinsk Tid sclerosis. Proceedings of the Second International Sym- skriJt 2(Special No.):120-123, February 1971. posium.Chicago, November2.5,1969. New York, Springer-Verlag, 1970, pp. 108-111. Factors that have significance for the possibility of infarct patients to stop smoking are discussed. Factors The following experiments were conducted:I) favorable to stop smoking were severe infarct and first cholesterol-fed rabbits were exposed to a carbon mon- instance of infarct. Patients who had previously received oxide (C0)-containing atmosphere for 10 weeks, causing a tranquilizers and those who had difficulty sleeping at 15-20 percent carboxyhemoglobin (COHb) concentration: night had greater difficulty in giving up smoking. Certain 2) cholesterol rabbits were exposed to a10 percent attitudes toward smoking also appear to influence the oxygen atmosphere for 8 weeks; 3) cholesterol-fed rabbits outcome. were exposed to a 28 percent oxygen atmosphere for 10 weeks; 4) rabbits fed a normal diet were exposed to a CO-containing atmosphere for 13 weeks, causing an 11 71-0467. Aronow, W. S., Dendinger, J., Rokaw, S. N. percent COlib concentration. Tissue cholesterol in the Heart Rate and Carbon Monoxide Level After Smoking CO-exposed rabbits was 2.5 times greater than in controls. High-, Low-, and Non-Nicotine Cigarettes. A Study in In hypoxic animals, this difference in cholesterol deposi- Male Patients With Angina Pectoris. Annals of Internal tion was even more pronounced. Triglyccrides in aortic Medicine 74(5):697.702, May 1971. tissue were significantly increased in both CO-exposed and hypoxic animals, while phospholipids showed only Ten cigarette smokers with angina pectoris had blood minimal and nonsignificant changes compared to controls. pressure, heart rate, and expired-air carbon monoxide Aortic cholesterol content in the hyperoxic group was measurements before and after smoking each of five high-, only half of that in controls. Both macroscopically and low-, 3nd non-nicotine cigarettes. There was a significant microscopically, it was easy to differentiate experimental increas: in systolic and diastolic blood pressure after from control animals. The hypoxic group showed a deep smoking each high- and low-nicotine cigarette, with a sig- transmural lipid infiltration of the vascular wall causing a nificant it:crease in peak systolic and diastolic blood pres- prominent interstitial xanthomatosis in the perivascular sure from cigarette 1 to cigarette 5. There was a signifi- structures. In the rabbits fed a normal diet and exposed to cant increase in heart rate after smoking each high- and small CO concentrations, multifocal vascular damage of low-nicotine s:garet te but no significant increase in peak the early arteriosclerotic type was found. Other autopsy heart rate from cigarette I to cigarette 5. There was no findings included the frequent occurrence of exudate in significant increase in blood pressure or heart rate after the serous cavities, especially in CO-exposed animals. smoking a don-nicotine cigarette. There was a significant Apart from quantitative differences, changes in the CO- increase in carbon rionoxide level after smoking each exposed and hypoxic groups were identical. high-, low-, and non - nicotine cigarette, with a significant incease in peak carbon :nonoxide level from cigarette I to cigarette 5. (Auth. Abs.)

87 84 CARDIOVASCULAR DISEASES

71-0469. Branemark. P.-I. Smoking and Coronary Disease 71-0473, Flinfeldt, D. Smoking and Coronary Disease (8): (13): Microvascular Effects. Complete English transla- Smoking Habits of Heart Infarct Patients. Complete Eng- tion of Lakartidningen 671 3):266-27 I . January 14. 1970. lish translation of Lakartidningen 67( 2): 168-169 . January 7.1970. Sec Abstract 70-0627. See Abstract 714)120.

71-0470. Brewer, G. J.. Eaton, J. W.. Grover. R. F.. Weil. J. V. Cigarette Smoking as a Cause of Hypoxemia in Man 714)474. Elwood. P. C. Hughes R. E., Hurley, R. J. atAltitude. nest 59(5, Supplement):30S3IS, May Ascorbic Acid and Serum-Cholesterol. (Letter) Lancet 1971. 2(7684):1197. December 5, 1970.

Carboxyhemoglobin levels of smokers in Leadville. If plasma ascorbic acid, which is lowered by smoking, Colorado (altitude 3100 meters) were significantly higher is involved in cholesterol metabolism, a raised prevalence than in smokers near sea level. Oxygen pressure in arterial of arteriosclerosis in heavy smokers might result. A study blood (Pa02) was significantly lower in Leadvillc smokers of 254 normal women, including 154 nonsmokers and than in nonsmokers. In 8 of 10 smokers who abstained 100 smokers, in a Welsh mining valley showed a decrease from smoking for 24 hours, Pa02 increased to levels in plasma ascorbic acid with increased cigarette consump- equivalent to those of nonsmokers. The hemoglobin oxy- fion, but no evidence of a significant association between gen affinity of Leadville smokers was slightly increased plasma ascorbic acid and scrum cholesterol. compared to sea level normal values and was most in- creased in individuals with hematocrits over 56 percent. Total red cell mass was higher in smokers compared with 71-0475. Erwin, C. W. Cardiac Rate Responses to Ciga- nonsmokers. These results indicate that cigarette smoking rette Smoking; A Study Utilizing Radiotelemetry. Pry. may produce pronounced limitations on oxygen transport chophysiology 8( I ):75.8 I, January 1971. at high altitude and may restrict one's ability to adapt to the reduced oxygen tensions. Radiotelemetry of the human EKG was obtained to observe for rate alterations during spontaneous cigarette smoking. Ten subjects were observed for a total of 26 71-0471. Carver. S. T. Ecology of Coronary Heart Dis- hours during which time 50 cigarettes were smoked. The ease. New York State Journal of Medicine utilization of telemetry allowed the subjects to continue 71(10):1065-1070.May 15,1971. theirusualafternoon behavior, There were no rate changes before, during, or after smoking which could be The possible influence of external or internal environ- attributed to the cigarette. These results differ from most ment on the pathogenesis of coronary heart disease forms previous reports. Telemetry allows for two departures the basis of this study. Risk factors in relation to internal from past designs; subjects were ambulant and smoking environment, such as genetic abnormalities, body build. behavior was spontaneous (both in initiation and rate), It hypertension, personality type, and elevation of serum is suggested that these departures are related to the results cholesterol are considered. The effect of man's external of the present study. (Auth. Abs.) environment on the development of coronary heart dis- ease includes a consideration of smoking, diet, stress. climate, impurities in inhaled air, and physical activity. 71-0476. Fodor, J. Smoking and Coronary Disease (4): However, it is stressed that the pathophysiologic processes The Prague Study, Complete Englishtranslation of which determine the subsequent risk is established early Lakartidningen 67(2):150-152, January 7, 1970. in life and that future investigations of the genesis and prevention should be centered more on the periods of See Abstract 71-0122. childhood and adolescence. (Auth. Abs. Mod.)

71-0477. Guenter, C. A., Welch, M. H..11ammarsten. J. F. 71-0472. Ceia, F., Lopes, M. G., Banos, F. B. Micro- Alpha,- Antitrypsin Deficiency and Pulmonary Emphy- metodo de Astrup. Valores Normais de pH, PCO2, Bicar- sema. Annual Reriew of Medicine 22:283-292, 1971. bonates Standard e Excesso de Base no Swipe Capilar, (Micromet)tod of Astrup. Normal Values of pH, PCO2, Thisreview summarizes the availableinformation Standard Bicarbonates and Base Excess in Capillary regarding the characteristics of scrum proteinase inhibi- Blood.]Jomal da Sociedade des Ciencias Medicos de tors, the incidence and type of pulmonary disease associa- Lisboa 135( I ):55-63, January 1971, Portuguese. tion with familial alphas-antitrypsin deficiency, and the evidence that pulmonary tissue injury may be related to The results of a study of pH, PCO2, standard bicar- the deficiency of these inhibitors. bonates and base excess levels in the capillary blood of 23 normal individuals of both sexes, ages 21-30, showed that: I) pli values are significantly different in smoking 71-0478. Harland, W. A. The Problems of Atherosclero- and nonsmoking males, being higher in smokers, and for sis.Practitioner 206( 1233):312-329, March 1971. females the values are identical to those for nonsmoking males; 2) PCO2 values are significantly lower in females; A review of the anatomy, epidemiology, pathogenesis, and (3) there are no significant differences between sexes risk factors, and treatments of atherosclerosis is given. as regards standard bicarbonates and base excess. Emphasis is primarily on the numerous risk factors that

85 CARDIOVASCULAR DISEASES

aggravate this disease. Studies show that serum choles- to atherosclerosis; newer knowledge about the serum terol, high blood pressure. and cigarette smokinghave a lipoproteins and the regulation of lipid metabolism. both direct relationship; that physical activity and environ- sterols and triglycerides: consideration of prophylactic as mental temperature have inverse relationships: andthat well as drug therapy directed against pathogenic median- soft water and genetic factors idveno evidence of a rela- isms: and a discussion of progress to date and future tionship with atherosclerosis. The cumulative effectof all prospects of plans directed toward the control of athero- these factors is also discussed. sclerosis.

71-0479. Hess, H. Smoking and Arterial Circulatory Dis- 71-0482. Kjeldsen, K. Carboxyhemoglobin and Scrum turbances of the Extremities. Complete English transla- Cholesterol Levels in Smokers Correlated to the Incidence tion of "Rauchen and Weddle Durchblutungsstorungen of Occlusive Arterial Disease.In: Jones. R. J. (Editor). der Extremitaten", from: Schievelbein, H. (Editor). /I therosch.rosis. Proceedings of the Second International Nikotin: Plrarmakologie and Toxikologie des Tabak- Symposium. Chicago, November 2.5, 1969. New York. ranches. Stuttgart. West Germany, Georg Thicme Verlag, Springer-Verlag, 1970. pp. 378-381. 1968. pp. 193-198. A population of 1000 industrial workers. half of Various studies on the relationship between smoking whom were tobacco workers, were investigated for and Raynaud's disease, acute inflammatory arterial dis- carboxyhemoglobin and scrum cholesterol levels and the eases, and chronicobliteratingvasculardiseasesare relation of these values to smoking values and clinical reviewed. Smoking appears to be only one factor in the signs of cardiovascular disease. Of the 59 subjects diag- genesis of obliterating vascular diseases. This is supported nosed as having atherosclerotic cardiovascular disease, 3 by the fact that this disease has been observed in non- were light smokers. 34 were moderate smokers and 20 smokers, children and horses; that the majorityof were heavy smokers. Average carboxyhemoglobin values smokers do not contract the disease; that men are more were 6-8 percent in diseased subjects as compared to 3-4 prone to attack by the disease: and that there is no corre- percent in controls. There was also a highly significant lation between the degree of smoking and the incidence difference in scrum cholesterol valties between these two or severity of the disease. Smokit'plays no role in the groups. Healthy smokers had significantly higher scrum pathogenesis of Raynaud's disease and its only connection cholesterol levels than nonsmokers, while no such differ- with acute inflammatory vascular diseases would have to ence was present in diseased subjects. Both carboxy- be through an allergic process, but there have been no hemoglobin and scrumcholesterol concentrations reports on this to date. Abstention from smoking is increased with the intensity of smoking, suggesting a recommended as the basis of treatment for the obliter- positive correlation betweencarboxyhemoglobin and ating vascular diseases. scrum cholesterol values. Tobacco workers had sign cantly higher carboxyhemoglobin and scrum cholesterol values than other workers. 71.0480, Jacobs, D. The Aetiology and Possible Preven- tion of Myocardial Infarction. South African Medical Journal 45(11):275-279, March 13, 1971. 71-0483. Kjeldsen. K. Smoking and Coronary Disease (12): Carbon Monoxide Exposure and Frequency of The subjects of this study were 250 cases of myo- Atherosclerosis. Complete English translation of Lakar- cardial infarction treated personally. Despite lack of proof Midwest 67(3):262.265, January 14, 1970. that the relationship is causal there is a clear association with obesity, excessive cigarette smoking, hypertension, See Abstract 70-0639. emotional stress, hyperuricemia and in qualified groups hyperlipidemia. Until the etiology of myocardial infarc- tion has been clarified, it would appear reasonable to treat 71-0484. Liljefors, I. Smoking and Coronary Disease (7): these factors so as to perhaps afford potential myocardial Smoking Habits and Coronary Diseaseina Twin infarction sufferers some prophylaxis. Indirect clinical Study. Complete English translation of Lakartidningen evidence is presented, which, correlated with the struc- 67(2):161.164, January 7, 1970. tural chemical similarities between cholesterol, sex hor- mones, vitamin D3 and cortisone, suggests that future See Abstract 71 -0127. research be guided along these lines in the hope that a O common denominator willeventually be discovered. (Auth. Abs.) 71-0485. Mathiesen, F. R. Rationelle Forholdsregler for Patienter med Kredslobslidelse i Benene. [Rational Mea- sures for Patients With Vascular Insufficiency of the 71-0481. Jones, R. .1. (Editor) Atherosclerosis. Proceed- Legs.)Ugesictift for Larger 132(41 ):1916-1919. Octo- ings of the Second International Symposium. Chicago, ber 8, 1970, Danish. November 2.5, 1969. New York, Springer-Verlag, 1970, 706 pp. Reconstructive surgery, when possible, is considered the best method of treating vascular insufficiency in the This symposium provides an up-to-date review of the legs. Unfortunately, only about 20 percent of all patients pathogenic processes involved in atherosclerosis and of with vascular insufficiency are suited for this treatment. the proposals that have been made for their control. In- Of all the medical and prophylactic measures which can cluded are sections on the basic pathogenesis of athero- be offered to the remaining 80 percent, only tobacco sclerosis; arterial thrombosis and its resulting complica- abstinence and walking exercises have been proven to be tions; epidemiological considerations in coronary heart of significant prognostic value, These should be instituted disease from around the world; nutritional studies relating instead of drug therapy which, at its best, is of doubtful

89 86 CARDIOVASCULAR DISEASES

benefit. Considerable evidence is also available on the The greater affinity of hemoglobin for carbon mon- importance of maintaining a normal hemoglobin level and oxide than for oxygen can lead to increased carboxy- avoiding minor injuries to the feet. hemoglobin in blood donors who smoke. The presence of carboxyhemoglobin has an adverse effect on the oxygen dissociation curve resultingina decreased release of 71-0486. Matts, S.G.F. Coronary Thrombosis. British oxygen to the tissues. When this is present. along with the Journal of Clinical Practice 24(12):545-547, December progressive decrease in oxygen-carrying capacity resulting 1970. from storage, bank blood will have an even greater loss in ability to provide oxygen to the tissues of a recipient. The main causal factors in coronary thrombosis can be Carbon monoxide can be displaced from hemoglobin by divided into three categories: pathological factors, physi- oxygen when there is room air exchange by donor respira- cal activity, and psychological stress. Included in the first tion. The rate of this exchange can be accelerated by categoryare cigarette smoking which causes arterial taking advantage of the natural gas laws and using a higher damage, obcsit y ,hypertension, hypercholesterolemia, concentration of oxygen for respiration or by increasing atheroma and platelet abnormalities. A large step forward ventilatory exchange. Volunteers in the present study has been taken with the widespread adoption of cardiac raised their carboxyhemoglobin levels by heavy smoking monitoring and setting up of intensive care units. This has and had the rate of decrease in carboxyhemoglobin tested enabled the mortality rate of hospital patients to be cut either after breathing pure oxygen or after exercise- around 10 percent and has provided a vast wealth of new induced hyperventilation. The decreasesin carboxy- information for analysis. Thus, more data will become lichioglobin levels were accelerated by either method. available as to the predisposing causal factors and their Donors who had not unoked showed low carboxy- relevant importance, leading to developments in preven- hemoglobin levels which did not decrease after exercise. tion rather than cure of coronary thrombosis. Thus, blood banks could minimize carboxyhemoglobin levels in collected blood by restricting the smoking of donors, by not collecting blood for at least 2 to 4 hours 71-0487. Raf, L. E. Harmful Clinical Effects of Smoking. after smoking, or by using oxygen breathing or exercise- Smoking and Diseases of the Peripheral Vessels. Com- induced hyperventilation to accelerate the donors excre- plete English translation of "Medicinska Skadeverkningar tion of carbon monoxide. (Auth. Abs.) av Rokning. Rokning och Perifera Karlsjukdomar", Social- Medicinsk Tidskrift 2(Special No.):67-71, February 1971. 71-0490. Strong, J. P., Eggen. D. A. Risk Factors and Of 98 patients admitted for surgery of the peripheral Atherosclerotic Lesions.In:Jones, R.J. (Editor). circulatory system (intermittent claudication), 94 had Atherosclerosis. Proceedings of du, Second International been smokers when their symptoms began. Of these 94. Symposium. Chicago, November 2.5, 1969. New York, 68 were cigarette smokers averaging 15 cigarettes/day. Springer-Verlag, 1970, pp. 355-364. Ages varied from 39-82, but almost half of the patients were in the 60-70 age group. Men strongly predominated Data from the International Atherosclerosis Project (86 percent). Experiences from the Mayo Clinic are and other recent autopsy surveys are used to illustrate the reviewed which suggest that tobacco withdrawal improves association of risk factors for coronary heart disease to the prognosis for patients with intermittent claudication: coronary atherosclerotic lesions. Coronary atherosclerosis of 87 patients who continued smoking, 10 had amputa- is found to vary with age, sex, geographic location, and tions while of 80 who stopped smoking, none had ampu- race. Lesions seems to be related to scrum cholesterol and tations. Because of the strong indications of the harmful dietary fat when comparing populations, but insufficient effect of smoking on the peripheral circulation, patients data are available to confirm such associations on an with intermittent claudication must be strongly instructed individual basis within a population. Lesions are greater in to stop smoking. hypertensive and diabetic individuals than in those with- out these conditions. Lesions are also greater in heavy cigarette smokers than in nonsmokers. No consistent asso- 71-0488. Schoendorf, T., Wilkening, J., Cliffton, E. E. ciation of atherosclerotic lesions is observed with physical Influence of Cigarette Smoking on Some Blood Coagula- activity or obesity. There is much variability in extent of tion Tests. Journal of Medicine; Experimental and Clini coronary atherosclerosis among individuals of similar race, cal I (2):117-128, 1970. sex, age, geographic location, disease, and smoking habits. Thus, there are other important factors involvedin The aim of this investigation was.% study certain development of atherosclerosisthat have yetto be effects of cigarette smoking on the blood coagulation determined. (Auth. Abs.) system. Twenty-seven habitual smokers took part one or more times in the study. Three types of cigarettes were used containing different nicotine concentrations in the 71-0491. Thiscus, S., Tibbling, L. Smoking and Coronary mainstream smoke. Some alteration could be observed in Disease (9): Angina Pectoris or Angina Cardiac? Com- the blood clotting system after smoking two standard plete English translation of Lakartidningen cigarettes. A proportionate dose response in the blood 67(2):165.167, January 7, 1970. clotting system to the differing nicotine concentration could not be demonstrated. (Auth. Abs.) See Abstract 71-0139.

71-0489. Shields, C. E. Elevated Carbon Monoxide Levels 71-0492, Tibblin, G. Harmful Clinical Effects of Smoking. From Smoking in Blood Donors.Transfusion Myocardial Infarct and Smoking. Complete English 11(2):89.93, March-April 1971.

90 87 OTHER DISEASES AND CONDITIONS

translation ofMedicinska Skadeverkningur av Rokning. disease, was undertaken to determine if, as previously Iljartinfarkt odi Rokning", Social.Medieinsk Tidskritt reported, the use of hard water reduced the natural inci- 21Special No.):6567, February 1971. dence of chronic cardiovascular disease. Ilistory of smok- ing, educationallevels,socioeconomicindices and Smoking is a risk factor in the development of myo- patterns of living, such as church attendance were also cardial infarction in young and middle aged men. Of great recorded. Results showed fewer persons using soft water etiological significance is the at herogenic effect of carbon died from arteriosclerotic heart disease. Church atter' monoxide. Judging from Japanese studies, among others. dense correlated best with reduction in the average death there are population groups that are heavy smokers with a rate. The risk of fatal arteriosclerotic heart disease was low incidence of myocardial infarction. This suggests that greater among smokers than nonsmokcrs and was dose- in certain population groups there are factors which have related. a protective effect.

71-0496, Wilhelmsen, L. Smoking and Coronary Disease 71-0493, Tibblin, G., Wilhelinsen, L. Smoking and Coro- (10): The Relationship Among Risk Factors in Coronary nary Disease (5): Men Born in 1913. Complete English Disease. Complete English translation of Lakartidningen translation of Lakartidningen 67(2):I53.155, January 7, 67(3):249-255, January 14,1970. 1970. See Abstract 70-0653. See Abstract 71-0140.

71-0497. Zdichyncc, II.,Proks, C. Vyznam Kuractvi 71-0494. Von Hoist, II. E. Smoking and Coronary Disease Cigaret z Illediska Infarktovych Zmen na Elektrokardio- (I):Introduction, CompleteEnglishtranslation of gramu. (Cigarette Smoking and Infarction Changes on the Lakartidningen 67(2):138139, January 7, 1970. Electrocardiogram.)Casopis Lekaru Ceskrch 110(11):256-257, 1971, Czech. See Abstract 70-0650. An analysis of 637 cases of transmural myocardial infarctions (TIM) and intermediary coronary syndromes 71-0495. Wehrmacher, W. II. Healing Waters and Healing TICS) showed a higher incidence of ICS and anteroseptal Faith. Current Medical Dialog38(5):437-439, May TIM among smokers. The development of ICS in younger 1971. males is not favorable from the prognostic aspect. Possible pathogenetic mechanisms which need experimental con- An epidemiological study of white men 45.65 years of firmation are discussed. age who died of arteriosclerotic and degenerative heart

See also, 71-0355,71.0356,71-0360,71-0368,71-0370,71-0377,71 -0386, 71-0390,71-0399,71-0405,7141410,71-0421,71-0449,71-0502

OTHER DISEASES AND CONDITIONS

71-0498. Chanial, G., Joseph, J., Colin. L., Duclaux, C. for the laboratory-determined maximal oxygen consump Dermatitis in Tobacco Workers (Remarks on 9 Observa- tion if the subjects are well motivated. (Auth. Abs. Mod.) tions). Complete English translation of Bulletin de la Societe Francaise de Dermatologie et de Syphilographie 77(2):281.283, July 1970. 71-0500. Dcnnish, G. W., Casten, D. 0, Inhibitory Effect of Smoking on the Lower Esophageal Sphincter. New See Abstract 70.1128. England Journal of Medicine 284(20):1136-1137, May 20, 1971.

71-0499. Cooper, K. H., Zechner, A. Physical Fitness in Pressurein the lower esophagus, lower esophageal United States and Austrian Military Personnel. A Com- sphincter and gastric fundus was measured in six normal parative Study. Journal of the American Medical Asso- males, all chronic smokers. to determine the effect of ciation 215(6):931.934, February 8, 1971. smoking on lower esophageal sphincter pressure. In all subjects, sphincter pressure dropped within two or three The level of physical fitness of men, ages 18 to 29, in minutes after smoking began and remained low until the U.S. Air Force and the Austrian Army was compared. smoking stopped. Pressure levels also fell in two of three A marked difference in endurance performance was subjects smoking cigars and in one of two subjects smok- observed on a I2-minute field test of running perfor- ing pipes. Apparently, the fall in sphincter pressure during mance irrespective of the stage of training or the age, even smoking reduces the sphincter's effectiveness as a pressure though the Austrian soldiers weighed more and a com- barrier to gastroesophageal reflux and may explain the parable percentage of them smoked cigarettes. The results clinical association between smoking and heartburn. indicate that the I2minute field test is a good substitute

91 88 OTHER DISEASES AND CONDITIONS

71-0501. Fang, H. S., Liu, II. M. The Influence of Smok- livers were undetectable regardless of maternal smoking ing and Drinking on Binocular Depth Percep- habits. At 11.13 wk gestation. very loss levels of hydroxy- tion.(7 se Journal of Physiology20(4 ):27 I -277. lase activity were observed in placentas of smokers. and 1970. slightly higher levels were apparent in smoker placentas at 14.16 wk gestation. Ilydroxylating capacity of placental The binocular depth perception test was made on homogenate% from nonsmokers was not detected at 8- 16 thirty-seven random healthy male Chinese. about half of wk gestation. Steroids synthesized by human placental them being medical students and the rest business and tissues,i.e.cwstradiol.estrone.andprogesterone. teaching staff. The Howard -Dolman depth of perception markedly inhibited the placental-catalyzed hydroxylation apparatus was employed for measuring the distance differ- of benzopyrcne. Cholesterol. dehydrocpiandrosterone, ence of depth perception, i.e., depth perception error. testosterone, and androstenedione. which serve as sub- The interpupillary distance was also measured. Based strates for other placental mixed-function oxidase upon the former two values the binocular parallactic angle tents, however. exhibited comparatively minor inhibitory was then computed. It was found that smoking of I or 2 effects.Similareffects of these and other steroids cigarettes did not affect the score of depth perception test Imethyitestosterone and pregenolonto were observed on and binocular parallactic angle. On the other hand, 30 and the placental hydroxylase of 3-methyleholanthrene pre- 60 minutes after drinking of I ounce of scotch whiskey treated rats. (Auth. Abs.) the depth perception error was significantly larger than that of the control reading. Such an amount of whiskey. however, had no appreciable effect on the binocular 71-0504. Kashinskas, R. Vu. Chronic Pharyngitis and parallactic angle. The average control value of the depth Allergy. Complete English translation of l'estnik Ora perception error was 16.0 mm, the interpupillary distance rinolaringulugii 31(31:52-57. May-June 1969. 63.0 mm, and the binocular parallactic angle 51 seconds. These values are quite close to those of Americans. (Auth. See Abstract 70.1130. Abs.)

71-0502. WI, T. M., Ulett, G. A., Hsu. W., Klingenberg, 71 -0505. Kreis.11.,Peltier, A., l'ournaud. S.. Dupin.Girod. II., Ulett, J. A. The Effects of Smoking Withdrawal on S. Precipitation Reaction Between Certain Human Sera Quantitatively Analyzed EEG. Clinical Electroenceph- and Soluble Tobacco Extracts. Complete English transla- alograph). 2(1):44-51, January 1971. tion of A small's de Medecine Interne 121(41:437-440, April 1970. Thirty-two young male chronic cigarette smokers were deprived of smoking for a 24-hour period. EEGs were See Abstract 70.1298. recorded before deprivation, at the end of the 24-hour smoking deprivationperiod, and againimmediately following the smoking of three cigarettes. The EEGs were 71-0506. Miskiewiez,II. Zwiazek Palenia Tytoniu z examined by visual inspection, by digital computer permed Chorobami Przewodu Pokarmowego. !Connection Be- analysis, and by electronic frequency analysis. All three tween Tobacco Smoking andDigestive TractDis- methods of EEG analysis demonstrated that at the end of eases.1 Wiadumusc iI . e hors!: ie23(22) :1991.1995. a .24-hour period of smoking deprivation an increase in November 15. 1970, Polish. slow activity occurred, although the frequency bands differed depending on the method used. Only the fre- Etiological aspects of the association of tobacco smok- quency analyzer data showed changes at a statistically ing with diseases of the alimentary tract are brielb dis- significant level, Ten minutes after the subjects were cussed. Smokers in comparison to nonsmokers are more permitted to smoke three cigarettes a shift back toward afflicted by certain diseases of the alimentary tract. but a the normal resting pattern was seen. These findings distinction must be made between the incidence arising in support the results of an earlier pilot study which shv.wed the various portions of tlrr tract. In a smoker, the oral a significantincrease in slow wave activity following cavity, the esophagus, the stomach, the duodenum, and smoking deprivation and were interpreted as a typical the liver all show their individual proneness to develop EEG sign of decreased vigilance, These EEG changes and certain diseases. The oral cavity will show slight distur- their reversibility support the content that smoking is a bances (impairment of the taste sensations) but also complex psychosomatic problem, analogousto drug greater disturbances (inflammations. leukoplakia, and can- addiction. (Auth. Abs.) cer). The attack on oral cavity is a fourfold one: the mechanical attack by particles, the hydrodynamic attack due to inhaling tobacco smoke, the thermal one due to 71-0503. Juchau, 141. R. Human Placental Hydroxylation the ingestion of hot smoke which may reach the mouth of 3,4-Benzpyrene During Early Gestation and at with a temperature as-high as 60°C. and the chemical Term.Toxicology and Applied Ph ar ma c ologr attack which is due to nicotine, carcinogens and other 18(3):665-675, March 1971. noxious ingredientsinthe smoke. The esophagus of smokers shows six times as high an incidence of cancer as Benzopyrene hydroxylase activity in human placental in nonsmokers. The stomach, which may become afflicted tissues was investigated during early gestation (8-16 wk) by various diseases induced by smoking. will show signs of in order to determine whether cigarette smoking would an impaired pepsin excretion and other enzymatic allera produce increased hydroxylation capacity at this gesta- tions. tional stage. Particulate subfractions of term placental homogenates from %lomat who smoked cigarettes during pregnancy exhibited relatively high levels of enzymatic 71-0507. klukherjtn, S. K. Some Observations on Peptic activity. At 8-10 wk gestation. however, levels of enzy- Ulcer (A Study of 500 Cases).Antiseptic matic activity in homogenates of human placenta or fetal 67(11):841.849, November 1970.

92 89 OTHER DISEASES AND CONDITIONS

A study of 500 patients with peptic ulcer at the Vagotomized and sham-operated male Sprague-Dawley Medical College Hospitals in Calcutta in 1965 and 1966 rats received daily subcutaneous injections of nicotine relates to the types of peptic ulcer, their clinically diag- (2000 micrograms base/2.0 ml/kg) or nicotine control nosed features to warrant hospitalization, and their treat- saline (2.0 nil 0.85 g/100 ml w/v NaClikg). After 14 days ment on hospitalization. A variety of factors including of injections the rats were isolated from food for 40 hours age, sex, religion, dietary habits, smoking, psychological and basal unstimulatcd gastric secretion collected follow- factors, blood groups, gastric acidity, blood-urea after ing pylorus ligation. In sham-operated rats, nicotine signif- bleeding episodes, parasitic infections, and associated dis- icantly increased basal gastric juice volume, acid output eases are statistically analyzed. Among the male patients, and pepsin output. Following vagotomy, however. there 86.7 percent were smokers. were no differences between chronic nicotine- or chronic nicotine control-injected rats. Thus. abdominal vagotomy prevents nicotine-induced gastric secretory stimulation. 71-0508.NationalResearch Council. Committee on Maternal Nutrition. Maternal Nutrition and the Course of Pregnancy. National Academy of Sciences, Washington, 71-0512. Thompson, J. II., George, R., Angulo, AI. Some D.C., 1970, 241 pp. Effects of Nicotine on Gastric Secretion in Rats, Pro- ceedingsof theWestern Pharmacology Society Current knowledge concerning the problems, practices 14:173-177,1971. and research on maternal nutrition and its effect on the course and outcome of pregnancy is reviewed. The report Vagotomized and sham-operated male Sprague-Dawley examines the epidemiology of human reproductive casu- rats (250-300 g) with and without hypothalamic lesions alties in terms of biomedical, biosocial and psychobiologi- were injected subcutaneously for 14 days with either cal determinants of pregnancy outcome; normal physio- nicotine (2 mg/kg) or NaCI. In sham-operated rats, nico- logical changes that occur during pregnancy; the various tine significantly increased basal gastric juice volume acid kinds of anemia encountered during pregnancy and the output and pepsin output. Following vagotomy, there was puerperium with emphasis on the roles of iron and folic no difference for any parameter between chronic nico- acid in their prevention and treatment; and the role of tine-, or chronic nicotine control-injected rats. Nicotine nutrition in fetal growth and development, pregnancy in still stimulated gastric juice and acid and pepsin outputs adolescence and the toxemias of pregnancy. after caudal hypothalamic lesions, but these responses ere blocked by vagotomy. Anterior hypothalamic k sions blocked the nicotine-induced gastric secretory 71-0509. Pettersson, F. Harmful Clinical Effects of Smok- simulation. There were no differences between these ing. Smoking and GynecologicalObstetrical Condi- hsioned rats with or without vagotomy. These results tion.Complete Englishtranslation of "Medicinska suggest that chronic nicotine-induced gastric secretory Skadeverkningar av Rokning. Rokning och Gynekologisk- stimulation is mediated via anterior hypothalamic activa- Obstetrisk aTillstand",Social-MedicinskTidskrift tion and intact vagus nerves. 2(Spccial No.):78-82, February 1971.

Even if a number of biological and social variables are 71-0513. Vos-Brat, L. C., Rumke, P. Immunoglobulin taken into consideration, it remains that smoking women Concentration, PHA Reactions of LymphocytesIn Vitro, have offspring with lower birth weights. Thus far it has and Certain Antibody Titers of Healthy Smokers. Com- not been possible to detect any serious consequences of plete English translation ofJaarboek Kankeronderzoeken the reduced birth weight. In a multifactorial analysis, no Konkerbestrl/ding19:49-53, 1969. increased risk of abortion in smoking mothers was found. Smoking women appear to have more pregnancies than SeeAbstract 71 -0316. nonsmoking women.

71-0514. Yamagiwa, 11, Studies on the Chronic Gastritis. 71-0510. Philips, C. The EEG Changes Associated With U. Relationships of Gastric Diseases to Smoking, Drinking Smoking.Psychophysiology8(0:64.74, January 1971. and Blood Type.Mie MedicalJournal 20(1):89-9 I. May 1970. Computer analysis of EEG data, recorded under both resting and work conditions following smoking, was Histological findings of 222 cases of chronic gastritis. compared to the appropriate control data in 6 male sub- 158 cases of duodenal ulcer and 54 cases of gastric car- jects. Following digitizing, a power spectra analysis was cinoma were observed in relation to smoking, drinking performed which revealed significant reductions in the and blood type in the clinical history of the patients. No peak alpha frequency component up to 20 minutes fol- significant difference was found in the frequency of gas- lowing smoking, during a visual task. Eyes open resting tric diseases between non-drinking and drinking patients. data showed a similar but not significant loss, after 8 Gastriculcers, duodenal ulcers and gastric carcinoma minutes. No indications of increased fast activity were occurred more frequently in smokers as compared to non- found. These results were related to comrrable work on smokers. Blood type showed no relationship to gastric animals and humans. A suggestion was made as to the disease. Neither drinking nor smoking showed any correla- relevance of these changes. (Auth. Abs.) tion with intestinal metaplasia.

Seealso, 71-0353,71-0357,71-0358,71-0367,71.0369, 71.0511. Thompson, J. H., Angulo, M. Chronic Effects of 71-0378,71-0381,71-0391,71-0395,71.0400, Nicotine on Gastric Secretion in Vagotomized Rats. Ex- 71-0404,71-0405,71-0406,71-0410,71.0453, perientia27(4):404.405, April 15, 1971. 71-0526 93 90 BEHAVIORAL AND EDUCATIONAL RESEARCH

71-0515. lijartvcit. K. Restrictive Actions. The Influenc- was more common than in the lower. The average number ing of Smoking Ilabits by Restrictive Measures. Coin- of cigarettes was about ter. per day. For 70 percent this pleteEnglish translation of "Restriktionsatgarder. was the maxima. and the highest nut 1)er of cigarettes Pavirkning av Roykevaner ved Restriktie Tilltak". Social. reported was 20 per day. A total of 87.5 percent of the Medicinsk Tidskrift2(Special No.): 123-127. February smokers reported that they inhaled the smoke. Fighty- 1971. two percent were of the opinion that smoking did not affecttheir health while 15 percent reported adverse Some of the proposed and practiced methods of effects. The results suggest that smoking is on the increase restricting tobacco are reviewed, including: reduction or among women. (Auth. Abs. Mod.) prohibition of tobacco advertising; warnings on cigarette packages or in tobacco advertising; information on tar/ nicotine content; limitations of tobacco sales and selling 71 -0518. Lebovits, H., Wield, A. Smoking and Personal. hours; age limitations; upper limits for total content of ity: A Methodological Analysis. Journal of (Ironic !)is. tobacco per cigarette or of tar/nicotine content per ciga- eases 23110/111:813-821, March 1971. rette; increases in tobacco taxes; and increases in no smoking areas and periods. The attitude of the press A review of studies ott smoking and personality shows towards tobacco restrictions, the application of public that little attentionis paid to the fact that important health methods of disease control to combat tobacco differences exist in smoking behavior as a function of age, hazards, the possibility of a "backlash" reaction to restric- socio-economic status. family smoking habits. occupation. tions, and the importance of evaluating the effects of andreligion. Whenclassifiedaccordingtosmoking restrictions after they have been initiated are discussed. In behavior, various studies not only use different criteria applying restrictions to combat the harmful effects of but also make use of what appears to be illogical criteria. tobacco, a strategy must be devised that is based on a Scores on personality tests arc frequently used as the coordinated effort involving all three types of influencing independent variable. However, little or no attention is agents: information, treatment and restrictions. paid to such things as defensiveness; the unavailability of norms that are adequate for the various age. sex and socio-economic groups; the effects of different adminis- 71-0516. llom, I). Epidemiology and Psychology of Ciga- trations and settings on the tests; and the validity and tette Smoking. Chest 59(5, Supplement):22S-24S, May reliability of the tests that are used. Statistical analyses 1971. have not taken into consideration the fact that a number of the independent variables are significantly intercom:- Per capita consumption of cigarettes from 1947 to bled and that each may actually represent a somewhat 1969 is discussed along with possible reasons for the different way of measuring the very same variable. Also. periodic increases and decreases. The 1953-54 reduction large numbers of tests of significance may be made with in cigarette smoking reflects the effects of the first wide- no mention of this fact and often only significant findings spread press accounts of studies linking smoking to lung are included. Hypotheses are not derived from theoretical cancer and to heart and respiratory diseases. The 1964 formulations and little attention'is paid to data available Surgeon General's Report on Smoking and Health was in areas such as child and adolescent development. soci- responsible for another large drop in cigarette consump- ology and group dynamics. A few studies have attempted tion. Following a leveling-off period in which increased to utilize psychoanalytic constructs and to explain smok- ex- smokers were balanced by increased women smokers, ing behavior as a function of them. Here. though, the consumption began to drop around the second half of meaningfulness of an independent variable that is studied 1967 and has continued at an accelerating rate for about in retrospect is doubtful. 2 1/2 years. Reasons for this drop include a change in smokers' attitudes, extensive press reporting of scientific studies on smoking hazards and on various political and 7 1-05 19.Lichtenstein,E. Modification of Smoking control activities in relation to it, antismoking ads on tdc- Behavior: Good DesignsIneffective Treatments. Jour- vision, and public awareness and acceptance of the evi nal of Consulting and Clinical Psychology 36121:163-166. dence against smoking. The roles of the National Clearing- April 1971. house for Smoking andHealth, and theNational Interagency Council on Smoking and Health are briefly Cigarette smoking provides opportunities to investi- described. gate behavior change processes in a meaningful, naturalis- tic context that still permits adequate measurement and .controls. Although several recent behavior modification 71.0517. KatiKoskinen,0.,Hirvonen,L. Smoking studies, exemplified by the Marston and McFall paper, are Among the Female Workers of a Cotton MM. Ada well designed, the treatments employed remain ineffec- Scandinarica 2(I ):23 -27, 1970. tive. It is suggested that treatment ineffectiveness may be due to insufficient pilot (clinical) work and premature An inquiry into the smoking habits of the female freezing of techniques into group programs. Itis also workers of a Finnish cotton mill was carried out by means argued that process studies of smoking modification must of questionnaires in the spring of 1969. Of 1029 workers, await demonstration of an outcome effect or, at the least. 16.5 percent smoked. All the 170 women smokcd ciga- process variables must be shown to effect outcome. The rettes, each of them only a single brand, with the excep- problems involved in verifying smoking rates and whether tion of five women. Smoking was most frequent among Ss arc performing the "homework" assignmentsfre- young unmarried women. In the higher social classes it quently given by behaviorists are also discussed. (Auth. Abs.)

91 94 BEHAVIORAL AND EDUCATIONAL RESEARCH

71-0520. Markiewiez, K. Tyton w Wierzeniach i Ceremon- weakne.of aversive control for the "stimulus satiation" iachReligijnych, MagiiiPierwotnymLecznictwie. group which was instructed to smoke three cigarettes in 'Tobacco in Religious Creeds and Ceremonies, in Magic rapid succession each time a cigarette was desired. For a and in Primitive Medicine.Mai 11.godna 1.1.karski "hierarchical reduction" condition in which cigarettes 26(5):191 -193, February I, 1971, Polish. desired least were eliminated. It was proposed that cutting down by eliminating undesiredcigarettes might The ritualistic aspects of tobacco smoking are briefly strengthen rather than weaken smoking, since its rewards reviewed. Smoking was a habit of the American Indians, arc, if anything, increased. (Audi. Abs.) but it was not merely an act undertaken for pleasure. Rather it was a custom based on their primitive culture. The habit was observed in Indians who inhabited what is 71-0523. Midwives Chronicle. Action on Smoking and now called Virginia. Honda, and Peru, who might or Health. Midtvires Chronicle 84(99S):94. March 1971. might not have had contact with each other, and also in the Yibaros who presumably were not culturally influ- The goals of the Action on Smoking and Health. an enced by other Indians. The act of smoking formed part independent organization sponsored by the Royal College of the religion, and was also a part of mystic invocations. of Physicians, are briefly outlined. Europeans who adopted the habit later soon ascribed their own interpretations to tobacco use. For example, during the Sixteenth Century the Huguenots thoroughly 71-0524, Newman, A. N. How Teachers Sec Themselves detested tobacco, believing itto lead to sodomy and in the Exemplar Role in Smoking Education as Evidenced hermaphroditism. A study throughout many countries, by Their Attitudes and Practices.Journal of School such as Dahomey in Africa, Brazil, and Mexico, showed Health41(51:275-279, May 1971. that once the habit of tobacco smoking was accepted, it not only led to physical manifestations of diseases which This study attempted to determine how elementary could be diagnosed, but also to psychic changes which and secondary teachers view their own behavior, their may be interpreted as degenerations. awareness of the smoking problem, and whether they would make changes if they believed it would favorably influence their students. Results showed that teachers 71-0521. Marston, A. R., McFall, R. M. Comparison of were mindful of their responsibilities and were willing to Behavior Modification Approaches to Smoking Reduc- restrict smoking as an example to students; were more tion,Journal of Consulting and Clinical Psychology likely to report a smoking student if they were smokers 36(2):153 -162, April 1971. themselves; and believed by a ratio of 5:1 that teachers should not smoke where smoking is prohibited to stu- Two experimental treatments for the modification of dents. It was concluded that teachers display a readiness cigarette smoking were compared with two control condi- to assume the exemplar role in smoking education. tions, using a refined methodology for collecting daily smoking records and providing for an examination of therapist effects, One experimental treatment employed a 71-052S, Russell, M.A.H. Cigarette Dependence: I -- stimulus satiation technique in whichSswere instructed Nature and Classification.British Medical Journal to smoke three cigarettes on each smoking occasion. The 2(5757):330.331, May 8, 1971. second, a hierarchy approach, involved gradual reduction beginning with the period of the day judged easiest for Smoking is a dependence disorder since most smokers relinquishing cigarettes. In one control treatment,Ssused smoke not because they wish to, but because they cannot a pill designed to coat the mouth to make cigarettes aver- rosily stop. Most people smoke to obtain nicotine and are sive; the other control groups were instructed to quit, unsatisfied by nicotine-free cigarettes. Nicotine acts as cold turkey. Each of the four conditions showed its own either a stimulant or a sedative and often shares with characteristic reduction curve and all reduced to a mean other dependence-producing drugs the quality of acting as level below 25 percent of base. There was a significant a primary reinforcer of behavior. Depression, tcnsion, and effect of therapist during treatment, but none at six- irritabilityare some of the psychological withdrawal month follow-up by which time all groups had shown a symptoms, while sleep disturbance, sweating, gastroin- considerable relapse. (Auth. Abs.) testinal changes and a drop in pulse rate are prominent physical withdrawal effects. Some of the past methods of classifying smokers are briefly reviewed and a new scheme 71-0522. Mausner, B. Some Comments on the Failure of based on five types of smoking derived from the various Behavior Therapy as a Technique for Modifying Cigarette reinforcers of smoking behavior (psychosocial, indulgent, Smoking. Journalof Consulting and Clinical Psychology tranquilization, stimulation and addictive) is described. 36(2):167-170, April 1971.

The failure of behavior therapy for smokers is attri- 7I-0526. Steinfeld. J. L. Cigarette Smoking Is on the In- buted to two factors: first, the Inadequacy of external crease Among Women- -and They Also Find It Harder to contingencies, and second, the lack of effect of aversive Quit.Bulletin National Tuberculosis and Respiratory control. Smokers find it easy to return to smoking once Disease Association 57 (5 ):2-5,May 1971. they are outside the therapeutic situation. Data from a role-playing experiment are interpreted to signify that The health hazards associated with smoking by women positive reinforcements for refraining from smoking might and especially pregnant women are discussed. Since 1955, be more successful than aversive controls in changing the percentage of women smokers has increased in prac- smoking behavior.Neither of Marston and McFaU's tically every age group, while only 15 percent of the experimental groups showed greater reduction in smoking women smokers were able to give up the habit. This than their control groups. This was attributed to the argument was primarily attributed to: girls starting to

c 5 92 TOBACCO ECONOMICS

smoke at earlier ages; advertising, particularly by home- smokers were found to have 20 percent more unsuccessful making magazines; the fear of weight gain from cessation; pregnancies due to spontaneous abortion, stillbirth, and desire to break away from old social restrictions; and death of the infant in the first month of life than non women being less affected and, therefore, less conscious smokers. of the deaths and diseases caused by smoking. Women See also, 71-0379, 71-0398, 71.0403, 71-0466, 71-0534

TOBACCO ECONOMICS

71-0527. Medical Officer. Smoke Reduction on Two over the previous year. In the three-week period following Fronts. Medical Officer 125(7):84, February 12, 1971. the publication of the Royal College of Physicians' 1971 report, cigarettesales dropped 10 percent and pipe In 1971 the content of sulfur dioxide and smoke in tobacco sales increased 20 percent. the British air dropped 6 and 13 percent, respectively, See also, 71-0530

BILLS AND LEGISLATION

71-0528. British Medical Journal. Cowardice About Smok- setting forth the tar and nicotine content of each cigarette ing.(Editorial.;British Medical Journal1(5751):683, on the package and in all advertising, should be required. March 27, 1971. Appropriations for massive public education and for research to seek the development of a cigarette not The British government is criticized for its lack of hazardous to health are also recommended. The report is effective action on smoking, particularly for not propos- appended by seven documents including a report of tar ing legislationto ban cigarette vending machines, to and nicotine content of the smoke of 120 varieties of furtherrestrictcigan.tte advertising, and to prohibit cigarettes, dated October 21, 1970. smoking in public places. 71-0530. Federal Trade Commission. Statistical Supple- 71-0529. Federal Trade Commission. Report to Congress. ment to Federal Trade Commission Report to Congress, Pursuant to the Public Health Cigarette Smokira Pursuant to the Public Health Cigarette Smoking Act. Federal Trade Commission, Washington. Act.Federal Trade Commission, Washington, D.C., December 31, 1970, 24 pp. December 31,1970, 14 pp.

The FTC report to Congress on cigarette advertising The purpose of this statistical supplement is to update concerns itself primarily with the effectiveness of ciga- charts previously published by the Commission concern- rette labeling and with the current practices and methods ing sales of cigarettes and other products by cigarette of cigarette advertising and promotion. In the latter, three manufacturers. expenditures for cigarette advertising in basic themes are noted to prevail in most advertising: 1) various media, and exposures to cigarette advertising by appeals to satisfying taste; 2) association of smoking the various age groups to include data for the years 1969 and advertised brand with desirable personality characteristics; 1970. As in previous years, these data were obtained by and 3) relieving anxieties about the health dangers of ciga- the Commission staff from domeatic cigarette manufac- rette smoking by the use of humor, the association of turers. Additionally, one portion of this supplement dis- cigarettes with undisturbed nature, and claims concerning cusses distribution of sample cigarettes during 1969 and the effectiveness of a filter, Miscellaneous promotional 1970 and recommends legislation to prohibit distribution techniques also used include offers of coupons, trading of sample cigarettes through the mail. The data are tabu- stamps, or money, a variety of merchandise at special lated to include: total cigarettes sold; per capita consump- prices, and the mailing of free sample packages. The regu- tion; filter and non-filter sales; menthol and non-menthol latory activity of the Commission during 1969-1970 is sales; cigarette sales by size; total sales of cigarette manu- discussed as well as the voluntary regulation of cigarette facturers (including non-cigarette products); total ciga- advertising by the cigarette and broadcasting industries. rette advertising expenditures; market share and adver- The commission recommends legislation requiring that tising expenditures of filter cigarette varieties, 100-milli- the warning on aU cigarette packages and advertising be meter length cigarette varieties, and of cigarettes yielding required to read as follows: "Warning: Cigarette smoking 15 milligrams of tar or less; television advertising of is dangerous to health and may cause death from cancer, cigarettes (all U.S. inhabitants); and network program coronary disease, chronic bronchitis, pulmonary emphy- advertising (exposures among children and teenagers, ages sema, and other diseases." Furthermore, a statement 2-17).

96 93 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

71-0542. Alfsen, A., Chiancone, E., Antonini, E., Waks, In this in vitro experiment. ()- nicotine is oxidized M., Wyman, J. Studies of the Reaction of Haptoglobin by NADPH and oxygen dependent mixed function oxi- with Hemoglobin and Hemoglobin Chains. III. Observa- dases of guinea-pig tissues to two optically-active stereo- tions on the Kinetics of the Reaction of the Hapto- isomers of nicotine-1 -oxide and to cotinine when the globin Hemoglobin Complexes with Carbon soluble fraction is also present. Of the tissues examined Monoxide.Biochimica et Biophysica Acta liver is the most active in synthesizing these three metabo- 20713):395 - 403,1970. files although there is sonic activity in lung and kidney but little or none in brain, heart, spleen or blood. The Hemoglobin bound to haptoglobin reacts with CO at a ratios of the amounts of the three metabolites vary with faster rate than free hemoglobin, both in flow and flash different tissues. The substrate concentration affects the experiments. The change in the kinetics of recombination rate of formation of these oxidation products differently, with CO measured in flash photolysis experiments after relatively large amounts of faeronicotine-1 -oxide being mixing hemoglobin with haptoglobin has the same time- synthesized at the lower (--)nicotine concentrations. course as the binding observed in fluorescence-quenching None of the three metabolites is metabolized further experiments. When deoxyhemoglobinisexposed to when incubations are in air, but under anaerobic condi- haptoglobin even for a long time, a small but finite frac- tions nicotinc-I -oxides are enzymically reduced to nico tion of hemoglobin is bound, as revealed by the presence tine at different rates. With initial substrate concentration offastreacting material.In hemoglobin haptoglobin of 0.4 mM, laero-nicotine-1 -oxide is reduced six times as mixtures, the appearance of fast-reacting material is en rapidly as Ow dextrorotatory isomer. (Auth. Abs. Mod.) hanced. Mixtures of hemoglobin and haptoglobin in a 1:1 molar ratio. which show no free hemoglobin in clectro- phoresis, are heterogeneous in the reaction with CO due 71-0545. Bracco. M., Curti, P. C. La Sostanza Tensio- to fib: presence of fast- and slowreacting material. The Attiva Dell'InduitoAlveolare: Costituzione Chimica, functional heterogeneity of bound hemoglobin disappears Originc e Funzione Nel la Fisiologla Polmonare. Nuove when haptoglobin is in excess. These effects reflect the Acquisizioni Chimiche e Istochimiehe. The Tensio-Active presence of different types of complexes. (Auth. Substances of the Alveolar Lining: Chemical Structure, Abs.) Origin, and its Function in Pulmonary Physiology. New Chemical and Histochemical Findings.] Medici di Sonde lo 18(1):5.58, January-March 1970, .talian. 71-0543. Becker, R. F., Mart.., J. C. Vital Effects of Chronic Nicotine Absorption and Chronic Hypoxic Stress During Pregnancy and the Nursing Period. American The results of research on the chemical structure of Journal of Obstetrics and Gynecology 110(4):522-533, the tensio-active substance of the alveolar lining and on its June 15,1971. histochcmical demonstration are presented. The surface- activity of lung washing with saline is related to lipid Four experiments were performed in which 3.0 mg of spherules or liposomes. By centrifugation it is possible to nicotine/kg of body weight twice daily was administered isolate a fraction of pure liposomes; this fraction is the to the gravid rat during the entire gestational period. only one provided on the typical surface -area character- Other pregnant rats were subjected to hypoxic stress once istics. If contamination with blood and tissue is carefully daily during gestation. Increasing the amount of nicotine avoided, the liposomic fraction of the lung washings is administered as weight increased over the gestational composed purely of phospholipids with only traces of period had no greater effect than continuing the dose protein. The behavior of the alveolar granules is identical begun on Day 0. Continuing injections until Day 21 re- to that of the tensio-active liposomes fractionated from suited in no additional effects over injecting through Day the pulmonary lavage with saline. Pretreatment of lung 20. The offspring of rats given nicotine were significantly sections with anhydrous cold acetone does not alter the more underweight at birth than salineinjected controls; histochemical reaction which however disappears follow- fewer live young were born; and mothers were delivered ing lavage of the sections with acetone (75 percent) in of their infants later and gained less weight during gesta- water, chloroform, or ethanol. This histochcmical method tion. Offspring whose mothers received nicotine through- has been applied to the study of experimental pathology out the nursing period in addition to the above had a in white mice in comparison with volume-pressure dia- poorer survival chance after birth. Hypoxic young tended grams of the excisedlungs. Prolonged inhalation of to be lighter in weight at birth. The sex ratio was shifted cigarette smoke provoked in mice a marked modification to some extent for both nicotineinjected and hypoxic of the static volume-pressure diagram of the excised lungs, groups in favor of males. (Auth. Abs.) indicative of an increased retractive pressure. The mechan ical alterations are related to profound derangement of the alveolar surfactant. 71-0544. Booth, J., Boy land. E. Enzymic Oxidation of (--)-Nicotine by Guinea-Pig TissuesIn Vitro.Bio- 71-0546. Brody, J. S., Coburn, R. F. Effects of Elevated chemical Pharmacology 20(2):407415, February 1971. Carboxyhemoglobin on Gas Exchange inthe Lung.

96

99 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

Annals of the New York Academy of Sciences174(Art. 71-0549. Decherd, .1. F. The Medical Effects of Mari- 1):255-260, October 5,1970. huana.Southwestern Medicine51(8): 170-172, August 1970. Measurements in patients corroborate theoretical cal- As far as can be critically ascertained from a review of culations and make it unnecessary to postulate that small recent available literature from well-controlled studies, amounts of CO directly interfere with alveolar gas ex- cannabis increases the pulse rate to a mean of 10 beats per change. These studies have shown that the tissue hypoxia minute above resting values at 15 minutes. This effect is produced by CO inhalation may to accentuated by rather dissipated after 90 minutes. There is no change in respira- marked degrees of arterial hypoxemia in patients with tory rate or in blood sugars. The inhaled smoke is irrita- heart or lung disease or in normal subjects when ventila- ting and long, continued exposure to it is suggested to tion-perfusion (V/Q) ratios become abnormal, and that induce chronic respiratory disorders. Interestingly,hyper- the arterial hypoxemia in these instances results from the phagia has been reported by a number of marihuana users. CO-induced changes in the shape of the oxyhemoglobin There is no ready explanation for this medically, es- dissociation curve. peciallyinterms of blood glucose concentrations. Whether there is some increase in the simple desire for food or whether food ingestion becomes more pleasurable has not been elucidated. No physical dependence or toler- 71-0547. Chakraborty, B. B., Kilburn, K. D., Thornton, ance has been demonstrated. Further, it has not been R. E. Reduction in the Concentration of Aromatic Poly- demonstrated that cannabks causes any lasting mental or cyclic Hydrocarbons in Cigarette Smoke.Chemistry and physical changes. The extent of psychological dependence Industry24:672, June 12,1971. on marihuana in the United States is not known. It may be reasonably presumed to be less than that of narcotic Smoke condensate collected from cigarettes made drugs. Cannabis does seem to uniformly cause conjunc- from flue-cured cut tobacco treated with bismuth oxide tival injection and as a corollary does not cause pupillary and calcium oxalate was analyzed for aromatic polycyclic dilatation. The suggested teratogenic effects of marihuana hydrocarbons by gas chromatography. Results showed and the effects on the liver cells are fragmentary and that both additives caused reduction of up to 50 percent await further confirmation after better and more con- in the delivery of aromatic polycyclic hydrocarbons. In trolled studies have been done. Further, the long-term terms of the total concentration of the measured aromatic effects of marihuana upon man are forthcoming and can- polycyclic hydrocarbons in cigarette smoke (as defined by not be reasonablypredicted at this time,just as the long- total particulate matter measurements), the reduction was term effects of tobacco were not realized until 10 or 15 45 percent for bismuth oxide and 30 percent for calcium years ago. (Auth. Abs. Mod.) oxalate. 71.0550. Dragiyev, M., lvanchev, V. lzmeneniya Aktiv- nosti Adenozintrifosfatazy, Suktsindegidrogenazy 71-0548. Chance, B., Erecinska, M., Wagner, M. Mito- Pecheni, Pochek, Serdtsa i Mona Krolikov pod Vliyani- chondria! Responses to Carbon Monoxide Toxicity. yem Toksicheskilth Vedschestv, Obruuyushchikhsyapsi Annals of the New York Academy of Sciences174(Art. Fermentatsii Tabaka. (Changes in the Activity of Adeno- 1):193-204, October 5,1970. sine Triphosphatase and Succinic Dehydrogenase of the Liver, Kidneys, Heart and Brain of Rabbits Under the A study of the dynamic response of the CO-inhibited Influence of Toxic Substances Formed in the Fermenta- respiratory component of isolated mitochondria gives tion of Tobacco.]Gigiena Ruda i ProjessionarnYe several important hints for those who are interested in the Zabolevanila15(2):32-35, 1971, Russian. total picture of carbon monoxide toxicity. First, compen- satory mechanisms whereby the respiratory chain is able Changes occurring in the activity of adenosine Ui- to diminish its inherently high vulnerability to carbon phosphatase and succinic dehydrogenase of the liver, kid- monoxide areidentified as branching and cushioning neys, heart and brain of rabbits following an acuteand phenomena. Essentially, they can be defined as an ability subacute complex action of toxic substances formed during factory fermentation of tobacco were studied. The of the matrix of enzymes involved in membrane-bound adenosine Uiphosphatase activity increased after the 5th electron flow to be activated effectively to establish tedox day. Starting from the 10th day, it quickly decreased, patterns of optimal effectiveness by remaining unin- dropping after the 15th day below that observed in con- hibited cytochrome molecules, thus enabling the flow of oxidizing equivalents to spread through the totality of the trol animals and remaining at this level until the 35th day membrane components. Time factors associated with this (the end of the experiment). The adenosine triphophatase activity also declined in an acute experiment. The succinic response are related not only to the kinetics of the pro- dehydrogenase activity increased progressively up to the cess itself, but also to the function of the large pool of 10th day and remained at this level until the end of the reducing substances in the mitochondrial electron transfer experiment. It also increased in animals undergoing an system. The times required for these pools to be activated acute test. It was concluded that a complex action of by CO-inhibited cytocluome depend critically upon the substances formed during factory fermentation of metabolic state which, in turn, controls the reactivity of tobacco provoked a deranged dephosphorylation of the these pools in electron flow. The extreme sensitivity of adenosine triphorisitate and of one of the Krebs cycle mitochondria in the uncoupled or metabolically active substrates in the test animals. (Auth. Abs. Mod.) state to small concentrations of CO in transient changes from anoxia to normoxia is emphasized and pointed to as a further complexity in considering the totality of tissue 71.0551. Environmental Protection Agency. Air Pollution CO toxicity. (Auth. Abs.) Control Office. Air Quality Criteria for Nitrogen Oxides.

t 10 97 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

Environmental Protection Agency, Air Pollution Con- equilibrium curve, although other sites of action should trol Office, Washington, D.C., AirPollution Control be investigated. The precise functional effects of the ex- Office Publication No. AP-84, January 1971,94 pp. pected decreases in tissue P02 are difficult to predict because of lack of knowledge of the tissue itself. This publication reviews the chemical and physical characteristics of the nitrogen oxides and considers the relative merit of various analytical methods for measuring 71-0554. Fulginiti, S., Orsingher, 0. A. Effects of Learn- them in the atmosphere. It also discusses their effects on ing, Amphetamine and Nicotine on the Level and Syn- visibility, vegetation and materials; their toxicological thesis of Brain Noradrenaline in Rats.Archives Inter- effects on animals and humans; and epidemiological nationales de Pharmacodynamie et deTherapie studies that assess the general population dose response 190(2): 291 -298, April 1971.' and the specific response of children to nitrogen oxides. There is no evidence that NO produces significant adverse A conditioning session in a shuttlebox (100 trials 30 health effects at the ambient atmospheric concentrations sec inter-trial intervals) did not modify the noradrenalinc thus far measured. NO2 exerts its primary toxic effect on (NA) levels in hypothalamus and hemispheres of rats the lungs and at concentrations greater than 188 mg/m3 it when compared to controls. Animals presented only with is lethal to most animal species. Hamster studies have unconditioned stimuli (100 electric shocks at 30 sec inter- shown that the combined effects of NO2 (28.2 mg/m3) val) showed a significant decrease in the NA levels in both withtobacco smoke forshort periods producesir- brain structures. Moreover, the conditioning session in- reversible, marked alterations in the surface morphology creased the rate of synthesis of NA in whole brain, as of lung tissue, an atypical structure of mucussecreting measured by the injection of tyrosine-CI". DI.-ampheta- cells, a marked loss of cilia, and a decreased resistance to mine sulphate (2 mg/kg) and nicotine (0.2 mg/kg) did not bacterial pneumonia. The short-term exposure of humans provoke appreciable ipodifications in the rate of con- to NO2 has produced a transient increase in airway resis- version of tyrosine Clto brain NA when animals were tance (9A mg/m3 for 10 minutes) andsulmonary edema killed 80 min after treatment; when assayed at 20 min, and reduced vital capacity (162 mg/m" for 30 minutes). amphetamine, but not nicotine, evidenced a marked in- In long-term exposure studies, an increased incidence of crease in the specific activity of NA. Possible causes for acute respiratory disease was observed in family groups the .ack of effect of nicotine are discussed. (Auth. Abs.) when the mean range of 24-hour NO2 concentrations, measured over a 6month period, was between 117 and 205 micrograms/m3 and the mean suspendednitratelevel 71-0555. Gilgen, A. Luftverunreinigung and Gesundheit. during the same period was 3.8 micrograms/m" or greater. [Air Pollution and Health.] Zeitschrift fur Proventiv The frequency of acute bronchitis increased among in- medizin15(3):217 -230, May-June 1970, German. fan ts and school children when the range of mean 24-hour NO2 concentrations, measured over a 6-month period, The effects of air pollution on morbidity and mortal was between 118 and 156 micrograms/m3 and the mean ity have been presented in this review of the literature. suspended nitrate level during the same period was 2.6 Various well-known smog catastrophics are cited. Itis micrograms/m3 or greater. concluded that the smoking habits and the socio-econ- omic conditions must be understood in order to evaluate the importance of air pollution in lung cancer etiology. In 71-0552. Food and Cosmetics Toxicology. Polybenzoid addition, itis considered that the role of air pollution Hazards.Food and Cosmetics Toxicology7:169-171, itself in the genesis of lung cancers must be viewed more March 1969. critically. The probability of the promoting effect of air pollution on mortality due to other types of cancers, The hazards presented by polycyclic aromatic hydro- however, appears to have been demonstrated. The in- carbons (PAII) which include some of the most potent creased incidence of chronic bronchitis due to air pollu- carcinogens known are reviewed. Sources of exposure to tion is established, with the severity of the symptoms PAH include industrial exposure as well as exposure to air influenced by meteorological factors. Clear evidence of of industrial cities, in cigarette smoke, in certain foods, the damage to lung function without visible signs of ill- and in water and soil. Education and improvement in nessisnot yet available. Fuller investigations on sub- personal hygiene could go a long way towards eliminating jective stress caused by air pollution are lacking. these hazards, especially in the case of industrial workers and heavy cigarette smokers. 71-0556. Grocnen, P. J., Van Gernert, L. J. Flame Photo- metric Detection of Volatile Sulphur Compounds in 71-0553. Forster, R. E. Carbon Monoxide and the Partial Smoke From Various Types of Cigarettes.Journal of Pressure of Oxygen in Tissue.Annals of the New York Chromatography 57(2):239-246, May 6, 1971. Academy of Sciences174(Art. 1):233-241, October 5, 1970. A gas chromatograph with flame photometric detec- tion was used to detect at least thirty-seven sulfur com- The possible effects of HbCO on tissue P02 produced pounds in the vapor phase of cigarette smoke. A sugges- by the shift of the oxyhemoglobin curve to the left arc tion as to their possible identity is given for many of reviewed. Normally man has about 0.5-1 percent HbCO in them. According to the literature only thirteen sulfur his blood, of which 0.4 percent represents the effect of compounds sofar have been found in smoke. In a endogenously produced CO. This total value can reach comparative study on three types of cigarettes, prepared 5-IQ percent in smokers. At present, the major effect of from flue-cured, air-cured and sun-cured tobacco, respec- HbCO in the blood is predicted to be a lowering of tissue tively, a great similarity was observed, but there were also venous Po2 produced by changes in the oxyhemoglobin some striking differences between air-cured tobacco on 101 98 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

the Tests With FilterCigarettes. Third Communication.' one hand and flue-cured and sun-cured tobacco on March, 1970,1 other. It is possible that on this basis a method maybe BundesgesundheitsblattI3(7):92-93, developed for the determination of the amount of air- German. curcd tobacco in an unknown tobacco blend. Nothing is with Thirty commercial brands of cigarettes were processed known about the importance of sulfur compounds The respect to the health of the smoker, though onecould in a smoking machine under identical conditions. cigarettes were first smoked with filters and then smoked speculate on a possible protective effect against alkylating after removal of the filters. The effectiveness of the filters smoke constituents. (Auth. Abs.) for their retention of tars and nicotine could thenbe determined by the difference in their yields. Five had a filter retention for nicotine below 30 percent.17 from 71-0557. Haase, E., Muller, W. Messbare Beeinflussung des of EOG durch Zigarettenrauchen? [Measurable Effects on 30.40 percent, 7 from 40.47 percent. and I a retention 53 percent. The nicotine content of the smoke of6 the EOG by Cigarette Smoking?'Klinische Alonatsblat- 158(5):677 -681, May 1971, brands was below 1.0 mg, of 13 from 1.3 mg and of 11 ter fur Augesiheilkunde brands German. above 1.3 mg. The tar content of the smoke of 4 MIS below 15 mg; 13 contained from15-20 mg, and 14 The dark phase of the second EOG in two directly had more than 20 mg tar. The brands were notidentified table sum- subsequent COG leads shows a significant lowering of the by name but were numbered 66 to 95. A includes dark depth. Leads on different days under approximately marizes the analytical data of 95 analyses (this the same conditions do not show this behavior. The mean 25 brands tested in 1966 and 30 tested in 1968). value LOG's of the trial groups correspond to one an- is therefore recommended to record control other. It N. I. EOG's, if possible, on another day. These studies indicate 7141561. Lovkov a, M. Yu., ll'in, G. S., Klinieneeva, and no significant changes in the EOG caused by rapidsmok- Role of Aspartic Acid in the Biosynthesis of Nicotine ing of two tillerless cigarettes as compared to control Anabasine. Complete English translation ofFiziologiya leads on another day under otherwise similar conditions. Rastenii,17(2):409-415, March-April 1970. (Auth. Abs. Mod.) To study nicotine and anabasine biosynthesis, inN. tabacum L. seedlingsand N.glaucaL. shoots, U-C1"-N'- 71-0558. fluke, 11.-P., Drcws, C. J., Schuller, D. Uberdas aspartic acid was introduced as a precursor ofthe alka- Vorkommen von Norbornenderivaten in Tabakrauchkon- loids. At the end of the experiments preparationsof densaten.[Appearance of Norbornene Derivatives in nicotine and anabasine were isolated from theplant Tobacco Smoke Condensates.]Tetrahedron Letters material, and their oxidative cleavage to nicotinic acid was (43):3789 -3790, 1970, German. performed. It was shown that aspartic acid is a precursor of nicotine and anabasinc;however,its role in the bio- The application of mass spectrometry in conjunction synthesis of these alkaloids differs. Thus, after incorpora- with gas chromatography revealed the presence of several tion into nicotine, the nitrogen of aspartic acid isutilized bicyclo compounds, hitherto not known to be present in primarily for biosynthesis of the pyridine ring, while the tobacco smoke condensate. These compounds are deriva- carbon atoms participated in the formation both ofthe tives of bicyclo-(2.2.1)-2- heptene, apparently resulting pyridine and of the pyrrolidinc rings of thealkaloids. In from a Diels-Alder reaction in the smoke condensate. anabasinc biosynthesis, on the contrary, aspartic acid Details of the analysis are included. participates primarily in the formation of the piperidine ring of the alkaloid, while it is incorporated lessactively into the pyridine heterocycle. Possible pathwaysof the 71-0559. Kroner, E. Ergebnisse von Abrauchversuchen utilization of aspartic acid in nicotine and anabasine bio- mit Filterzigaretten. 2. Mitteilung. [Results of Smoking synthesis are considered. (Auth. Abs.) Tests With Filter Cigarettes. Second Communication. Bundesgesundheitsblatt12(20):319, 1969, German. 71-0562. Markicwicz, K. Psssive Smokers. The Harm Twenty-five commercial brands of cigarettes were pro - From Passively Inhaled Smoke of CigarettesSmoked by cessed in a smoking machine under identical conditions. Others. Complete English translation of "Bicrni Palacze. The cigarettes were first smoked with filters and then O Szkodliwosci Biernie Wdychancgo Dymu zPapicrosow smoked after removal of the filters. The effectiveness of Palonych Przez lnnych ",PolskiTygodnik Lekarski the filters for their retention of tars and nicotine could 25(52):2041-2042, December 28, 1970. then be determined by the difference in their yields. Five had a filter effectiveness (retention) for nicotine below 30 SeeAbstract 71-0393. percent, 14 had a filter effectiveness of 30 to 40 percent, 5 from 40 to 50 percent and 1 above 50 percent effective- ness. The smoke of 6 brands contained up to 1.0 mg 71-0563. Michael, L. W., M.:nden, E. E., Petering, H. G. nicotine per cigarette; 11 had from 1.0 to 1.3 mg nicotine Copper-Binding Activity of It33acco Smoke Condensate. and 8 had more than 1.3 mg. Only in the smoke of 3 Environmental Science an4 nchnology5(3):249 251, brands was the tar content below 15 mg; 13 contained March 1971. from 15 to 20 mg tar and 11 above 20 mg. The cigarettes were not identified by name but, in continuationof a The distribution of cowr between abuffered previous analysis, were numbered 41 to 65. aqueous solution of the metal kiti and anorganic solution of tobacco smoke condensate (TSC)in 4-methy1-2- The analytical 71-0560. Kroner, E. Ergebnisse von Abrauchversuchen pentanone (M1BK) has been studied. mit Filterzigaretten. 3. Mitteilung. [Results of Smoking parameters, metal ion and hydrogen ion concentrations

102 99 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

were investigated. Metal ion concentrations were deter- Obstructing vision by wearing opaque goggles consistently mined by atomic absorption spectrophotometry. TSC was reduced the salivary response to smoking in all 16 sub- collected with use of a Mason Mark Ill Smoker and jects. Unstimulated resting levels were lower when vision acetone traps maintained at 0 C. This material was trans- was blocked, suggesting a more general phenomenon than ferred to MIBK by evaporation at reduced pressure. A merely removal of the sight of the stimulus-object. Smok- 10-nil aliquot of an aqueous solution 0.IM in 2-amino-2- ing cigarettes through a Cambridge filter assembly, which (hydroxymethyl)-1,3-propanediol (IRIS) 0.0IM in CuCl2 trapped the particulate matter and rendered the exhaled and p11 5.6 to 6.1 was equilibrated with an equal volume smoke invisible, had no effect on salivary secretion. This of the MIBK solution of TSC, which contained the equiv- indicates that the salivary stimulation derives from irri- alent of five cigarettes. Analysis of an aliquot from the tating materials in the gas phase of the smoke. (Auth. organic phase afterequilibration of the two phases Abs.) yielded a maximum value of 300 micrograms of copper per cigarette when fresh, nonfractionated TSC was used. This simple, rapid extraction technique has been used to 71-0567. Rees, E. D., Mandelstam, P., Lowry, J. Q., determine variations in the chemical activity of tobacco Lipscomb, H. A Study of the Mechanism of Intestinal smoke condensate. (Auth. Abs.) Absorption of Benzo(a)pyrene. Biochimica et Bio- physica Acta 225:96-107, January 5, 1971.

71-0564. Montesano, R. Systemic Carcinogens (N-Nitroso Benzo(a)pyrene and other polynuclear aromatic Compounds) and Synergistic or Additive Effects in Respi- hydrocarbons are readily absorbed from the gut when fed ratory Carcinogenesis. Tuniori 56(6):335 -344, Nov- to rats, but little is known about the mechanism of the embet-December, 1970. absorption. To study the mechanism, everted sacs of small intestine were incubated in a medium containing a lipid Systemic carcinogens induce respiratory tract tumors emulsion of benzo(a)pyrene (50-1500 micro M). After in various animals species. Typical examples of systemic incubation, the concentration of benzo(a)pyrene in the carcinogens are the N-nitroso compounds, which require sac tissue and in the medium inside the sac was deter- metabolic conversion to :nit their carcinogenic effect. In mined by spectrofluorimetric analysis of chloroform ex- this review particular emphasis is put on the comparative tracts. The data are in accord with a mechanism of physi- studies performed in the same species with diluent nitro- cal adsorption of benzo(a)pyrenetotheintestinal samines, thus providing an experimental model in which it mucosal surfacd and then passive diffusion into and is possible to examine and correlate the biochemical through the intestinal wall. Two phases of adsorption are changes preceding the development of detectable tumors postulated:first, unilayer (Langmuir) adsorption, then and the carcinogenic effect. In addition studies describing multilayer (Polanyi) adsorption which would account for synergistic or additive effects in respiratory carcinogenesis the exponential nature of the accumulation. are reviewed and discussed. (Auth. Abs.) 71-0568. Rodkey, F. L. Discussion: Carbon Monoxide 71-0565. Nikolova, M. Ye. Radioaktivnyy Faktor Tabach- Estimation in Gases and Blood by Gas Chromatography. nogo Dyma. (Radioactive Factors in Tobacco Smoke.) Annals of the New York Academy of Sciences 174(Art. Gigiena t Sanitariia 35(8):89-93, August 1970, Russian. 0:261-267, October 5, 1970.

The possible role of radioactivity in the genesis of lung Carbon monoxide content of blood and respiratory cancer has occasionedthis review of the radioactive gases may be measured by gas chromatography. The CO elements present in air, s2I1 and tobacco. The maximal present in the gas sample (or liberated from a blood and minimal values of Po in tobacco in the U.S.A., sample) is separated from other gases on a 5A molecular South Africa, Rhodesia, New Zealand and the USSR for sieve column. The column effluent containing CO is select years is presented. Soviet tobacco, according to one mixed with hydrogen and the CO is catalytically reduced source, contains from 600 to 1600 picocuries/kg tobacco to methane for detection by flame ionization. The ex- leaf. The Po' I° content in tobacco products is lower treme sensitivity of this detection system allows accurate because of isotope degradation during the fermentation blood CO content determination with 0.1 ml of blood. process and subsequent warehouse storage. One analysis Larger volumes of blood may be used for samples of ex- of the Po220 content of a smoked cigarette shows 9 per- Uemely low (less than 0.05 volumes percent) CO content. cent Po2 I " in the ash, 29 percent in the butt, 8 percent in Respiratory gas or ambient air is analyzed with samples of the filter and 50 percent in the iphaled smoked. Unfil- approximately 5 ml. The transient effects of oxygen in tered cigarettes have a higher Po2 Icontent in the smoke the sample do not interfere with CO estimation. Carrier but the filter is not considered as having sufficient pro- gas of low CO and CH4 contamination should be used tective activity. The biological importance of Pot with when the CO content of the gas sample is below 1 ppm. A respect to ii ms tissue is debated and it is evident that the coefficient of variance for the analysis of about ± 1 per- role of Po" in cigarette smoke requires further clari- cent was obtained for measurements of CO content of fication. blood and gases. (Auth. Abs.)

71-0566. Pangbom, R. M., Sharon, I. M. Visual Depriva- 71-0569. Rouch, Y., Rioufol, F., Bourbon, P. Oxycar- tion and Parotid Response to Cigarette Smoking. Physi- bonemie Spontanee et Apses Exposition Pendant ology and Behavior 6(5):559-561, May 1971. Quelques Minutes a une Atmosphere a Un Pour Mille d'Oxyde de Carbone Chez 43 Sujets. (Carbon Monoxide Cigarette smoking significantly increased parotid sali- Content in Blood: Normal and After a Few Minutes vary secretion in eight smokers and eight nonsmokers. Exposure to an Atmosphere Containing One Part per

103 100 CI1EMISTRY, PHARMACOLOGY AND TOXICOLOGY

Ncuropharuacology 10(3):247.258, May 1971. Thousand Carbon Monoxide in 43 Subjects. Archives des Maladies Professionnelles. de Medicine du Travail, et The effect of nicotine on the behavioraland auto- de Securite Sociale 32(3):27I.282, March 1971,French. nomic response pattern, "alarm", evoked inawake cats well implanted with recording devices by stimulation of stereo- The permanent presence of CO in blood is now a electrodes was studied. established fact. This remanent CO could have two ori- tax ically oriented hypothalamic Before stimulation, the lowest effective intravenousin- gins: atmospheric pollution and hemoglobin catabolism induced EEG (breaking of the alpha-methane bridge). The COlevel is fusion rate of nicotine (10 micrograms/min) desynchronizatioll, increased gastrointestinal motility and variable, higher on the average in smokers than in non- 50 smokers; however, in heavy smokers, the blood content is decreased heart rate. As the infusion rate was raised to arterialpressureincreased, and in one out of two cases as low as in nonsmokers. Ashort, micrograms min, the moderate iliac and mesenteric vasoconstrictionoccurred. 4-minute exposure to an atmosphere containing one part short hypo- per thousand CO in air using the "stablestate" method The effects of nicotine on the response to thalamic stimulation (100.500 msec) were: lesstachy- leads to an average rise of 0.45 ml of CO per 100 ml of of gastro- blood, corresponding to a blocking of 2 parts per 100 of cardia, a marked post-stimulus enhancement growling, hemoglobin. In smokers, an identical quantity of Immo- intestinal motility, a decreased threshold for and an increased number of somatic responses(head g:obin becomes inadequate to convey oxygen, but the to long tobacco intoke in itself plays a supplementary toxic role turn). The effects of nicotine on the response of CO in hypothalamic stimulation (1.5 sec) were, in addition, a upon the upper respiratory passages. This rise reduction of the iliac the blood is on the average identical even thoughindi- more marked pressor response and a vidol differences exist which are not explained either by vasodilatation. (Auth. Abs.) the initial level, or by the use of tobacco, or by the quality of the pulmonary exchanger. These facts justify a 71-0573. Rumen, N. M., Chance, B. Heme-themeInter- further study. (Auth. Abs. Mod) action of Crystalline Lamprey Hemoglobin.Kinetics and Equilibrium of the Reaction of Carbon Monoxide. 71-0570. Roughton, F.J.W. The Equilibrium of Carbon Biochiica et Biophysica Acta 207(3):404-412, 1970. Monoxide With Human Hemoglobin in Whole Blood. Ktictics and equilibrium of the reaction of crystalline. Annals of the New York Academy of Sciences 174(Art. polymeric lamprey hemoglobin with CO are reported.The I):177.188, October 5, 1971. A8, C and E type of crystals used in this studyof the carbon liganded form and that of deoxy -lamprey hemoglobin A review of research on the equilibria of CO has shown the monoxide with hemoglobin in whole human blood is pre- are all isomorphous. Equilibration with *mold shape of the curve, and hem-hem interaction. sented. Among the subjects reviewed am: the validity of demon- Haldane's first law; the effects of partial saturation of Thus the crystalline lamprey hemoglobin has hemoglobin with one gas upon the equilibrium of the strated for the first time that quaternary conformational of changes of the subunits of oxy- and deoxy-hemoglobin residual hemoglobin with the other gas; the comparison interaction. Similarly, the COHb dissociation curve (in the absence of oxygen) are not necessary for hcme-home ab- association-dissociation phenomena observed in the solu- with the oxyhemoglobin dissociation curve (in the be sence of carbon monoxide; and recent results onthe tion with the lamprey hemoglobin did not appear to COHb and oxyligmoglobin dissociation curves at PCO2 40 significant in the heme-heme interaction. (Auth. Abs.) torr, pH 7.4, 37 C. 71-0574. Scherbak, M. P., Smith, T. A. A Colorimetric Nitro- 71-0571. Rowlands, J. R., Cause, E. M. Reaction of Method for :he Determination of Total Oxides of 95(1136):964.968, Nitrogen Dioxide With Blood and Lung Components. gen in Cigarette Smoke. Analyst Electron Spin Resonance Studies. Archives of Internal November 1970. Medicine 128(0:94-100, July 1971. A method is described for determiningthe oxides of of the Electron spin resonance studies of the effects of nitro- nitrogen present in tobacco smoke. Components blood and lung vapor phase of smoke are trapped oncharcoal. The trap is gen dioxide and cigarette smoke upon oxidation tissue components were performed. in vivo exposure of eluted with sodium hydroxide solution and the small animals to NO2 and cigarette smoke has beeninter- products of nitric oxide appear as nitrite and nitrate salts. An ion-exchange technique is used to release andpurify preted in terms of pollutant reaction with the hemc then moiety of hemoglobin. Results imply that the pollutants the free acids by removing excess of alkali. They are have migratnd through the erythrocyte membrane. So as neutralized, made just alkaline and evaporated to dryness. (1l) to understand the effects of these pollutants uponthe The residual salts are dissolved in sulfuric acid iron sulfate is added, and the absorbance of the pink complex membranes themselves, various model systems have been of studied, particularly the interaction of nitrogen dioxide is measured. The equivalent concentration of oxides nitrogen is determined from a calibration graphobtained with unsaturated lipids. Three stable free radicals have of been characterized as products of these reactions; and a with nitrate standards. The method overcomes some short-lived initial free radical was observed, the structure the problems of those reported previously, in that it determines both major products of oxidation of nitric of which provides r *:v sr ;he initial reaction site oxide in smoke, and avoids the use of nitric oxide gas to and mcclkutism. prepare standards. Results have been comparedwith those obtained from separate determinations of the amounts of 71-0572. Rubinstein, E. H., Sonnenschein, R. R. Modifi- nitrite and nitrate formed by oxidation of the nitric cations of the "Alarm" Pattern by Nicotine. oxide. All results are computed and reported as nitric

104 101 CHEMISTRY, PHARMACOLOGY AND TOXICOLOut oxide. The method has a coefficient of variation of 5.2 Cincinnati, 1.6 in Philadelphia and 2.5 in Los Angeles percent. (Auth. Abs.) The highest lead concentrations occurred during autumn and winter; during the day, highest concentrations oc- curred in the early morning. Mean lead concentratiops in 71-0575. Tibbling, L. Smoking and Coronary Disease heavy traffic ranged from 14 to 25 micrograms/n on (16): Central Nicotine EffectStress Factor? Complete Cincinnati streets and Los Angeles freeways to 44 micro- English translation of "Rokning och Koronarsjukdom grams/m" in a vehicular tunnel. Blood lead concentration ( I 6):CentralNikotineffekt S tressfa ktor?", Lalcartki in 2300 individuals was determined as was that in the ningen67(3):282-283, January 14,1970. urine of 1700 males within the same groups. These in- dividuals included groups selected because of their appar- See Abstract 70-0579. ent exposure to different amounts of laid in the ambient air in which they lived and worked, groups representative of occupations that provided an opportunity for lead 71-0576. US. Department of Health, Education, and Wel- exposure, and groups selected because they had certain fare. Public Health Service. Marihuana and Health. A Re- chronic diseases that might conceivably affect their ability port to Congress From the Secretary, US. Department of to dispose of lead. Only II persons were found with Health, Education, and Welfare.U.S. Department of blood lead concentrations equal to or in excess of 0.06 Health, Education, and Welfare, Public Health Service, mg/100 g blood. Levels of lead concentration in the urine Health Services and Mental HealthAdministration, were within normal limits. No relationship was found National Institute of Mental Health, Washington, D.C., between levels of lead in the blood and age. Levels in March 1971,100 pp. females were slightly lower than those in males from comparable groups. In nearly all instances, the mean con- This report to the Congress summarizes the current centration of lead in the blood of smokers was slightly state of knowledge concerning marihuana usage and its higher than that of nonsmokers. There were no unusual effects on man and begins with a description of the vari- findings among persons investigated because of chronic ous natural and synthetic forms of the material and their diseases. Persons who lived and worked in rural or sub- chemistries. The extent and patterns of marihuana use urban areas had the lowest blood lead concentrations and and abuse are discussed in terms of the scope of the prob- it was in these areas that the lowest atmospheric lead lem in the U.S., estimates of its use, its use by out-of- concentrations were found. Highest blood leadlevels schooladults,graduations of usc, socio-dcmographic occurred in groups who worked (and in some cases lived) characteristics of users, attitudes and interests of users, in areas with higher lead concentrations. These results initiation and source of supply, and its use in other generally confirm earlier findings bad on more limited countries. Preclinical animal studies on marihuana tox- observations. icity, central nervous system effects, autonomic and cardiovascular effects, respiratory effects, hypothermic effect, hormonal effects, antibiotic activity, interaction 71-0578. Yoshida, D. Tabako no Kemuriju Taruryo ni with other drugs, neurophysiological effects, behavioral Oyobosu Kosaku Joken no Eikyo. VI. Kemurijo Tartuyo effects, teratologic effects and metabolic effects are de- ni Eikyo wo Oyobosu Tabako no Naiyo Seibun. (Effects tailed. Therapeutic uses are reviewed followed by a of Cultural Practices on the Tar Content in the Smoke of detailed description of the acute and chronic effects of Cigarettes. VI. Effects of Chemical Components in the marihuana as determined by experiments on humans, and Cigarettes on the Tar Contents.) Hatano Tabako of the health consequences for the user. Social and cul- Shikcn /o Gyotci Hokoku 68:9-1 8, 1970, Japanese. tural concomitants of marihuana use and an indication of future research needs and directions are outlined. The effects of the chemical constituents in cigarettes on the tar content of the smoke were studied. The cigar- ettes were made from leaves which varied with respect to 71-0577. US. Department of Health, Education, and maturity, curing methods used (flue or air cured) and Welfare. Public Health Service. Survey of Lead in the variety (Bright Yellow and Matsukawa). The components Atmosphere of Three Urban Communities. U.S. Depart- analyzed included nicotine. total sugars, total nitrogen, ment of Health, Education, and Welfare, Public Health starch, chlorogenic acid, lignin, cellulose hemicellulose. Service, Environmental Health Service, National Air Pollu- pectin, alcohol-benzene extract, alcohol-benzene extract tion Control Administration, Raleigh, North Carolina, minus sugars, hexane extract, ether extract. acetone ex- Public Health Service Publication No. 999-AP-12, En- tract, 80 percent ethanol extract, hot water extract, and vironmental Health Series, April 1970, 94 pp. hot water extracted residue. Tar content in the smoke increased with maturity of the leaf and was higher with From June 1961 through May 1962 some 3400 upper leaves than with middle leaves. Content of nicotine, samples of particulate lead from the atmosphere were ob- alcohol-benzene extract and alcohol-benzeneextract tained at 20 sites in Cincinnati, Los Angeles and Phila- minus sugars showed the same tendencies as tar content. delphia. Lead in the blood and urine of selected groups of Tar content in the smoke showed a high correlation with persons in the populations of these cities as well as atmo- contents of nicotine and alcohol-benzene extract minus spheric lead concentrations in heavy traffic and in a vehic- sugars in the cigarettes. Percentages of radioactivity trans- ular tunnel were also sampled. The annual average concen- ferred from the radioactive alcohol-benzene extract mixed tration of atmospheric lead ranged from 2 micrograms /m in the cigarettes to the tar by smoking were higher in of air in the downtown and industrial area of Cincinnati comparison with that from the residue of the alcohol- to about Iin outlying areas. Values for corresponding benzene extract. Content of alcoholbenzene extract in areas in Philadelphia ranged from 3 to1, and in Los the tobacco leaves were appreciably higher (15 to 30 per- Angeles from 3 to 2. The average lead concentration in all cent in the dry matter). Therefore, it is assumed that the samples in each city was 1A micrograms/min alcohol-benzene extractinthe cigaretteplays an CHEMISTRY, PHARMACOLOGY ANDTOXICOLOGY

paraoxon. No catalepsy wasachieved with , important role in the formation of tatin the smoke. coniinc, and dimethylphenylpiperazinium(DMPP). Atro- (Auth. Abs. Mod.) pine and scopolamine were the anticatalepticdnigs of lowest specificity for they antagonized allcataleptogens. Differentiation of Specificity was highest with pempidinewhich was active 71-0579. Zeiler, G. Pharmacological antagonized nico- Neuropharrna- only against nicotine. Mecamylamine "Nicotinic" and "Muscarinic" Catalepsy. tine, , and lobeline. Sparteine wasanticataleptic cology 10(3):289 -296, May 1971. againstnicotine, arecoline, lobeline,pilocarpine, and tremorine. The catalepsy due to neuroleptics,bulbo- A cataleptic state was produced inmice by nicotine, to sparteine, bulbocapnine, capnine, and paraoxon was resistant arecoline, lobeline, pilocarpine, tremorine, mecamylamine, and . It is concludedthat nico- trifluoperazine, haloperidol, and paraoxon.Unwanted in cholinergic antagonists' tinic and muscarinic steps are involved peripheral actions were prevented by specific neurological processes promoting catalepsy. Asin earlier not penetrating the bloodbrainbarrier;Lexamethonium experiments, hypothermia and catalepsy werefound to be againstnicotine and lobeline; methylatropine against independent phenomena. (Auth. Abs.) arecoline, pilocarpine, and tremorine; pralidoximeagainst See also, 71-0583, 71-0602, 71-0675,71-0678, 71-0700

MORTALITY AND MORBIDITY

banning Socio-Economic action which has been taken in several countries 71-0580. Benckert, A., Lindholm, B. the advertisement of cigarettes on radio andtelevision, Consequences of Smoking. Complete Englishtranslation been sug- Rokning. and several preventive measures which have of "Samhallsekonomiska Konsekvenser av gested for the purpose of reducing tobaccoconsumption Rokningens Samhallsekonomiska Konsekvenser", are outlined. Med icinskTidskrifts2(Special No.):91-95, February 1971. An estimation of the socio-economic costsfor damage 71-0582. Wolff, G., Lauter, J. StatistischeBeziehungen to health stemming from cigarettesmoking during 1967 is zwischen epidemiologischen Daten. [StatisticalRelation- presented. Three different alternatives incalculating these ship Between Epidemiological Data.)Zeitschrift fur die costs yield estimates of 88, 257, or686 million kroner. gesamte Hygiene and ihre Grenzgebiete17(2):127-134, The calculations are based on the fact thatsmoking con- February 1971,German. stitutes a serious health problem andtherefore a socio- economically expensive habit. Greateconomic resources would be released if measures wereinitiated to limit the A total of 776 outpatientsof a tumor clinic, among damaging effects of smoking. them 261 healthy patients and200 cancer patients, were epidemiologically interviewed. Numerousgenetic and en- vironmental factors, such as placeof birth, residence, St. Luke's 71-0581. Lanfranco, A. Smoking and Disease. body weight, smoking habit, alcoholconsumption, dia- Hospital Gazette 5:181-186, December 1970. betes, dental diseases, blood-group,former diseases, number of brothers and sisters, etc. wererecorded. The Beginning with a historical discussionof the develop- statistical correlation of all factors wereascertained. The ment of the smoking habit, and thefirst steps taken by (product moment) against the correlation coefficientscalculated international health organizations to warn significant relations hazards of smoking, a brief summary ispresented of yielded a great number of statistically between the factors investigated. The smokinghabit was comparative morbidity studies andresearch findings patients; 70 percent of which link smoking to many specificdiseases, among most prominent among the cancer disorders. Legislative the cancer patients had bronchial carcinomas. them pulmonary and cardiovascular See also, 71-0555

106 103 NEOPLASTIC DISEASES

71-05d3. Baums lag. N.. Keen. P., Petering, 11. G. Car- The possibility that caesarean section has an enhancing cinoma of the Maxillary Antrum and its Relationship to effect on formation of rilmonary adenoma exists but Trace Metal Content of Snuff. Archives of &Piton- requires confirmation. (Auth. Abs. Mod.) mental Health 23(1):1-5. July 1971.

Social habits and customs are related to different 71-0585, Carlens, L. Harmful Clinical Effects of Smoking. disease patterns. Snuff inserted in the nares has been Smoking andCancer ofthe Respiratory Passages. shown to be associated with the incidence of antral carci- Complete English translation of "Medicinska Skadeverk- noma in the Bantu. Carcinoma of the maxillary antrum ningar av Rokning. Rokning och Cancer i Luftvagarna", constitutes 45.5percent of alltherespiratorytract SocialMedicinsk Tidskrifts,2(Special No.):71-73, Feb- cancers in the Bantu. A pilot study was conducted to ruary 1971. examine the trace metal content in samples of Swazi snuff by atomic absorption spectrometry. The metals analyzed A brief survey of recent research findings concerning were zinc, chromium, copper, lead, nickel, and cadmium. the relationship of smoking and lung cancer is presented. Samples of soot from Swazi huts were also analyzed for Primary emphasis is given to a study by Hammond and the same metals. The Swazi snuff showed high concen tra- Auerbach who have been able to provoke lung cancer in tions of nickel, chromium, and zinc. Since nickel and dogs using cigarette smoke. Their results showed that of chromium in some forms are known carcinogens, the 14 dogs smoking 7 cigarettes a day (heavy smokers), 2 association between carcinoma of the maxillary antrum died with typical lung cancer before two years. Of the and snuff may be prevented if the source of trace metal remaining12 which were sacrificed, 8 had advanced contamination is eliminated. (Auth. Abs.) cancer and the other 4 had cancer in the initial stage. The microscopic analysis of the cancers revealed them to be the same as found in cigarette smoking humans. 71.0584, Bulay, 0. M. The Study of Development of Lung and Skin Tumors in Mice Exposed In (hero to Poly- cydic Hydrocarbons..4 cm Medico Turcica 7(1):3-38, 71-0586. Feinstein, A. R. Smoking and Cancer Morph- 1970. ology. (Letter) Journal of the American Medical Associa lion 213(1):131, July 6,1970. The study was conducted to determine whether car- cinogenic effects occur in utero in the progeny of animals An apology is made for the premature publication of a exposed to polycyclic hydrocarbons during pregnancy. study on cigarette smoking and histological morphology This has been accomplished in experiments in which in patients with lung cancer which interpreted the pre- caesarean section foster fed offsprings were studied. Two liminary results as indicating that heavier smoking caused experimental carcinogenesis systems have been studied. greater degrees of malignancy in lung cancer. The study's The first is the formation of pulmonary adenomas and the base population consisted of patients with lung cancer second is initiation of skin papillomas. Two carcinogens, and not a general group of smokers and nonsmokers, and benzo(a)pyrene (BP) and 7,12-dimethylbenz(a)anduacene although increased smoking rates were associated with in- (DMBA), were used. In utero carcinogenic effects on lung creased rates of undifferentiated small cell cancers, such and skin occurred with both carcinogens but were pro- cancers were not the most clinically malignant tumors duced to a greater degree with DMBA. In utero carcino- found. Inthis study, epidermoid carcinoma, generally genic effects could be produced by either intraperitoneal regarded as a "cigarette smoker's cancer", was present in or by subcutaneous injections of carcinogen into the four nonsmokers and the rate of this carcinoma showed mothers. A secondary contribution of the study was the no increase in association with increased smoking rates in demonstration for the first time that initiation of skin the 449 patients studied. papillomas can be produced in the fetus. The following conclusions are suggested from the studies:I) Trans- placental passage of polycyclic hydrocarbon carcinogens 71-0587. Gajaraj, A., Johnson, T. H., (Jr.), Feist, J. H. occurs in sufficient amounts to produce carcinogenic Roentgen Features of Giant Cell Carcinoma of the Lung. effects in utero and to a greater degree than would be American Journal of Roentgenology, Radium Therapy anticipated from a review of the literature. 2) BP, a and Nuclear Medicine II 1(3):486 -491 , March 1971. moderately potent carcinogen, causes an enhancement of pulmonary adenoma formation in mice exposed to this Twelve cases of giant cell carcinoma of the lung wcrc carcinogen in utero. 3) BP also causes the initiation of studied in retrospect. The roentgen features wcrc cor- skin papillomas in utero. 4) DMBA, a more potent car- related with the clinical and autopsy findings. The cinogen than BP, has a greater effect in utero as seen by autopsy and available nidiologic data of 51 other an early occurrence of skin papillomas in large numbers. cases reported in the literature were also analyzed and 5) Increasing doses of polycyclic hydrocarbon cause an studied to assess the size, location, and the local or distant enhanced carcinogenic response in the offsprings. 6) The spread. The tumor was found to be common in males (85 occurrence of a slightly lower tumor incidence in off- percent) and in smokers (76.2 percent). Its peripheral springs allowed to nurse on their mothers which had been location, early hematogenous metastasis and a compara- injected with BP as compared to offsprings delivered by tively rapid growth, resemble adenocarcinoma; but the caesarean sectionsuggestthatmilk and excreta of male preponderance, relationship to smoking and fre- mothers injected with polycyclic hydrocarbon carcino- quency of pleural involvement help to differentiate it. gens has little effect in causing tumors in the progeny. 7) Thus, giant cell carcinoma of the :Ling has a few specific

104 107 NEOPLASTIC DISEASES

in the oropharynx, roentgen features whichdistinguishitfrom other cancer at exactly these posterior sites rather than more anteriorly in the oral cavity wherethe pulmonary neoplasms. tissues do not directly bear the brunt of the onslaught from the smoke. It is revealing to find that the highrisk to be the least 71-0588. Garcia, G., De Acosta, V. M., Algorri, I. Cancer sites involved in tobacco chewersappear affected in smokers, and vice versa. (Auth. Abs.) de la Laringe. (Cancer of the Larynx.]Cocoa Medico de Mexico101(3):331-334, March 1971, Spanish.

The relationship of three different components of the 71-0591. Larsen, K. A. Smoking and Pulmonary Disease Pathological Anatomy and Pathogenic Factors. tobacco habitage the habit began, duration of habit and (1): Complete English translation of "Rokning och Lungs- intensity of habitto laryngeal carcinoma was investigated ju kd om ( I): Patologisk Anatomi og Patogenetiske in 149 cases using multiple regression and correlation January 21, analysis. The analysis showed that the most important Fa k torer",Lakertidningen67 (4) : 375-383 , coefficient was the duration of habit, followed by age 1970. habit beganand intensityof habit. However, the data used were elements extrinsic to the patient with no con- SceAbstract 70-1234. sideration of the individual's genetic susceptibility to carcinogenic agents. The therapeutic criteria and results 71-0592. Laurie, W., Szaloky, L. G. Sputum Cytology in obtained usingsurgeryand radiotherapy are described. Medical Journal The survival rate at five and ten years is shown in relation the Diagnosis of Bronchial Carcinoma. to the different laryngeal and laryngopharyngeal cancer of AustraliaI (5):247-25 I, January 30, 1971. sites in patients treated exclusively with radiotherapy. An assessment is made of the relative values of several methods of investigation used in establishing the diagnosis 71-0589. Guleria, J. S., Gopinath, N., Talwar, J. R., in 500 consecutive cases of bronchial carcinoma. In con- Bhargava, S., Pandc, J. N., Gupta, R. G. Bronchial Carci- venience, cost and accuracy, sputum cytology far out- nomaAn Analysis of 120 Cases.Journal of the Associa- weighs the results of other methods of investigation, tion of Physicians of IndiaI9(3):251-255, March 1971. showing 91.7 percent positive findings for those patients from whom specimens of sputum were received. Atten- The clinical features and methods of diagnosis in 120 tionis drawn to the gravely increasing incidence of patients with bronchial carcinoma at the All India Insti- bronchial carcinoma, which seems to be doubling every tute of Medical Sciences Hospital, New Delhi, India are five years. In the face of government apathy towards the described. The patients included 70 smokers, 35 non- control of cigarette smoking, there is no hope of reversing this trend in the foreseeable future, and the only hopeof smokers, and 15 in whom the smoking history was not individual recorded. Heavy and prolonged smoking was an obvious improving the present grim prognosis for the important causative factor in these cases. Since early patient is by much earlier diagnosis. It is suggested that detection of bronchial carcinoma is considered essential this is feasible by the use of sputum cytology surveys in for a cure, itis suggested that the following high risk high-risk populations. individuals be submitted to clinical and radiological examination of the chest and exfoliative cytological examination of the sputum at frequent intervals: I) heavy 71-0593, Leuchtenberger, C., Leuchtenberger, R. In- fluence of Chronic Inhalation of Fresh Cigarette Smoke and long-term smokers, 2) patients with chronic bronch- Tumors in itis of several years duration, and 3) all males above the and Its Gas Phase on the Development of Lung Snell's Mice. Complete English translation of "Elnfluss age of 50 years. chronischer Inhalationen von frischem Zigarettenrauch and dessen Gasphase auf die Entwicklung von Lungen- Zeitschrift fur Prarentiv- 71-0590. Jussawalla, D. J., Deshpande, V. A. Evaluation tumoren bei Snell's Mausen", of Cancer Risk in Tobacco Chewers and Smokers: An medizin17(6):457-462, November-December 1970. Cancer28(I):244-252, July Epidemiologic Assessment. Chronic inhalation of whole smoke as well as of its gas 1971. phase by Snell's mice led to the early and increasedinci- A retrospective stu4v of cancer at high risk sites in the dence of lung tumors in which the influence of the gas region of the head al:. neck was undertaken at the phase was especially noteworthy. The effect in the male Bombay Cancer Registry, in 1968, to evaluate the effects mice was stronger than in the female mice. Bronchogenic of tobacco when chewed or smoked. There is sufficient carcinomas such as occur frequently in human cigarette evidence available today to indict chewing and smoking of smokers were never observed in the mice. Rather, after inhalation of the whole smoke or of the gas phase, only tobacco as factors of great importance in the etiology of glandular tumors were observed. Such tumors are of a oral, pharyngeal, laryngeal, and esophageal cancers--the the most common sites affected by the disease in Greater histological type which also occurs occasionally in Bombay. This cause/effect association is probably as controls and then only at a later age. intimate as that of cigarette smoking and lung cancer. The carcinogenic action of chewed tobacco is particularly evident at those sites where the bolus is retained in place 71.0594. McNelis, F. L., Esparza, A. R. CarcinomaIn Situ for any length of time. Likewise, inhalation of tobacco of the Larynx.Laryngoscope81(6):924-930, June 1971. fumes during the act of smoking produces a stream of gas and of solid particles which impinges directly on the oro- Carcinoma in situ of the larynx has been found to be a pharynx and especially on the soft palate initially and disease entity that is being recognized more frequently at exposes smokers to the increased risk of developing the Rhode Island Hospital. Of 14 cases of carcinoma In

108 105 NEOPLASTIC DISEASES

situ diagnosed during the 1966-1970 period, all but one by a greater incidence of fatal carcinomas in the experi- were male, all were smokers, and the ages ranged from 45 mental group. Thirty-one of 174 deaths in the experi- to 72, with 50 percent being in the sixth decade. The mental groups were due to cancer, as opposed to 17 of technique of microlaryngoscopy with biopsy of the areas 178 deaths in the control groups (P = 0.06). An analysis retaining Toluidine blue, plus the recognition of varying of smoking habits showed a higher frequency of carci- degrees of differentiation of carcinoma in situ were held noma deaths in the experimental group; there was no non- responsible for this increase. Treatment is discussed, but dietary explanation for this. best modality has not yet been determined. Utilization of the TNM system of stage 0 for carcinoma in situ in lesions of the larynx is proposed. 71-0598. Stavraky, K. M., A Study of Precursor Illness in Lung Cancer Patients. Journal of Chronic Diseases 23(10/11):691 -705, March 1971. 71-0595. Neutel, C. I., Buck, C. Effect of Smoking During Pregnancy on the Risk of Cancer in Children. Journal of This study was attempted to demonstrate differences the National Cancer Institute 47(1):59-63, July 1971. occurring years prior to death in the illness histories of a group of men dying of lung cancer and a group of From the Ontario Perinatal Mortality Study and the controls dying of other causes but matched to the cases British Perinatal Mortality Survey, 89,302 babies surviving for age, place of residence, occupation and cigarette at least 7 days served as a base population for a pro- smoking. It was postulated that differences inillness spective study of the relationship between smoking in patterns present long enough prior to death to be evident pregnancy and cancer in the offspring. The smoking before symptoms of lung cancer emerged, might be useful habits of the mother during pregnancy were recorded in predicting which smokers will subsequently develop before or just after the birth of the child. In the two base lung cancer. Histories of hospitalized illnesses for the populations combined, there were 65 cancer deaths and 12-year period prior to death of case or control were 32 cancer survivors in the period from birth to a mini- obtained for 526 veteran pensioners who died of lung mum of 7 and a maximum of 10 years of age. For cancer cancer and 526 matched controls dying of other causes. of all sites, the children of smokers had a relative risk of Analysis of these histories did not support the hypothesis 1.3with 95 percent confidencelimits of 0.8-2.2. that illness patterns present prior to death from lung Evidence of a dose-response relationship was lacking. cancer might be predictive of those smokers who are sus- Although these results make it most unlikely that in utero ceptible to lung cancer. The results did suggest that minor exposure to tobacco smoke has a broadly carcinogenic differences in illness patterns between cases and controls effect on the fetus, a response confined to one tissue or are related to the smoking habit and the tendency for expressed over a narrow age range cannot be ruled out. lung cancerpatientsto smoke more intensely(as (Auth. Abs.) measured by amount and duration of smoking) than controls who smoke the same number of cigarettes. (Auth. Abs.) 71-0596. Paymaster, .1. C., Gangadharan, P. The Problem of Gastro-Intestinal Cancer in India. Indian Practitioner 24(1):7.15, January 1971. 71-0599. Stuart, B. 0., Willard, D. H., Howard, E. B. Studies of Inhaled Radon Daughters, Uranium Ore Dust, The incidence of cancer in the gastro-intestinal tract Diesel Exhaust, and Cigarette Smoke in Dogs and varies from country to country and sometimes within the Hamsters.Battelle Memorial Institute, Pacific Northwest country. A high incidence of cancer of the esophagus is Laboratory, BNWL-SA-34I9:12 pp, 1970. observed in India, whereas cancer of the stomach, colon and rectum have a low rate in our country. Cancer of the In the present continuing experiments, daily six-hour anal canal has a high frequency rate in India. Certain exposures of groups of 100 hamsters to either 30 working habits like smoking and chewing pan are associated with levels (WL) of radon. daughters, 600 WL of radon cancer of the upper two-thirds of the esophagus. Differ- daughters with 15 mg/m- uranium ore dust (carnotite), or ences in the distribution of cancers of the gastrointestinal laboratory air (controls) have been underway for 19 to 23 tract observed between the various communities of months. After 6 months or more of exposures, hamsters Western India are presented. (Auth. Abs.) receiving 600 WL radoe daughters or 600 WL radon daughters with 15 mg/m'' uranium ore dust showed lung changes including edema, emphysema, and occasionally 71-0597. Pearce, M. L., Dayton, S. Incidence of Cancer in hyperplasia and metaplasia of the bronchiolar epithelium. Men on a Diet High in Polyunsaturated Fat. Lancet Several of theanimals exposedto 600 WL radon 1(7697):464467, March 6, :171. daughters with the uranium ore dust seem to have de- veloped changes in the bronchiolar epithelium suggestive In an eight-year controlled clinical trial of a diet high of early tumor formation after 14 months of exposures. in polyunsaturated vegetable oils and low in saturated fat Mortality, body weight and hematology studies have and cholesterol in preventing complications of athero- shown no significant differences between experimental sclerosis, 846 men were assigned randomly to a conven- groups and controls. These findings indicate that other tional diet or to one similar in all respects except for a mine air contaminants, in this case carnotite ore dust, substitution of vegetable oils for saturated fat. Fatal may contribute to the development of several types of atherosclerotic events were more common in the control respiratory tract pathology, including neoplasia, and that group (70 vs. 48;P <0.05). However, total mortality was an experimental protocol of daily long-term exposures at similar in the two groups: 178 controls vs. 174 experi- levels that do not produce lifespan shortening may be mentals, demonstrating an excess of non atherosclerotic necessary to produce these effects. Continuing experi- deaths in the experimental group. This was accounted for ments also involve life-span exposure of hamsters to diesel

IQs 106 NEOPLAST1C DISEASES

exhaust with and without 600 WL radon daughters plus methylbenz(a)anthracene (DMBA) was followed 2 weeks ore dust, to determine whether this agent is capable of a bier by 5 times weekly application of 40 mgtobacco contributory or synergistic action in the observed pre- smoke condensate. After 573 days. 36 of 60 mice bore cancerous and probable cancerous lung pathology. Sixty- papillomas; 14 bore carcinomas. In a group receiving con- nine beagle dogs have been placed on daily life-span ex- densate only, 18 of 60 mice bore papillomas; 4 borecarci posures. Forty dogs in two groups are smoking 10cigar- nomas. There were 8 mice withpapillomas after a single ettes over a 16-hour period daily, seven days per week. dose of DMBA and repeated application of acetone. These Forty dogs are receiving daily 4-hour head-orkly exposures findings reaffirmthattobacco smoke condensate is to 600 WL of radon daughters with 15 mg/m" of uranium primarily a tumor-promoting agent with weak carcino- ore dust. No significant biological effects of these ex- genic activity. Application of 20 microgramsDMBA, posures have been observed after six months of exposures, followed by thrice weekly application of 5 micrograms although transient changes have been observed in respira- benzo(a)pyrene (BaP), resulted in 21 of 30 micewith tory rates and volumes of individual exposed animals. papillomas and 11 with carcinomas after 462days on test. Physical and radiological examinations and hematology BaP application alone at the same dose resulted in8 of 20 studies on all dogs are continuing on a program of life- mice with papillomas and I with a carcinoma,suggesting effect time daily exposures. that the carcinogen BaP has a "promoting-like" after application of an initiating agent. (Auth.Abs.)

71-0600. Trendelenburg, F., Mall, W. Epidemiologie and Entdeekung des Bronchialcarcinoms. [Epidemiology and 71-0603. Weiss, W., Boucot, K. R., Cooper, D. A.The Detection of Bronchial Carcinomas.]Internist Philadelphia Pulmonary Neoplasm ResearchProject. 11(9):303-317, September 1970, German. Survival Factors in Bronchogenic Carcinoma.Journal of the American Medical Association 216(13):2119-2123, Mortality statistics for bronchial carcinoma in various June 28, 1971. countries are presented ar..I the endogenous and exo- genous factors reviewed. The influence of cigarette smok- During a ten-year prospective study of 6,136 men ing, especially with inhalation of the smoke, on the aged 45 and older, screened every six months by 70-mm development of bronchial carcinoma is cited by various photofluorograms and questionnaires, 121 men who did authors. One author found 1.0 percent of current smokers not have lung cancer visible on the entryfilm developed cytologically positive as against 0.35 percent of non- lung cancer; 94 cases were proved histologically. The over- smokers and 0.47 percent of ex-smokers. Another study all survival rate was 8 percent at five years. From astudy of 1586 male smokers above 40 years of age, revealed 11 of various factors in the 94 proved cases, theprofile of cases (malignant cells in the sputum) not detectedby the men most likely to survive five years includes: ageless X-ray examination alone. A combined cytological and than the median of 64 years, smoking one pack ofcigar- X-ray program can reveal 90 percent of all lung cancer ettes per day or less, absence of chroniccough prior to malignancies. Recommended preventive measures include detection, a histologic type of squamous cell carcinoma or publicinformation on the harmfulness of cigarette adenocarcinoma, a roentgenogram of the chest negative smoking, antismoking campaigns among juveniles and for cancer within 12 months before detectionof the adult smokers, public awareness of the early symptoms of cancer, and resectability of the cancerwith survival longer lung cancer, and the instruction and involvement of phys- than 30 days after surgery. (Auth. Abs.) icians, medical students and health personnel in anti- smoking measures. 71-0604. Yoshida, 0. Bokogan ni Rang= Kenkyu. I. 71-0601. Tyrrell, A. B., MacAirt, J. G., McCaughey, Nihonjin Bokogan no Tokeiteki oyobi Ekigakuteki W.T.E. Occupational and Non-Occupational Factors Kenkyu. [Studies on Carcinoma of the Urinary Bladder. I. Statistical and Epidemiological Studies on Cancer of the Associated With Vesical Neoplasm in Ireland. Journal of Acta Urologica Japonica the Irish Medical Association 64(410):213-217, April 22, Bladder in Japanese.] 12(10):1040-1064, October 1966. 1971. In a survey of occupational and non-occupational Of 163 males with bladder cancer, 150 or 92 percent factors associated with vesical neoplasm in the Republic smoked as compared with 126 or 77.3 percent of 163 controls. Of 29 females with bladder cancer, 11 or 37.9 of Ireland, there was no evidence of a significant associa- percent smoked as compared to 8 or 13.6 percent of 59 tion with occupation or environment. There was evidence of a significant relationship between smoking and the controls. Both these differences are significant by the chi- squared test. The relative risk for males was 3.35 and for disease, but an association with the duration and intensity females 3.8. Of the 150 male smokers with bladder of such smoking was not demonstrated. (Auth. Abs.) cancer, 65 or 43.4 percent were heavysmokers as compared to 42 or 33.3 percent of 126 controls; 62 or 71-0602. Van Duuren, B. L., Sivak, A., Katz, C., 41.3 percent were medium smokers as compared to 40 or 31.8 percent of the 126 controls; and 23 or 15.3 percent Mekhionne, S. Cigarette Smoke Carcinogenesis: of Lance of Tumor Promoters. Journal of the National were light smokers as compared to 44 or 34.9 percent the 126 controls. These differences are also significant by Cancer Institute 47(1):235-240, July 1971. the chi-squared test. Histological studies of 42 of the 65 The tumor-promoting activityof tobacco smoke heavy smokers with bladder cancer showed 41 cases of condensate was examined by skin application in ICR/Ha transitional cell cancer and 1case of squamous cell Swiss mice. One application of 50 micrograms 7,12-di- cancer.

110 107 NEOPLASTIC DISEASES

714605. Zacho, A., Nielsen, J., Larsen, V., Cederqvist, C. seven percent of the male and 68 percent of the female Intolerance of Tobacco in Patients With Gastric Cancer. smokers had stopped or reduced their smoking prior to Acta Chirurgica Scandinavica 137(3):277- 278,1971. their admission to a hospital, especially during the last year before admission. The most common reason was that A total of 221 patients with gastric cancer (157 men tobacco no longer tasted good or that it actually disagreed and 64 women) were questioned in detail concerning their with them. This factor must be taken into consideration smoking habits. Ninety-one percent of the men and 48 in statistical studies on the etiological role of tobacco in percent of the women had been regular smokers. Sixty- gastric cancer. (Auth. Abs.)

Sec also, 71-0555, 71-0582, 71-0625, 71-0690

NONNEOPLASTIC RESPIRATORY DISEASES

71-0606. Albert, R. E. Bronchial Clearance Abnormalities ductance as measured by a body plethysmograph were in Man Produced by Cigarette Smoke and Lung Disease. compared in normal nonsmokers, normal smokers, and Chest 59(5, Supplemen 0:3S, May 1971. patients with obstructive pulmonary disease. The time required to expire the middle half of the forced vital Tests were conducted to determine whether discrete capacity (FVC) correlatedbetterwith specific con- waves discharged from the trachea of subjects who in- ductance than with forced vital capacity, one-second haled two different sized aerosols separated by a time forced expiratory volume, the ratio of one-second forced interval were due to: 1) deposition in the same discrete expiratory volume to forced vital capacity, or maximal areas of the lung for both aerosols, with a uniform rate of midexpiratory flow. Poorer correlations with time to mucus flow; or 2) a uniform pattern of particle deposition expire the first and last quarters of forced vital capacity associated with an intermittent flow of mucus. Results emphasize the effort-dependence of these portions of the showed that the timing of the clearance waves was deter- forced vital capacity. Normal smokers demonstrated a sig- mined by an intermittency in mucus movements in heavy nificantly lower specific conductance than normal non- smokers and normals. In some tests, both types of simi- smokers. The FVC and maximal midexpiratory flow larity were observed, indicating that discrete whole lung demonstrated this difference spirometrically. The FVC is clearance waves can, in the same individual, be caused by proposed as a simple and more accurate screening test for different mechanisms. early detection of increased airway resistance. (Auth. Abs. Mod.)

71-0607. Aldas, J. S., Dolovich, M., Chalmers, R., New- house, M. T. Regional Aerosol Clearance in Smokers and 71-0609. Anderson, W. H. Acute Exposure to Cigarette Nonsmokers. Chest 59(5, Suppkment):2S, May 1971. Smoke as a Cause of Hypoxia. Chest 59(5, Supple- ment):33S-34S, May 1971. The effects of a repeated smoking exposure on pul- monary clearance of inhaled aerosol was studied by In this study, 16 patients with and 16 without chronic following the retention of 1311 human serum albumin obstructive pulmonary disease (COPD) smoked, over a aerosol with respect to time in nine smokers who inhaled five-minute period, 6 cm of an unfiltered cigarette con- a cigarette every 15-20 minutes and in ten nonsmokers. taining 27 mg tar and 1.9 mg nicotine. Smoking caused Results showed that although overall clearance of activity significant changes in average V/0, as indicated by in- from the lung was faster in smokers, the clearance rate in creased A-a gradient for oxygen, venous admixture and the large proximal airways was slower than normal, while alveolar shunting of blood, and in eight subjects these that more peripherally was faster. This probably explains changes caused a significant decrease in Pa02. Preceeding why there was a relative accumulation of activity in the smoking with mild exercise did not alter the response in perihilar region in many of the smokers at 11/2-2 hours. either group. In six patients with COPD, smoking one The more rapid overall clearance in smokers is explained cigarette increased carboxyhemoglobin from 4.26 to 5.36 by the abnormal deposition, there being much less aerosol percent. Three of these individuals showed a mean de- deposited on presumablynon-ciliated airways, which crease of 1.1 L/minute in cardiac output. Thus, in some emphasizes the importance of deposition pattern in deter- instances, smoking can result in a Pa02 drop, an increase mining clearance rates. in carboxyhemoglobin, a leftward displacement of the oxyhemoglobin dissociation curve and a decreasein cardiac output, which significantly decreases 02 delivery 71-0608. Allen, G. W., Sabin, S. Comparison of Direct for cellular metabolism. and Indirect Measurement of Airway Resistance. A Criti- cal Analysis of the Forced Vital Capacity Curve. Ameri- can Review of Respiratory Disease 104(I):61-71, July 71-0610. Black, L. F., Hyatt, R. E. Maximal Static Res- 1971. piratory Pressures in Generalized Neuromuscular Dis- ease.American Review of Respiratory Disease The results of spirometric tests and specific con- 103(5):641-650, May 1971.

108 NONNEOPLASTIC RESPIRATORY DISEASES

Maximal static respiratory pressures were determined 71-0613. Finklea, J. F., Hasselblad, V., Sandifer, S. H., Hammer, D. 1., Lowrimore, G. R. Cigarette Smoking and by simplified method in 15 patients of whom 10 had neurobtiscular disorder alone and 5 had neuromuscular Acute Non-Influenzal Respiratory Disease in Military disease in addition to chronic obstructive lung disease or Cadets.American Journal of Epidemiology major airway obstruction. The former group included two 93(6):457-462, June 1971. smokers and the latter three smokers. The maximal static ill- respiratory pressures were more frequently abnormal than Acute upper and lower non-influenzal respiratory vital capacity, maximal midexpiratory flow or maximal ness, but not enteric or traumatic illness, wassignificantly breathing capacity. This methoddetectedmuscle weak- more frequent among cigarette smokers thannonsmokers. ness even in the presence of coexistentintrapulmonary Outpatient and hospital acute upper respiratory incidence disease and was helpful in evaluating dyspnea in these rates forheavy smokers (>one pack per day) were 1.3 patients. Early in the disease, the maximal static respira- times those of nonsmokers. Acute lower respiratory tory pressures can be abnormal even though the resultsof disease rates for heavy smokers were twice those of non- spirometry are normal. smokers. In each case, both lighter cigarette smokers, and cigar, pipe and ex-smokers exhibited intermediate rates. An index of severity, the ratio of hospital incidence rates 71-0611. Brille, D. incidence of Chronic Bronchitis in to outpatient rates, was similar for smokers and non- Women. The Role of Tobacco. Complete English trans- smokersin eachillnesscategory.Cigarette smokers lation of "Frequence de la Bronchite Chronique Chez la comprised 34.5 percent of the 1,848 volunteers in this Femme. Role du Tabac",Revue de Tuberculose et de study. (Auth. Abs.) Pneumologie33(6):794-797, 1969.

SeeAbstract 71-0077. 71-0614. Galy, P., Brille, D., Coudray, P., I srael-A ssclain, R., Le Melletier, J., Michel, F. B., Migueres, J., Pham G. T., Voisin, C. Colloques sur la Bronchite Chronique. I. 71-0612. Cohen, A. B., Cline, M. J. The Human Alveolar Nosologie et Epidemiologie. [Symposium on Chronic Macrophage: Isolation, CultivationIn Vitro,and Studies Bronchitis. I. Nosology and Epidemiology.]Revue de of Morphologic and Functional Characteristics.Journal Tuberculose et de Pneumologie34(5):723-748, July- of Clinical Investigation50(7):1390-1398, July 1971. August 1970, French.

Human alveolar macrophages were lavaged from surgi- The symposium comprises various discussions and cally resected lungs and from lungs of normal subjects. presentations of highlights from studies dealing with the Macrophages that had been purified by glass adherence nosology and epidemiology of chronic bronchitis. After were maintained in tissue culture for as long as54 days. defining anatomically the significance of the term chronic After 3-4 wkin vitrothey underwent transformation bronchitis and discussing the nosological border-line re- into multinucleated giant cells. These aged cells had more lationship of the disease with asthma and emphysema, the than 30 times the phagocytic capacity that the same symposium deals withthe epidemiology of chronic group of cells had had after 1 dayin vitro.Phagocytosis bronchitis based on several studies briefly presented by of heat-killedCandida albkans was inhibitedby ioda- the various participating members. Specifically, these cetate, sodium fluoride, potassium cyanide, and low studies include research on the respiratory insufficiency in partial pressures of oxygen, suggesting that these cells a sample population of men and women agedfrom 30 to require both oxidative and glycolytic energy sources for 70 in Bordeaux, France, in whom the appearance of the maximal particle ingestion. Alveolar macrophages and different symptoms of the disease are statistically an- Listetia mono- monocyte-derived macrophages killed . alyzed.The role of tobacco and the distribution of disease cytogeneswith similar efficiency, but neutrophils were symptoms in smokers and nonsmokers are alsodiscussed. more efficientthan either of the other celltypes. Occupations are commented upon based on results from Bacterial killing is probably not dependent upon myelo- two studies: one dealing with workers from differentfac- peroxidase in the monocyte-derived macrophage or in the tories and in differing environments, and one dealing only alveolar macrophage since histochemical stains for with coal miners. A bacteriological study is presented peroxidase do not stain either cell type. C.albkaniblasto- which indicates the role that bronchopulmonary infec- spores, which are killed by neutrophils and monocytes tions play in chronic bronchitis. Viruses and predisposing that contain myeloperoxidase. were not killed by human factors for infection are commented upon. Endogenous alveolar macrophages during the 4-hr observation. Large factors and their role in chronic bronchitis also are dis- cells with supernormal phagocytic capacity were re- cussed. covered from patients with postobstructive pneumonia and from one patient with recurrent bacterial pneumonia. indicating that macrophage function can be altered in certain disease states. Human alveolar macrophages are 71-0615. Gauthier. H. L'Insuffisance Respiratoire an unique human phagocytes in their dependence on an Canada. [Respiratory Insufficiency in Canada.]Laval oxygen tension greater than 25 mm Hg for maximal Medical41:992-994, October 1970, French. phagocytosis. Carbon dioxide tensions as high as 70 mm Hg did not alter phagocytosis when the pH of the medium A brief review of the etiology of non-tuberculous res- was held constant, These data suggest that the increased piratoryinsufficiencyispresentedin which chronic bronchitis, emphysema, and lung cancer are discussed susceptibilityto pneumonia of patients with chronic bronchitis of atelectasis may be in part related to sub- particularly with relation to cigarette smoking. Statistics optimal phagocytosis by macrophages in areas of the lung which reflect the increased mortality due to respiratory with depressed oxygen tension. (Auth. Abs.) diseases are presented for the United States and Canada.

112 109 NONNEOPLASTIC RESPIRATORY DISEASES

71-0616. liammarsten, J. F., Henderson, L., Guenter, C. In population sample,s in England and Wales a greater A.,Ferguson, S., Welch, M. H. An Epidemiological frequency of positive sheep cell agglutination tests has Approach to Chronic Obstructive Pulmonary Disease and been found in Leigh and the Rhondda than in Wensley- Alpha,- Antitrypsin in Hospital Patients: A Tri-Racial dale, the Vale of Glamorgan or Watford. The urban popu- Study.Transactions of the American Clinical and Clima- lation of Leigh had more X-ray evidence of lung path- tological Association82: I 24-130,1971. ology than the rural population of Wensleydale. Sero- positive persons in both the urban populations of Leigh In a population with high prevalence of smoking, and the Rhondda and the rural populations of Wensley- chronic bronchitis, and obstructive lung disease, there was dale and Glamorgan had more X-ray evidence of lung no difference in distribution of alphas -antitrypsin levels pathology than seronegative individuals, the difference among the races. Whites had a significantly higher pre- being significant for healed tuberculosis of the lungs. valence of chronic bronchitis and obstructive lung disease thickened basal pleura and increased basal vascular mark- than Indians with Negroes occupying an intermediate ings. The association between the first two and rheuma- position. Thisisattributed primarilytothe heavier toid factor was equally present in those with and without smoking habits in Whites; that is, to cultural patterns arthritis but in the thirdit was limited to those with rather than genetic differences. (Auth. Abs.) arthritis. A history of bronchitis was no more common in persons with a positive sheep cell test than in those with a negativetest and theindirect maximum breathing 71-0617. Hardinge, M. Effects of Smoking on Body capacity showcd no significant relationship to rheumatoid Mechanisms.School Health Review2:5-7, April 1971. factor titer. No association was found between cigarette smoking and the sheep cell titer. It is concluded that The local effects of smoking on the respiratory tract parenchymal lung and pleural disease may act as a stim- are due primarily to the very fine particles of smoke ulus to the production of rheumatoid serum factor and acting directly on the lung tissue causing a narrowing or that this stimulus is independent of the presence or ab- constriction of the as passages resulting in shortness of sence of arthritis. (Auth. Abs.) breath or severe difficulties in breathing. They also attack the important defense mechanism of mucous and ciliary activity along the length of the respiratory tract. The 71-0620. Lourenco, R. V., Klimek, M. F., Borowski, C. J. systemic effects of cigarette smoking are produced by Deposition and Clearance of 2-Micron Particles in the absorbed substances, mainly nicotine, although carbon Tracheobronchial Tree of Normal SubjectsSmokers and monoxide also strongly affects the cardiovascular system. Nonsmokers.Journal of Clinical Investigation Studies of large population groups show that smokers of 50(7):1411-1420, July 1971. both sexes and all age groups suffer more illness and death than nonsmokers. The risk of death Is three times greater Deposition and clegInce of inhaled particles of iron in men smoking 20 or more cigarettes a day than in non- oxide labeled with I "Au were studied in 19 normal smokers. The logical approach to the reduction or elimi- subjects (10 nonsmokers and 9 smokers). For this pur- nation of the smoking problem isthe education and pose, monodisperse aerosols of particles with a 2-micron motivation of the young to choose not to start smoking. diameter were produced in a spinning disc atomizer. Thoracic counts and images with a scintillation camera were begun immediately after inhalation of the aerosol 71-0618. Hook, H. L., Morrice, G. (Jr.), deTreville, R.T.P. and continued for 6 hi. In all subjects, smokers and non- Fibrous Glass Manufacturing and Health. Results of a smokers, the deposition of the particles was uniform Comprehensive Physiological Study: Part 11.Industrial throughout both lung fields, with approximately half of Health Foundation44:103-111,1970. the particles deposited in the ciliated airways (tracheo- bronchial deposition) and half in the nonciliated airways Results of a thorough medical evaluation of a ran- (alveolar deposition). Tracheobronchial clearance in non- domly selected sample of employees working inthe smokers occurred immediately after inhalation, first at a manufacturing the processing of fibrous glass, fail to show fast rate for particles deposited in the largest and most any evidence which would support a hypothesis that central airways, awl then at a slower rate for particles those with dusty jobs were less healthy than those with from the smaller and more peripheral airways. Photoscint- minimal dust exposure at work. A pulmonary function igrams showed that the particles cleared steadily with no test of the older age group (over 50 years of age) was retention in any area. The general pattern of clearance conducted, and a comparison was made between the may be likened to a model of multiple conveyor belts greatest and least exposure groups in an attempt to with speed increasing from the peripheral to the central identify any adverse bioeffects of dust exposure on the airways in such a way as to prevent "particle jams" at lungs. The smoking habits of each subject were also con- airway confluerice points. In smokers, tracheobronchial sidered in analyzing his respiratory function. No evidence clearance was delayed for periods of 1-4 hr after inhala- was found of a measurable 'dust effect' affecting ability tion. Furthermore, in contrast with the findings in non- to diffuse gases across the alveolar membrane in this em- smokers, significant clearance was still occurring in many ployee group. It is concluded that fibrous glass dust in- of the smokers in the 5th and 6th hr after inhalation. haled and retained in the lungs has no associated morbid Also, photoscintigrams showed an abnormal accumulation effect. of particles in the large airways several hours after inhala- tion of the aerosol. (Auth. Abs.)

71-0619. Lawrence, J. S., Locke, G. B., Ball, J. Rheuma- toid Serum Factor in Populations in the U.K. I. Lung 710621. McLaughlin, R. F., Tuelkr, E. E. Anatomic and Disease and Rheumatoid Serum Factor.Clinical and Ex- Histologic Changes of Early Emphysema.Chest perimental Immunology8(5):723-739, May 1971. 59(6):592 -599, June 1971.

113 110 NONNEOPLASTIC RESPIRATORY DISEASES

(prick) and five-hour (intradermal) cutaneousreactions to Most systcms of classifying emphysema grade the in the according to type, distribution, and extent of involvement the enzymes were not significantly more frequent symptomatic (72 percent and 44 perccnt.respectively) from barely visible onward. Clinical and anatomic evi- and 24 dence of progression in these lesions suggests the exis- than in the asymptomatic subjects (56 percent tence of earlier stages. Thirty-nine lungs were studied.All percent). By contrast, there was a highly significant asso- ciation between skin reactions to the enzyme and tothree appeared grossly normal but contained widespread macro- exception of a his scopic foci of early centrilobular and panlobular em- common inhalant allergens. With the tory of food and dr4 allergy, z personal orfamily history physema. Numerous abnormal brownish pigmented likelihood alveolar macrophages were found in the adjacent, other- of atopic manifestations did not influence the of development of symptoms, nor did smokinghabit or wise intact appearing parenchyma. They were not found The findings in normal lungs. Identical pigmented macrophages were current, clinical evidence of bronchitis. found in sputum specimens obtained from apparently suggest that symptomatic bronchial reactionsin persons healthycigarette smokers. Frequencyof occurrence exposed to a potent sensitizing and chemically active material are determined by other factors inaddition to appeared related to the number of cigarettes consumed. Tests of The brownish pigment resembled tobacco but could not allergy, at least as indicated by skin reactivity. ventilatory and diffusing capacity showed no evidenceof be identified as such. In heavy smokers; many of these unsensitized sub- cells also contained iron particles, suggesting the possibil- permanent lung damage in sensitized or ity of tissue damage. Such cells are thought to produce jects, whether symptomatic or not. (Auth. Abs.) proteases. Their occurrence prior to evidence Of bronchi- olar-alveolar destruction may be of particular significance E. Pulmonary Surfactant. New in the various alpharantitrypsIn deficiency states. (Auth. 71-0624. Morgan, T. Abs.) England Journal of Medicine 284(21):1185-1193, May 27,1971. pulmonary 71-0622. Miller, G. 1,Ashcroft, M. T. A Community Recent advances in the knowledge of the Survey of Respiratory .Disease Am Ohs East Indian and surfactant system are reviewed in terms of its physiology, African Adults in Guyana. Thorax 26(3):331-338, May alveolar morphology, chemistry and surfactant biosyn- thesis and turnover. The role of pulmonary surfactantin 1971. disorders such as the respiratory-distress syndromeof prevalent newborns, pulmonaryarterialocclusion, pulmonary The belief that chronic bronchitis is More is among Indians than Africans in the Caribbean area was edema, pulmonary alveolar proteinosa and atelectasis described. The effects on surfactant of changes in the investigated by a community survey in Guyana. Respira- conditions of tory symptoms were assessed by a standard questionnaire, gaseous environment such as occur under high concentrations of oxygen, hypoxia and hypercapnia, ventilatory capacities were measured, and chest radio- inspired air graphs were taken of some 800 African and Indian men and of gaseous and particulate pollutants in and women aged 35 to 54 years living in adjacent and are indicated. Also mentioned are theeffects of surgical similar communities. Histories of morning cough, chronic procedures, aspiration and drowning on pulmonary sur- factants. The use of saline lavage of lungs and of aero- cough, morning phlegm, and chronic phlegm (chronic dis- bronchitis) were more common in Indians than Africans. solized surface-active agents as therapeutic measures is Although these respiratory symptoms were much more cussed. common in smokers than nonsmokers, the higher pre- valenceratesin Indiana could not be explained by smoking habits which were similar in the two races. 71-0625. Nasiell, M. Smoking and Pulmonary Disease (2): Sputum Cytological Studies of Smokers, Complete Chronic bronchitis occurred in 17.3 percent of Indian and (2): 2.4 percent of African male smokers and in 6.1 percent English translation of "Rokning och Lungsjukdom and 2.2 percent of Indian and African female non- Sputumcytologiska Studier av Rokare", Lakartidningen smokers, respectively. Judging by the history, lung func- 67(4):384-389, January 21, 1970. tion, and clinical signs, chronic bronchitis was more severe in Indians than Africans. The condition was more com- See Abstract 70-1259. mon among field laborers on sugar estates but, although the majority of field laborers were Indian, this occupa- tional difference only partially explained the difference in 71-0626. Poppius, H. Smoking and Pulmonary Disease prevalence between Indians and Africans. Indians, for (4): Clinico-Physiological Studies. CompleteEnglish reasons unknown, appear to have a greater susceptibility translation of "Rokning och Lungsjukdom (4): Kliniskt- than Africans to chronic bronchitis. (Auth. Abs.) Fysiologiska Studier", Lakartidningen 67(4):397.401, January 21,1970.

71-0623. Mitchell, C. A., Gandevia, B. Respiratory See Abstract 70-1260. Symptoms and Skin Reactivity in Workers Exposed to Proteolytic Enzymes in the Detergent Industry. Anted. J., can Review of Respiratory Disease 104(1):1-12, July 71-0627. Pratt, S. A., Smith, M. H., [adman, A. Finley. T. N. The Ultrastructure of AlveolarMacrophages 1971. From Human Cigarette Smokers andNonsmok- A survey of 98 workers in the detergent industry ers. Laboratory Investigation 24(5):33I-338,May 1971. exposed periodically to high concentrations of protcoly tic enzymes indicated that symptoms suggestive of asthma Alveolar macrophages were obtained by endobronchial developed in 50 percent on exposure either within one- savage of cigarette smokers and nonsmokers and were ex- half hour, after four or five hours, or at night. Immediate amined with the electron microscope. The macrophages

1. 114 111 NONNEOPLASTIC RESPIRATORY DISEASES

are characterizedbysurfaceprocesses, polymorphic symptoms are presented for a population of white male nuclei, an extensive Golgi apparatus, cytoplasmic fila- nonsmokers. The observed rates for chronic bronchitis ments. and various inclusions. The inclusions are mem- (persistent phlegm) are among the lowest rates for non- brane-bounded, are round to pkomorphic in shape, and smokers reported in the literature. The association of show a moderately dense matrix. They contain acid phos- cough and phlegm in this population with a history of phatase and are probably lysosomes and/or phagolyso- sinusitis and hay fever. and the association of dyspnea somes. In nonsmokers the inclusions are mostly round or with histories of coronary disease and hypertension rather oval and measure from 0.1 to 2.0 microns in diameter. than with respiratory symptoms or illness implies that Many contain onlymatrix material, but others also responses on the standard respiratory questionnaire, as possess round dense zones. lamellae, myelin-like figures. commonly analyzed, may not, for epidemiological pur- and homogeneous lipid-like zones. In smokers the in- poses. tItIoquately discriminate among upper respiratory clusions are strikingly heterogeneous and measure from allergicconditions, lowerrespiratory symptoms, and 0.1to over 20 microns in diameter. Many are pleo- cardiovascular symptoms. (Auth. Abs.) morphic in shape. They contain the structures seen in the inclusions of nonsmokers, but lipid-like zones are more abundant. Moreover, dense angular and needlelike struc- 71-0632. Stebbings, J.H. (Jr.). Chronic Respiratory tures were observed only in the inclusions of smokers and Disease Among Nonsmokers in Hagerstown, Maryland. II. may represent undigested smoke products. Various stages Problems inthe Estimation of Pulmonary Function of phagocytosisareprobablyrepresentedinlavage Values in Epidemiological Surveys.Environmental Re- samples from smokers since some macrophages in these search4(2):163-192, April 1971. samples contain many lysosome-like inclusions while, in other macrophages, lysosomes are reduced in number and Prediction equations for the FEV Id) and PEFR in a phagolysosomes predominate. (Auth. Abs.) population of white male nonsmokers are presented. Data are also presented to demonstrate the superiority, for epi- demiological purposes, of the maximum pulmonary func- 71-0628. Rasmussen, D. L. Impairment of Oxygen Trans- tion value in a series of trials over the mean of the se- fer in Dyspnek, Nonsmoking Soft Coal Miners.Journal quence. Statistically significant and sizable instrument of Occupational MedicineI 3(6):300-305, June 1971. and interviewer effects were found, and a technique for taking these effects into account is presented. Analysis of Among nonsmoking dyspneic southern Appalachian published data suggested that the relationship of pulmon- soft coal miners, impairment in oxygen transfer is almost ary function values to weight, chest expansion and di- always present. Significant abnormalities in oxygen trans- ameter, and hand grip strength should be reinvestigated. fer may be encountered in the presence of entirely normal Factors influencing the variability of an individual's pul- ventilatory function. There is little relationship between monary function values are discussed. The importance of radiographic findings of pneumoconiosis and impaired gas these questions to the design and analysis of longitudinal exchange. Such abnormalities may even be encountered in studies of pulmonary functionvaluesis emphasized. miners without definite radiographic evidence of pneumo- (Auth. Abs.) coniosis and who have normal ventilatory capacities. Reduced oxygen transfer capacity may be an early func- tional abnormality. Any assessment of respiratory function of coal miners must include evaluation of gas 71-0633, Tecukscu, D.; Stanescu, D. Pulmonary Ventila- exchange. (Auth. Abs. Mod.) tion and Distribution in Young Healthy Males, Smokers and Nonsmokers. CompleteEnglishtranslation of "Ventilatia si Mixica Pulmonara la Barbati Tined Sana- 71-0629. Rylandcr, R. Smoking and Pulmonary Disease tosi, Fumatori si Nefumatori",Studdi si Cercetari de (3): Studies of the Effect of Smoking in the Respiratory Medicina Inferno5(11):419423, 1970. ()mans Using Experimental Animals. Complete English translation of "Rokning och Lungsjukdom (3): Djur- SeeAbstract 71-0101. experimentella Studies av Effekter pa Andninporganen", Lakartidningen67(4 ): 390-396, January 21,1970. 71-0634. Van Game, W. F., Ferris B. G. (Jr.), Cotes, J. E. SeeAbstract 70-1261. Cigarette Smoking and Pulmonary Diffusing rapacity. Chest59(5, Supplement):33S, May 1971.

71-0630. Simonsson, B. G. Smoking and Pulmonary The pulmonary diffusing capacity in 70 men and 72 Disease (6): Acute Effects. Complete English translation women was found to decrease with increasing age and of "Rokning och Lungsjukdom (6): Akuta Effekter", with an increase in cigarette smoking, whether expressed Lakartidningen67(4):404405, January 21, 1970. as lifetime or current smoking. The membrane component in both men and women decreased with age, but did not SeeAbstract 70-1263. change with cigarette smoking habits. The volume of blood in the capillaries decreased with increasing age and decreased markedly with an increase in smoking, whether 71-0631. Stebbings, J. H. (Jr.) Chronic Respiratory Dis- expressed as current or lifetime smoking. ease Among Nonsmokers in Hagerstown, Maryland. I. De- sign of the Study and Prevalence of Symptoms.Environ- mental Research4(2):I46-162, April 1971. 71-0635. Van Haelst, L., Calay, R., Thys, J. P., Chailly, P. Le Poumon Polykystique Congenital. Expose d'un Cu et The prevalencerates of the standard respiratory Revue de Is Littenture. (Congenital Polycystic Lung. A

115 112 CARDIOVASCULAR DISEASES

lion is wen in the tendency toadhesion, especially of 710650. Giannini, S. D. Fatores de RiscoCoronariano. Excessive physiologi Arquivos Brasileiros de Car - thromb tes, to the vascular wall. (Coronary Risk Factors.] cal reactis.ris and pathologicalirritations or conditions can diogla 23:345-352, October 1970, Portuguese. induce adhesions of thrombocytesand other blood ele- Thus. changes in the vascular heart disease is ments to the vascular wall. A review of risk factors in coronary wall, endothelium or the blood can act aspromoters. The presented. From an analysis of propcctivestudies, the be separation and dis- hyperlipidemias, hyper- further fate of such adhesions may main risk factors are as follows: solution, the development of lateralthrombi which endo- tension, diabetes mellitus, obesity, smokinghabits, family thrombotic segmental abnor- thelialize as plaques or complete history, sedentary life, and electrocardiographic occlusions. There are mechanisms which canprevent or malities. Particular emphasis is given tohyperlipidemia break down such depositions and itis assumed that they and hypertension because they arethe most expressive those which reduce blood vis- heart disease, partic- are, in part, identical with conditions as predictors of coronary cosity to increase local blood flow. ularly when they are associated with oneanother. (Auth. Abs. Mod.) 714)653. Hickey, N., Bourke, G. .1., Gearty,G., Mulcahy, R. Mediscan: A Population ScreeningProgramme for the Mortality Detection of Coronary Heart Disease RiskFactors. Jour- 7141651. Gordon, T., Kennel, W. B. Premature 64(40W:155-162, From Coronary Heart Disease. TheFramingham Study. nal of the Irish Medical Association Journal of the American MedicalAssociation March 18, 1971. 215(10):161 7-1 625, March 8, 1971. A program for detecting coronaryheart disease risk along with details of Framing- factors at a population level is described Since 1948, a cohort of 5209 residents of the screening procedure and notes onthe methodology ham, Massachusetts, have beenexamined biennially. In categories. The program is heart disease and on the different risk factor the first 14 years, 120 died of coronary fully computerized to allow the handlingof large numbers (CUD) before reaching 65 years of age.Two thirds of of subjects. Initial feasibilitystudies suggest that the these deaths occurred outside thehospitalthe majority inexpensive enough to the terminal event. screening procedureis simple suddenly within one hour of onset of allow wide participation, andacceptable to both the Nearly one half of the deaths from theinitial coronary screening pro- One half of all per- medical profession and the public. The attack were sudden and unexpected. cedures consists of a brief questionnaireasking for details sons with sudden deathshad no prior clinical heart dis- physical activity; measurement of died of CHD and were free of on smoking habits and ease. All of the men who height, weight, biacromial diameter andskin fold thick- cardiovascular stigmas were cigarettesmokers. While non- preceded by clini- ness; electrocardiogram;blood pressure; scrum choles- sudden coronary deaths were ordinarily terol; blood sugar; and urinalysis.Risk factors of 2618 cal CHD, the disease was frequentlyfirst manifested close and their place- small percentage of persons male subjects from five population groups to the final episode. Only a ment in five risk categories rangingfrom (ow risk to overt were seriously disabled sixmonths before their death. number of smokers nearly one half of disease groups are discussed. The Even among persons with known CHD, among the total screened was48.4 percent which was the deaths occurred outside thehospital. It is concluded reported from a reduction in premature strikingly lower than the 70 percent that the only road to a substantial sample of Irish males ages 35-60 in 1961.This lower per- CHD mortality is prevention of CHD. centage of smokers may bedue to nonsmokers being more willing to volunteerfor such a screening service. 71-0652. Hess, H. New Considerations onthe Physiopath- ology of Obliterating Angiopathies.Part 2. Pathogenesis 71-0654. Jones, R. A., Strickland,J. A., Stunkard, J. A., and Therapy. Complete Englishtranslation of "Neue Siegel, J. Effects on ExperimentalAnimals of Long-Term Uberlegungen zur Physiopathologie obliterierenderAngio- Inhalation Exposure to CarbonMonoxide. Toxicology pathien. 2. Zur Pathogenese andTherapie", Fortschritte and Applied Pharmacology19(1):46-53, May 1971. der Medizin 88(24):923.928, August27,1970. Rats, guinea pigs, monkeys, anddogs were exposed A theory explaining the regulationof blood flow with continuously for 90 days to 51, 96,and 200 ppm carbon a "concerted action" ofchanges in vascular muscle tone monoxide. Animals were alsoexposed repeatedly 8 and blood viscosity is developed.Smoking increases blood hr/day, 5 days/wk for 6 consecutiveweeks to 106 ppm. viscosity, particularly in men withobliterating angio- No adverse toxic signs werenoted during these studies. pathy, and reduces peripheral circulation.In the latter After the continuous exposures to96 and 200 ppm, the case, nicotine causes a directdilation of vessels, a constric- mean hemoglobin andhematocrit values of all 4 species tion of skin vessels via a sympatheticreflex and dilation were elevated when comparedto prcexposure values, The of muscle vessels, and an initialvascular constriction by carboxyhemoglobin (COHb) values atequilibrium were stimulating peripheral sympathetic structures.Of the determined for the 4 species exposedcontinuously for 48 many possible mechanismsaffecting physiological changes hr at the 3 concentrations.These COHb values correlated in viscosity postulated in the theory,the role of plasmatic well with the affinity constantsfor the different species, clotting and of thrombocytes isemphasized. After view- and agreed closely with thetheoretical calculated values. circulation as a coopera- ing the regulation of peripheral (Auth. Abs.) tion of vascular wall and bloodviscosity via latent co- reversible changes agulation and lytic processes and local 71-0655. Kennel, W. B. Current Status of theEpi- in thrombocyte properties, thetheory of a uniform path- Occlusive segmental stenoses demiology of Brain Infarction Association With ogenesis of all angiopathies leading to 2(4):295-318, July-August and obliterations is derived. The occurrenceof oblitera- Arterial Disease. Stroke ting angiopathies of the most variedetiology and localize- 1971.

118 115 CARDIOVASCULAR DISEASES

While the problem of differential diagnosis of the vari- 71-0658.Meijler, F. L. Arts en Roken.[Diactors and ous categories of cerebrovascular disease presents a major Smoking.] Nederlands Tijelschriftpoor Geneeskunde obstacle to obtaining an undistorted picture of the epi- 115(12):511-513, March 20. 1971,Dutch. demiological features of stroke from death certificate mortality data, the addition of evidence from prospective The report discusses in general fashion the influence of studies, including those in Framingham, Massachusetts, re- smoking on cardiovascular morbidity and mortality in the veals that various types of arterial occlusion with cerebral Netherlands. Several reports referring to the morbidity infarction are by far the most prevalent type of stroke. and mortality statistics attributable to smoking in Great Any specific origin of atherosclerosis remains obscure. Britain and the United States are cited. Based on such Possible etiological candidates including dietary altera- statisticsitis estimated that of approximately 15,000 tions in salt, fat and refined carbohydrates, sedentary men who die annually of myocardial infarctinthe living, excessive calories promoting obesity, the cigarette Netherlands, 2000 are between 45.54 years and of these habit and even the mineral content of water in addition to 750 deaths can be attributed to the smoking habit. The marital status have all been incriminated. However uncer- morbidity is not as easily quantified but smoking evi- tain the final answer is, certain precursors for athero- dently promotes the morbidity and invalidism of 1500 sclerosis, such as hypertension, diabetes, and hyperlipi- men in this age group. The number of men in this bracket demia, are important. Of these, hypertension is clearly the who suffer coronary damage with no evident myocardial most important contributor to stroke incidence. Certain infarct is believed to be many times higher. The obliga- combinations of items carry more risk than do the same tions of Netherland's physicians and health workers to set items singly. For example, the risk of a brain infarction in a personal example by refraining from smoking, to induce diabetics with hypertension is probably about six times young people not to start, to demonstrate the harmful- that of normal subjects. In persons under SO at the time ness of smoking, and to take active participation in anti- of measurement, risk of cerebral infarction is possibly ten smoking measures is stressed. Several recanmended steps times higher in those with hypertension and elevated to protect the cardiovascular health of the people are lipids than in those without either elevated. This com- mentioned. pounding of risk has pathogenetic, preventive and public health implications. For purposes of stroke screening alone the most efficient and practical method would be to determine casual blood pressure, although it must be 71-0659. Paffenbarger, R. S. (Jr.), Gima, A. S., Laughlin stated that as yet there is uncertainty concerning the M. E., Black, R. A. Characteristics of LongshoremenRe- change in the risk if such blood pressure is treated. (Auth. lated to Fatal Coronary Heart Disease and Stroke. Amer- Abs. Mod.) ican Journal of Public Health 61(7):1362-1370, July 1971.

71-0656. Krosch, H. Zut Prophylaxe des Herzinfarkts. San Francisco longshoremen who underwent multi- (Prophylaxis of Myocardial Infarct.]Wissenschaftliche phasic screening in 1951 were studied for factorsthat Zeitschrift der Martin-Luther Universitet Halle-Witten- predisposed to fatal coronary heart disease and stroke in berg, Ma th e mat isch-Naturwi sse n schaftliche Reihe an 18-year follow-up. Men with physically less active jobs, 19(1):19-23,1970, German. who expende.! 925 fewer calories per work day, sustained coronary death rates one-quarter higher than cargo han- The more important factors involved in the develop- dlers. Differences in coronary mortalitywere largest at ment of myocardial infarct are discussed briefly. The find- younger ages and decreased steadily to disappearance at ings of the Framingham Study and of anti-coronary clubs older ages. Splitting the population into presumed high- are compared. An anti-coronary diet of 2000-2700 calor- and low-risk groups sorted out four other characteristics ies and 30-33 percent saturated and unsaturated fat in associated with coronary mortality: pre-existing heartdis- equal measure helps reduce overweight and favorably in- ease, systolic blood pressure above mean levels, cigarette fluences diabetic metabolic disorders, hypertension and smoking of one or more packs per day, and weigh t-for- hypenuicemia. Nicotine does not seem to increase the height above mean levels. The risk ofcoronary mortality likelihood of coronary sclerosis but appears to further accompanying each of these characteristics was greater for blood coagulation, and in younger individuals, acutecoro- individuals who were less active than forcargo handlers. nary occlusion mechanisms. An elevated viscosity of Longshoremen with more sedentary jobs sustained stroke blood and plasma has also been observed. Studies at the death rates similar to those of cargo handlers. Three other Medical University Clinic at Halle on several risk factors characteristics, however, identified groups at high-risk of for myocardial infarct (age, cholesterol level, and smok- stroke mortality; pre-existing heart disease, systolic blood ing) gave results not quite in accord with those of other pressure above mean levels, and abnormal glucose metab- authors. The role of psychic sum in myocardial infarct is olism. The association between work activity andcoro- debatable. Soviet studies seeking to prove that physical nary mortality, when considered with the lack of such activity (sports or hard physical labor) are useful pre- association with stroke mortality, suggests that physical ventive measures are also disputed. activity influences the myocardium or its functionmore than the atherosclerotic process.

71-0657. Lundman, T. Smoking and Coronary Disease (6):Coronary Disease in Smoking-Discordant Twins. 71-0660.Paras Chavero,E., Mercado Contreras, E., Complete English translation of "Rokning och Koronars- Quintero Novella, A. Tobaccoism and CoronaryCardi- jukdom (6): Koronarsjukdom hos Rolcningsdiskordanta opathy. Long-Term Effects hi the PatientWho Has Suf- Tvillingar", Lakartidningen 67(2):156-160, January 7, fered a Myocardial Infarct. CompleteEnglish translation 1970. of "Tabaquismo y Cardiopatia Coronaria. Su See Abstract 70-1289. Accion en la Evoluclon a Largo Plazo en el Pacit.nteque Ha Padecido

119 116 CARDIOVASCULAR DISEASES

Instituto de Car- high scrum cholesterol and triglyceridelevels, high dia- un Infarto del Miocardio", Archiros del smoking habit. Two diologia de Mexico 15(2)1 28-134, March-April, 1970. stolic blood pressure, and heavy references are cited which confirm thevalue of assessing of an indi- See Abstract 70-0904. the behavior pattern in the total assessment vidual's candidacy for future clinical coronaryheart dis- 71.0661. Paul, 0. Risks of Mild Hypertension: A Ten- case. Year Report.British Heart Journal33(Supple- ment):116-121, 1971. 71-0664. Sartwell, P. E., Masi, A. T.,Arthes, F. G., Greene, G. R., Smith, H. E. Tluomboembolismand Oral Data relating to the risks of hypertension are pre- Case-Control dis- Contraceptives: An Epidemiologic sented from six prospective studies of cardiovascular Study.American Journal of Epidemiology ease initiatedin the United States during the period 90(5):365-380, November, 1969. 1948 -1958. A total of 6640 men, aged 30 to 59 at entry, observations were re- were followed for 10 years and A retrospective study of thromboembolismin females corded for mortality from all causes with particular atten- of reproductive age was conducted in fiveAmerican cities. tion on morbity and mortality fromcardiovascular dis- from 43 85 to 104 mm Hg as Cases were 175 women aged 15-44, discharged eases. Diastolic blood pressures of hospitals afterinitialattacks of idiopathic thrombo- recorded on the initial visit have unfavorableimplications phlebitis, pulmonary embolism, or cerebralthrombosis or in terms of total death WC, deaths from coronarydisease, embolism. Idiopathic cases constituted only asmall frac- infarctions major coronary events (non-fatal myocardial tion of total thromboembolism patients. The 175hospital and deaths from coronary disease), andcerebrovascular controls were matched pairwise with the cases onhospi- episodes. The deleterious effect is most conspicuous for tal, residence, time of hospitalization, race, age,marital men in their fifties, but also appearsin the younger age status, parity and pay status. Both groups werefree of groups. The presence of high serumcholesterol concentra- chronic conditions either associated withthromboem- tion and the use ofcigarettes,increases the risk of non- bolism or constituting contraindications to pregnancy, fatal myocardial infarctions and coronarydeaths at essen- and were presumably fertile. They wereinterviewed to tially all blood pressure levels. provide information on their use of oralcontraceptives before hospitalization. Sixty-seven cases and 23controls had used these products until within onemonth before /1-0662. Petrovic, D. Uvecanje Broja Eritrocita iKolicine they were hospitalized; 11 cases and controls haddiscon- Hemoglobina u Krvi Pusaea. [Increase in the Numberof tinued use earlier. Duration of use did not affect therisk. Erythrocytes and in the Amount of Hemoglobin in the There were 57 care-control pairs in which only the case Blood of Smokers.]Medicinski Glasnik had used an oral contraceptive within onemonth com- 2 4(1 0/11):470-473, October-November1970, Serbo- pared to 13 in which only the control haddone so. The Croatian. relative risk of thromboembolism for the usersis esti- mated to be 4.4 times that of nonusers. Therisk was The carboxyhemoglobin (COHb), erythrocytes and higher for users of sequential products. It isestimated hemoglobin were determined in the blood of 343 men. that 25 percent of the cases in this series wereattributable Among them were 230 smokers and 113 nonsmokers.The to oral contraceptives. Data indicate anassociation of at COHb levels, the number of erythrocytes and the quan- least borderline significance between heavysmoking and tity of hemoglobin were found to be significantlylarger in thromboembolism. (Au th. Abs. Mod.) the blood of smokers than in the blood ofnonsmokers. This appeared to be the result of the compensatory for- mation of erythrocytes and hemoglobin in order to re- 71-0665. Semaine des Hopitaux (Informations)Le Ulm place elements which were bound with carbon monoxide. de l'Infuctus du Myocarde. [Evaluation ofMyocardial Significant differences were observed in persons who Infarct.]Semaine des Hopitaux (Informations).No. smoked up to 15 cigarettes per day and in individuals who 2:5. 7,10,12,14,15,17,20-23, March 14,1971,French. smoked more than 25 cigarettes per day. The amountof cigarettes smoked before blood samples were taken in the A review of the events and discussionswhich took morning also caused significantdifferences in COHb place during the European Heart Week inwhich myo- levels. Contrary to this, no significant differences were cardial infarct was evaluated is presented. The week was a found in relation to the kind of cigarettes theysmoked or prelude to World Heart Day to be sponsored bythe World the duration of their smoking habit. Health Organization in. April 1972. Myocardialinfarct is said to have reached epidemic proportions. InFrance, 41 percent of all deaths can be attributed tocardiovascular disease which is twice as many as deaths due to cancer, 71-0663. Rosenman, R. H. Assessing the Risk Associated factors in- with Behavior Patterns. Journal of the Medical Associa- tuberculosis, and polio combined. The risk volved are discussed, primarily pointing cut thedanger of tion of Georgia 60:31 -34, February 1971. smoking. In a study in Provence, France, 43 percentof those suffering from arteriopathy were heavysmokers Results from this study indicate that the behavior disease, pattern of an individual is significantly and in partin- while in a control population without arterial only 13 percent were smokers. Medical costsrelated to dependently related to his prospective coronary status. immedi- Accordingly, clinical assessment of an individual's be- cardiovascular disease, the need for treatment ately after aninfarct,surgicalpossibilities, artificial havior pattern not only helpsto define coronary- procedure proneness per se but significantly enhances thepredictive hearts, preventive measures, and the readaptive specificity of other more widely used risk factors, such as after suffering an infarct are discussed.

120 117 CARDIOVASCULAR DISEASES

71-0666. Sive, P. li., Medalie, J. H., Kahn, H. A., Neufeld, signed control groups, their findings were similar and in II. N., Riss, E. Distribution and Multiple Regression An- agreement with expectation in terMI. of findings from alysis of Blood Pressure in 10,000 Israeli Men. American clinical, pathological, animal-experimental. and descrip- JournalofEpidemiology 93(5):317 -327. May 1971. tive epidemiological research. Blood pressure distribution of 10,000 male Israeli gov- entment and municipal employees aged 40 and over ex- 71-0668. Szollosi, E., Medve, F., Jeney, E. Angaben zur amined in 1963 in the Israel Ischemic Heart Disease Proj- Wirkung des niedrigen Kohlenmonoxyd-Gehaltes in der ect show curves which rise with age, more steeply for Luft auf den Menschen. [Data on the Effect of Low Car- systolic pressure than for diastolic pressure closely re- bon Monoxide Content of the Air on People.]Zentral. sembling those of various populations in the United States blatt fur Arbeitsriaedizin and Arbcitsschutz and Europe. Despite marked differences in ways of life 20(9):263 -268, September 1970, German. among the regional birth groups, there is a remarkable similarityin their blood pressure distributions. Multiple Investigations of 142 bus drivers (1), 92 bus conduc- regression analysis relating systolic pressure to 18 biologi- tors (II) and 245 truck drivers (111) exposed to carbon cal and environmental variables showed that 14 of these monoxide (CO) concentrations varying from 30 to 60 Were together significantly responsible for 21.6 percent of mg/m3in the vehicle interiors were carried out in 1966 systolic pressure variance in the total population. The and 1967. The tests covered general health complaints, variables age and pulse rate, and to a lesser extent, myo- blood pressure, rarboxyhemoglobin (CO-Hb) content, red cardial ischemia on ECG and a weight-height ratio ac- blood cell count, hemoglobin content of the red blood counted for significant percentages of variance in all areas cells, and the quality of the blood picture. It was observed of birth. The remaining variables in order of their relative that groups I and Ill, neither of which contained female importance were: serum uric acid, cigarette smoking, employees, had higher CO-1413 levels after work than at serum cholesterol, hematocrit, diabetes mellitus, history the end of the day off, and the levels were higher in of peptic ulcer, history of renal disease, anxiety index, smokers than in nonsmokers. In group II, the CO-Hb financial, work and family troubles, and angina pectoris. levels were also higher in smokers than nonsmokers but Among the regional birth groups, the percentage variance the averages were higher after the day off than after work. in systolicpressure explained by the variables studied This is explained by the high percentage of women (46 ranged from 16.6 percent to 29.0 percent. This fact and percent) in this group who are exposed to high CO con- the differing relative importance of a number of variables centrations in their gas range-equipped kitchens. It was within these groups indicate the need for further studies also observed that operators of vehicles smoke rather including other environmental as well as hereditary fac- heavily and the additional CO concentrations in the tors in multivariate analysis of blood pressure in poly- vehicles can cause accidents due to the lowered hemo- ethnic population groups. globin content.

71-0667. Stamler, J. Acute Myocardial 1nfarctionPro- 71-0669. Tibblin, G., Wilhelmsen, L. Smoking as a Risk gressin Primary Prevention. British Heart Journal Factor. Complete Englishtranslation of "Rokningen 33(Supple men t): 145 -164, 1971. som Riskfaktor", Lakartidningen 68(7):687-689, Feb- ruary 10, 1971. Socioeconomic and sociocultural evolution' inthe twentieth century has led to a way of life for tens and This article reports on the first longitudinal study in hundreds of millions in advanced countries that is con- Sweden concerning the relationship of smoking with vari- ducive to widespread premature coronary disease. Re- ous diseases and death. Results indicate that among men, peated reference is made to coronary risk factors and ages 50-57, heavy smokers have 10 times greater risk of their frequent occurrence in the population of the devel- having myocardial infarct and 5 times greater risk of oped nations. These factors include rich diet and diet- dying than nonsmokers. With results from other foreign dependent hy perlipidemia, obesity, hyperglycemia, hyper- studies and in particular the "Men Burn in 1913" study as tension, hyperuricemla, cigarette smoking, impaired vital arguments, the physician corp is urged to take active capacity, sedentary and stressful living, hypothyroidism, measures against smoking. renal disease and positive family history of premature vas- cular disease. Three cardinal risk factors which stand out in view of their frequency of occurrence, their impact on 71-0670. Tibblin, G. Smoking and Coronary Disease (2): risk, and their preventibility and reversibility arc hyper- General Survey.Complete Englishtranslation of cholesterole mia,hypertension and cigarettesmoking, "Rokning och Koronarsjukdom (2): Allman Oversikt", particularly when present in combination. A review of Lakartidningen 67(2):140 -144, January 7, 1970. findings from the New York Anti-Coronary Club Study, the Finnish Mental Hospital Study, the Los Angeles See Abstract 70-1293. Veterans Administration Domiciliary Center Study, and the Chicago Coronary Prevention Evaluation Program, all first generation studies on primary prevention of coronary 71-0671. Waxier, E. B., Khnbiris. D., Dreifus, L. S. The heart disease, indicated that change in living habits, partic- Fate of Women with Normal Coronary Arteriograms and ularly diet, and in the Chicago study cigarette smoking, is Chest Pain Resembling Angifia Pectoris. American Jour- associated with decreased incidence or mortality, or both, nal ofCardiology 281(1 ):25-3 2, July, 1971. from myocardial infarction and coronary heart disease. Although these studies were imperfect in design, method- The clinical and laboratory findings and subsequent ology, or results, and were handicapped by such problems fate of 100 women with unexplained chest pain, having as relatively small numbers and improper randomly as- some or all of the features of angina pectoris, and normal 121

118 CARDIOVASCULAR DISEASES

of selective coronary arteriographic findings were studied. entary habits, and high blood pressure, the incidence Some basis for the chest pain was discovered in only 14 myocardial infarction in those exhibiting only one or two conditions risk factors has been low. When three factors occurredin percent (14 of 100) and included the unusual who of systolic click syndrome, primary myocardial disease, the same individual, the incidence increased. Those rheumatic heart disease and a cystic duct neuroma. Of the were smokers, had sedentary jobs, and hadboth elevated remaining 86 patients with no readily apparent cause for cholesterol and triglycerides had an incidence above10 their symptoms, the average age was 44 years. Atypical percent. The incidence was around 20 percentif all new angina was noted in 76 percent (65 of 86);46 percent (40 coronary events were counted. The removalof only one of 86) gained relief of pain from nitroglycerin, and 40 risk factor may have little or no impact on overall mor- percent (34 of 86) manifested anxiety neurosis. Of44 bidity or mortality. A multifactorial approach seems patients who exercised, 16 had a positive elecuocardio- necessary to influence a disease that, likeischemic heart graphic response of ST segment depression of more than disease, is affected by many environmental factors.The 1 mm, yet this group did not differ significantly from hypothesis that removal of several risk factors will de- those with a negative response to exercise. The smoking crease the incidence of ischemic heartdisease must be habits of 80 patients were also analyzed. Follow-up study tested before any large-scale changes are advocated in our of these 86 patients from 6 months to 2V2 years revealed life style; such a study is described. Changing social struc- larger impor- that 50 percent had a decrease or disappearance of pain. ture in the community, however, may be of More important, there was no instance of sudden death or tance for the prevention of ischemic heart diseasethan myocardial infarction. It is suggested that chest pain with any medical intervention. normal coronary arteriographic findings should be clearly distinguished, especially as to its benign prognosis, from the angina pectoris associated with large vessel obstructive 71-0673. Zdichynec, B. Zmeny v Bilem Krevnim Obraze u atherosclerosis and that it most likely is related to neuro- Dlouhodobych Kuraku. (Na Zaldade Srovnani Souboru circulatory asthenia, although other possible explanations Nemocnych s Transmuralnim Srdecnim Infaiktema Nemocnych bez Priznaku Koronami Choroby v Pred- are discussed. chorobi). (The Chvige in White Blood Cell Count in Long-Time Smokers. (Bans for the Comparison of Pa- dentsWith Transmeral Myocardial Infarct and Patients 71.0672, Werko, L. Can We Prevent Heart Disease? Am Vnitrni nals of Internal Medicine 74(2):278-288, February 1971. Without Symptoms of Coronary Disease).] Lekarstvi 17(4):327-330, April 1971, Czech. Prevention of heart disease is critically reviewed. Al- though several risk factors have been identified that seem In 159 patients with transmural myocardial infarction to characterize individuals most prone to laterdevelop. it was found that smokers in comparison with non- ment of ischemic heart disease, no one has been able to smokers, had a statistically significant higher rate of eosin- show that interfering with theta: risk factors will decrease ophilia and lymphocytosis. In a control group of long- the incidence of the disease. In the continuing population term smokers without a history of acutemyocardial in- study in Goteborg, Sweden, of males born in 1913 and farction, blood changes were very similar to those in the incidence of myocardial infarction among them in smokers with myocardial infarction. These results could relation to such risk factors as blood lipids, smoking, sed- be due to an allergic reaction to smoking. See also, 71-0571, 71-0575, 71-0597, 71-0617

OTHER DISEASES AND CONDITIONS

smoked 71-0674. Fedrick, J. Alberman, E. D., Goldstein,H. heart disease in singleton babies of mothers who was 7.3 per 1000 births, comparedwith 4.7 per 1000 of Possible Tetatogenic Effect of Cigarette Smoking. Nature babies of nonsmokers. An analysis of varianceshowed 231(5304):529.539, June 25, 1971. that the smoking effect was independent ofmaternal age, during parity and social class, and was highlysignificant. Al- In a study to determine the relation of smoking though the small number of cases made it difficult to pregnancy to the incidence ofcongenital heart disease, relate specifictypes of congenital heart disease with questionnaires were completed for 98 percent of all births be an association during the rust week of March 1958 and for stillbirths maternal smoking, there seemed to with patent ductus arteriosus and Fallot's tetralogy. and neonatal deaths during March, April andMay 1958 in England, Scotland and Wales. These amounted to 68 and in 204, respectively, excluding multiple births and those 71-0675. Battig, K., Hrubes, V. The Effect of Filtrate whom the defect was associated with anencephalus, spinal Fractions of Tobacco Smoke on SwimmingEndurance in bifida or Down's syndrome. Results showed that in both 16(2):205.210, groups there was a significant increasein the proportion the Rat. Zeitschrift jur Praventivmedizin of mothers who smoked compared with the mothersof March-April 1971. singletons in the control week who did not haveinfants with congenital heart disease. The incidence ofcogenital Twenty minutes after the termination of exposure to

122 119 OTHER DISEASES AND CONDITIONS filtered and unfiltered smoke, the swimming endurance of were found in half the low-tension glaucoma group; as 21 rats was measured. In experiment I (with only short Yet, it is too early to assess their significance or the result pretraining of the rats) 10 and 20 puffs resulted in minor of hydroxycobalamin therapy. The Farnsworth 100 Hue reductions of the swimming endurance, which did not Test was found of value in differentiating between the surpass the threshold of significance. In the second experi- diagnostic groups. The visualfield analyser (V.F.A.) ment with the same rats (20 puffs only), the exposure showed areas of central depression in a proportion of the sessions resulted in the following reductions of swimming nutritional type of low tension glaucoma, and in many of endurance as compared to the control: Cambridge-filtered the treated nutritional amblyopes which could not be de- smoke, I Ipercent (not significant); Cambridge-charcoal- tected by Goldmann or Bjerrum apparatus. Greater value filtered smoke, 18 percent (marginally significant); char- is now attached to the V.F.A. results since a survey was coal-filtered smoke, 29 percent (p <0.01) and full smoke, conducted on normalpatients which identifiedthe 32 percent (p < 0.01). The differences between Cam- normal levels of response for one particular machine. bridge-filtered smoke on one hand and charcoal-filtered Practical problems were exposed relating in part to the and full smoke on the other hand also exceeded the design of the apparatus, many of which are overcome by threshold of significance. (Auth. Abs.) the new front. (Auth. Abs.)

71-0676. Cohen, B., Poswillo, D. E., Woods, D. A. The 71-0678. Currie, A. R., Bird, C. C., Crawford, A. M., Effects of Exposure to Chewing Tobacco on the Oral Sims, P. Embryopathic Effects of 7,12-Dimethylbenz(a)- Mucosa of Monkey and Man. A Histological and Ultra- anthracene and Its Hydroxymethyl Derivatives in the structural Study. Annals of the Royal College of Sur- Sprague-Dawley Rat. Nature 226(5249):911-914, June geons of England 48(5):255.273, May 1971. 6,1970. Premalignant lesions occurring in the mouths of habit- 7,12-Dime thylbenz(a)anthracene and one of its ual chewers of tobacco-containing compounds in India hydroxymethyl derivatives have been shown to cause a were studied by light and electron microscopy. Prolonged variety of fetal abnormalities, especially when admin- exposure to these compounds was effected experimen- istered on day 13 of pregnancy. It is suggested that deriva- tally by sealing the material used by betel-chewers into tives of benz(a)anthracene must have active side chains the cheek pouches of monkeys. At both microscopic and situatedat C-7 and C-12 for embryopathic activity. submicroscopic levels close similarities were identified. (Auth. Abs.) The most conspicuous, which was also the earliest change seenexperimentally, was a ballooning of cells;this feature, previously attributed to intracellular edema, was 71-0679. Fisher, K. D., Carr, C. I., Huff, J. E., Huber, T. shown by electron microscopy to reflect the development E. Dark Adaptation and Night Vision. Federation Pro- of vacuoles within the cytoplasm. In both human and ceedings 29(5):1605-1638, September-October 1970. monkey mucosa a phenomenon conceivably indicative of invasion at its inception was identified; it comprised a This study was undertaken to provide a comprehensive disruption of the epithelio-connective tissue interface review of the state of knowledge on vision as related to through which extrusions of epithelial cells herniated into dark adaptation and night vision in man. In the prelim- the underlying corium. (Auth. Abs. Mod.) inary reviews of this subject, the interrelationships of the physiological, biological, behavioral, and physical factors that affect vision were considered. However, in this study, 71-0677. Crews, S. J., James, B., Marten, .1. B., West, R. emphasis has been restricted to the current biochemical H. Drug ar_JNutritional Factors in Optic Neuro- and biophysical concepts of dark adaptation and night pithy. Transactions of the Opthalmological Societies of vision, the role of nutrition as it affects dark adaptation, the United Kingdom 90:773 -794, 1970. and the pharmacologically induced alterations of night vision. In addition, the effects of smoking and noxious While many drugs are reported to have caused toxic environmental agents are considered as well as the poorly amblyopia, the number of cases for each drug is small. understood individual variability in night vision capacity. However, few surveys using sensitive tests have been con- (Auth. Abs.) ducted to assess sub-clinical degrees of toxicity. The low incidence would suggest indirect mechanisms of a nutri- tionalor vascular nature, genetic enzyme defects or 71-0680. Forster, W. Anamnestische Erhebung uber hypersensitivity. Identification and correction of such Ulcers ventriculi et duodeni. [ Anamnestic Investigation of predisposing factors should allow essential drug therapy Gastric and Duodenal Ulcers.)Schweizerische Rund- to be continued. Accordingly a number of patients with schau fur Medizin 59(48):1675-1681, December 1, 1970, optic neuropathies were investigated for these factors. German. These patients fitted into three main diagnostic groups low-tension glaucoma, nutritional amblyopia and Leber's Anamnestic data obtained by personal interrogation of optic atrophy, though there was some degree of overlap. 64 persons suffering from ulcers (39 duodenal, 25 gastric) Drugs could only be considered an etiological factor in a were examined. There were no visible differences between small number of cases; these drugs were, however, of a ulcer patients and controls regarding diet and alcohol and type in which multiple modes of action have been im- tobacco consumption. Visible differences appeared, how- plicated both as regards tobacco and other aspects of ever, when viewing psychosocial disturbances of patients nutrition. In 3 out of 4 cases there was a response to and controls. The duodenal ulcer patients, and to a lesser vitamin B12 therapy or cessation of smoking. Three of extent the gastric ulcer patients, were most clearly af- the patiers were using drugs which might induce sys- flicted. The results indicate that factors linked with per- temic hypotension. Tobacco and other nutritional factors sonality (poor assimilationof psychosocial problems)

12,3 120 OTHER DISEASES AND CONDITIONS

Gastrointestinal Secretions.Gastroenterology have a more important role than exogenousfactors (ali- mentation, alcohol, tobacco) in thedevelopment of 60161:1098-1105. June 1971. ulcers. The effect of nicotine on gastric. pancreatic, and hepatic exocrine secretions was assessed in conscious dogs 71-0681. Hamner, J. E., Mehra, F. S., Pindborg, J.J., prepared with various combinations of Heidenhainpouch, Daftary, D. K. An Epidemiologic andHistopathologic gastric, pancreatic, and biliary fistulas. The alkaloid was Study of Leukoedema Among 50,915 Rural IndianVil- infused in doses corresponding to amounts absorbed from lagers. Oral Surgery, Oral Medicine and OralPathology smoking up to four cigarettes in 1 hr. In the pancreas 32(0:58.65, July 1971. nicotine inhibited the secretinstimulated secretion of both fluid and bicarbonate, and the degree of inhibition Fifty-eight cases (0.11 percent) of leukoedema were was dose-related. Spontaneous biliary secretionof bicar- discovered in a house-to-house survey of50,915 rural bonate was also depressed by the drug. Nicotine did not villagers from four Indian states. The prevalenceranged alter gastric secretion of acid, gastric mucosal bloodflow, from 0.02 percent (four cases) in Bihar to 0.25 percent or the mucosal barrier to hydrogen orsodium ions. These (twenty-six cases) in Kends. Fifty-two of thefifty-eight tindings provide a possible link between cigarette smoking leukoedemic persons were men; the remaining six were and duodenal ulcer formation. Specifically, thenicotine fisherwomen who practiced reverse smoking inAndhra from cigars: to smoke may inhibit pancreatic andhepatic Pradesh. AU of those who exhibited leukoedemaalso bicarbonate secretion in man, thereby depriving theduo- practiced some form of smoking habit; bidismoking was denum of the alkaline secretion it needs toneutralize the most popular. There was no evidenceof epithelial gastric acid adequately. (Auth. Abs.) atypic or malignant change in any of the twentybuccal mucosal biopsies. The characteristic histologicfeature of leukoedema was the accumulation of spongy/vacuolated 71-0684. Kuenssberg, E. V. Therapeutische Prufungenin cells in the superficial epithelial layer. Inthirteen of the also deeper der Allgemeinpraxis. [Therapeutic Tests inGeneral Prac- twenty specimens these cells were present Therapiewoche 20(34):1674-1683, August26, within the stratum spinosum. (Auth. Abs.) tice.] 1970, German. 71-0682. Kessler, I.I., Diamond, E. L. Epidemiologic Several fundamental principles for the therapeutic Studies of Parkinson's Disease, 1. Smokingand Park- clinical testing of drugs by general practitionersansi some inson's Disease: A Survey andExplanatory Hypothe- reasons for possible failure of the tests arediscussed. A sis. American Journal of Epid:iniology94(I):16-25, large-scale investigation by the Royal College ofGeneral July 1971. Practitioners (Great Britain) concerning the effectsof anti-conception pillsis presented as a valid example of Nicotine has long been known to affect the central testing procedures. The majority of the pilltaking women and peripheral nervous systems of man. It hasvariously were in the smoker group. been regarded as an exacerbating factor or as athera- peutic modality in Parkinson's disease. Threeprospective studies have demonstrated a lower risk of deathfrom Parkinson's disease among smokers than nonsmokers. A 71-0685. Kueppers, F. Alpha, -Antitrypsin: Physiology, previous retrospective study confirmed thatpatients with Genetics and Pathology. Humangenetik11:177.189, this condition are less likely to smoke tobacco thanother 1971. patients, but attributed this to an artifact resultingin the selection of control patients with excessive smoking In human scrum, alpha t -antitrypsin (eta -at) is a glyco- habits. In the present investigation, the smokinghistories protein that inhibits the enzymatic activity of trypsinand of all Baltimore residents discharged with adiagnosis of other proteolytic enzymes. Its concentration innormal Parkinson's disease from the hospitals of Baltimore over a serum is 200-250 mg/ l00 ml. Incertain physiological 2-year period were ascertained. These patients wereless and pathological situations, such as pregnancy,under con- likely to have ever smoked and, if smokers, tended to traceptive medication and during inflammation, thelevel smoke less than a comparable group of patientswithout of et, at is elevated. The physiological role of aratis not Parkinson's disease. Tremors, rigidity, hypokinesia andal- known, but the interaction with proteolytic enzymes terations in fades and speech were somewhat less preva- from white blood cells is probably important.Electro- lent among male parkinsonians who smokedthan among phoretic techniques distinguish several phenotypes.which those who did not. Relatively few female patientssmoked can be explained by the existence ofseveral codominant and these did not differ substantially in theirneuropatho- alleles at one locus (probably the structural locus).Two logic symptoms from the nonsmokers. Smokerstended to alleles PiZ and PiS cause low concentrations of al-atin develop neurologic deficits at an earlier agethan non- serum: the approximate concentrationsof at-at for the smokers, thus suggesting the possibility of twoforms of different phenotypes are Z/Z 10 percent, M/Z 50-60 per- Parkinson's disease one more refractory than the other cent, S/S 60 percent, M/S 80 percent,where the level of to the effects of nicotine. Anhypothesis involving known 212 mg/100 ml found in the M/M phenotype is taken at metabolic pathways of the biogenic amines is suggested 100 percent; thus the effect of these alleles on the arat for further study of the observed relationshipsbetween concentration is additive. Homozygosity for thePiZ allele smoking and Parkinson's disease. (Auth. Abs.) is strongly associated with chronic obstructivelung dis- ease and there is also an association ofchronic obstructive PiZ or PiS 71-0683. Konturek, S. J., Solomon, T. E.,McCreight, W. pulmonary disease and heterozygosity for the G, Johnson, L. R., Jacobson, E. D. Effects ofNicotine on or both, but to a lesser degree. (Auth. Abs.)

121 124 BEHAVIORAL AND EDUCATIONAL RESEARCH

The scores on SPC were compared in terms of different The biological correlates of the structural and graphic personal variables and attitudes towards smoking. A sig- characteristics of figure drawings by healthy young adults nificant positive correlation (.27) was found between were investigated. The existence of a number 3f correla- scores on SPC and frequency of smoking in a day. (Auth. tions has been indicated. The final significance of these Abs.) findings remains to be ascertained, in view of the hypoth- esis-seeking nature of the present study. Differences be- tween drawings by men and by women were the most outstanding. Minimal differences were fours between 71-0706. Thomas, C. B., Jones, L. W., Ross, D. C. Studies drawings by smokers and nonsmokers. Meastareawnts of on Figure Drawings: Biological Implications of Structural height and body proportion of figure drawings showed and Graphic Characteristics. PsychiatricQuarterly little or no correlation with the physiological and metab- 42(Supplement):223-251, 1968. olic characteristics of the subjects. (Auth. Abs.)

BILLS AND LEGISLATION

71-070. U. S. Senate and House of Representatives, 91st respect to cigarette smoking and for other purposes as Congress. Public Law 91-222. Public Health Cigarette enacted by the Senate and House of Representatives of Smoking Act of 1969. U. S. Senate and House of Rep- the United States is presented as Public Law 91-222 resentatives, 91st Congress, H. R. 6543, April 1, 1970. passed on April 1, 1970 and to be cited as the "Public The Act to extend public health protection with Health Cigarette Smoking Act of 1969".

SMOKING CESSATION METHODS

71-0708. Rosenberg, A. Viewpoints on Smoking With- positive effect of the treatment: the elimination of CO drawal. Viewpoints on Smoking Withdrawal poisoning in the patient. Copenhagen Experiences. Complete English translation of "Synpunkter paRokavvanjning. Synpunkter pa RokavvanjningErfarenheter fran Kopenhamn",Social - 71-0709. Wilhelmsen, L. Viewpoints on Smoking With- Medicinsk Tidskrifts 2(Special No.):108 -110, February drawal. Smoking Withdrawal Clinic Activity in Gote- 1971. borg. Complete English translation of "Synpunkter pa Rokavvanjning. Rokavvanjningsverksamhet i Goteborg", A method for breaking the smoking habit is described SocialMedicinskTidskrifts2(Special No.):116-119, in which the psychological and psychic elements of the February 1971. tobacco habit are treated. The method is based on a breakdown of these elements into perception-physiologi- A description of the methods used and the results cal effects (the busy element in smoking or tobacco from experiences in two smoking withdrawal clinics in manipulation) and the pharmacodynamic effects. Treat- Goteborg, Sweden, are presented. The first experience in- ment consists of conversation therapy, autosuggestive ex- volved 291 men and 200 women, of whom 406 com- ercises in breathing and relaxation, and the use of psycho- pleted the treatment. A total of 261 had stopped smoking sedatives during the first part of the treatment. The exer- completely after the cure. The method consisted of 'daily cises are continued during as much as 12 months. The contacts with the clinic, 20-minute discussions with a importance' of determining the carboxyhemoglobin con- physician, and drug therapy for a two-week period. Re- tent of the patient's blood before and during treatment is sults indicate that men stopped smoking more easily than emphasized in order to be used as an indication of the women, and that those with a longer smoking history

19Q 126 SMOKING CESSATION METHODS

were more successful than those whosmoked for less than the patients had stopped smoking. it appears that serious 10 years and who were younger. Various jobconditions illness involves a substantially stronger motivation for and smoking exposure in the environment werealso ana- stopping than do milder illnesses. Generally, the results lyzed. The second experience involvedheartinfarct indicate that 50 percent of those who now smoke can patients born in 1913 or later cared for at aspecial heart stop relatively easily provided that they are sufficiently infarct center. The method consisted simplyof advising motivated. It is thought therefore that more sophisticated the patient when he left the hospital ofthe risks involved. methods are not necessary; information of harmful effects A pamphlet on the effects of smokingand health and and a method of stopping are often sufficient. However, which explained how to proceed in breaking thehabit was other methods must be developed for those who are more also given to each patient. After one year,50 percent of difficult to motivate and thus have more trouble stopping.

See also, 71-0704

GENERAL

71 -0710.Butters, D. Measurement of Paper Poros- 71-0713. Little, C. C. Report of the Scientific Director, ity.Beitrage zur Tabakforschung 5(61:307-311, Decem- 1969-1970. New York, The Council for Tobacco Re- ber 1970. search, 1970, 85 pp. Following a review of some of the special require- This report reviews current research activities spon- ments of the cigarette industry in regard to the measure- sored by the Council for Tobacco Research, including ment of paper porosity and some of the existingmethods studies on viruses and cancer, and the immunological for its measurement, a standard definition of air perme- system; progress on the development ofsmoking ma- ability of a sheet of paper is proposed and an air per- chines; a study on animal skin exposure to a concentrated meability instrument designed to use this definition is smoke stream; and experiments on chronic inhalation of described. smoke and polluted air. Cardiovascular research includes effortsto develop a method for measuring coronary artery blood flow; various studies on the roleof smoking, 71-0711. Egsmose, T., Stokholm, J., Egsmose, R. Danske especially nicotine, in the arteriosclerotic process; and a Laegen Holdning dl Bekaempelse of Tobaksproblemet. study to determine predictors of early heart disease.Re- [The Attitude of Danish Doctors Toward a Tobacco search in the area of chronic respiratory diseases includes Smoking Control Program.]Ugeskrift for Laeger investigations on metaplasia in nonsmokers, the relation 133(21):1041-1046, May 28, 1971, Danish. of antitrypsin deficiency to emphysema, and theeffects of cigarette smoke on animal lung function. In the areaof A random - sample questionnaire survey was madeof neuropharmacology and psychology, studies are con- 977 Danish doctors (13.2 percent of the nation's total) cerned with the effects of nicotine and/or smoking onthe during November-December 1970 to determine their atti- central nervous system and personality differencesbe- tudes toward a tobacco smoking control program. The tween smokers and nonsmokers. Also included areab- responses showed that 24 percent believe that public stracts of 93 reports on new experimental researchthat smoking habits would be influenced if doctors stopped have been published since the last report, and a list of smoking. Of the doctors with children, 80 percent had active and complete research projects supported by The encouraged their children not to smoke. Eighty percent Council. think that the government should urge antismoking action through information and campaigns in public schools, institutions of higher education, and in mass media. 71-0714. Medical Journal of Australia. Smoking and Seventy-one percent feel that a fraction of the tobacco Health Now. Medical Journal of Australia 1(3):109-110, revenues (0.5 to 1 percent) should be used for informa- January 16,1971. tion and antismoking campaigns. Twice as many support (58 percent) as oppose (28 percent) a total ban on all The Royal College of Physicians of London's report, tobacco advertising. "Smoking and Health Now", is reviewed followed by a few comments on selected aspects of the report, including the value of statistical evidence, the problem of the "safe cigarette" and imprecise mortality estimates in relation to 71 -0712,. Jones,J.B. The Smoking Disease.(Let- ter).British Medical Journal 1(5742):228, January 23, smoking. 1971. A study of cigarette smoking in 775 newlydelivered 71-0715. Nichols, P.J.R., Howell, B. Routine Pie- and mothers in relation to breast feeding showed a 35 percent Post-Operative Physiotherapy. Results of a Trial. Rheu- incidence among all the cases, 24 percent among smokers matology and Physical Medicine 10(7):321 -336, August and 19 percent among heavy smokers. 1970.

130 127 GENERAL

A trial to assess the value of routine pre- and post- Lions was more likely in patients who smoked. The signifi- operative physiotherapy is described. Patients with respi- Lance of the findings is discussed. (Auth. Abs.) ratory dysfunction and persistent bronchitis were ex- cluded from the trial. Of the 193 patients studied, 109 underwent orthopaedic operations involving the limbs, 32 71-0716. Papavassiliou, Pipetakis, G., Marcelou-Kinti, had operations involving upper abdominal incisions, and U. Mycological Flora of Cigarettes. Mycopathologia et 52 had operations involving lower abdominal incisions. Mycologia Applicata 44(2):117-120, May 3, 1971. The patients were distributed into groups; two groups re- ceived routine physiotherapy and two groups did not One hundred strains of fungi were isolated from 48 receive physiotherapy. Two further subdivisions were packets of Greek cigarettes. They were: Aspergillus (28 made, those having daily spirometry tests and those not strains), Penicillium (22), Mucor (18), Alternaria (14), having spirometry tests. Routine daily physiotherapy had Oadosporium (1), Streptomyces (4), Candida (11) and no effect on the incidence of post-operative complica- Geotrichum (2). From 55 packets of cigarettes manu- tions, nor on the incidence of post-operative reduction in factured outside of Greece another 100 strains of fungi pulmonary ventilation. A reductionin post-operative were isolated and identified as Aspergillus (35), Peni- pulmonary ventilation was almost invariable among those cillium (23), Mucor (10), Alternaria (13), Cladosporium patients undergoing upper abdominal surgery, very (5), Streptomyces (4), Candida (3), Geotrichum (1), common among those having lower abdominal incisions, Cephalosporium (2) and Scopulariopsis (4). Results of the and very rare following orthopaedic operations. The well - present study are discussed in relation to the mycological known correlation between smoking and bronchitis was flora of the air in Athens and to the coli-aerogenes bac- confirmed, and a tendency to post-operative complica- teria of cigarettes. (Auth. Abs.)

See also. 71-0580

131 128 CHEMISTRY. PHARMACOLOGY AND TOXICOLOGY

71-0717. Bernhard, P. The Effect of Smoking an Women tissue are examined. A substantial fraction of the extra- and Mothers. Complete English translation of "Die Wirk- vascular CO stores are located in muscle but it cannot be ung des Rauchens auf Frau and Mutter," Munchner Medi- precisely determined due to uncertainties in total body zinische Wochenschrift 104(39 ): 18264 831, 1962. myoglobin in experimental animals and variation in myo- globin concentration and carboxymyoglobin percent satu- The effects of smoking in 659 female smokers with ration in different muscles. The finding of carboxymyo- various medical conditions are compared to those in globinIcarboxyhemoglobin of nearly 3 percent in myo- 5,000 nonsmoking women with the same pathological cardium at ambient arterial oxygen tensions suggests that conditions. The general pathological effects of tobacco as much as 30 percent of cardiac myoglobin may be sat- smoking in both sexes, such as pulmonary cancer, coro- urated with CO in heavy cigarette smokers who may carry nasy sclerosis, and Buerger's disease are reviewed. The carboxyhemoglobin levels of 10-percent saturation. The effect of tobacco poisons on the female sex organs, the shift of CO into myocardium that occurs with arterial hormone glands, and fertilityis also discussed. Results hypoxemia and also with shock may be a factor in CO indicated pituitary disturbances in 36.2 percent of 659 toxicity to the myocardium and may be of particular smokers and in 5.8 percent of nonsmokers. Cigarette importance in patients with coronary disease. The finding smoking was particularly harmful during puberty, because that the partition of CO between blood and extravascular it caused malfunction of the hormonal glands. Develop. tissue over a wide range of arterial oxygen pressure is mental disturbances were found in 9.5 percent of smokers constant indicates that blood carboxyhemoglobin/car- and 4.5 percent of nonsmokers, which clearly indicates boxyhemoglobin is no longer proportional to the body damage to growth and development in puberty. Early stores under these conditions and thus is not a good index menopause and early aging were also significantly greater of tissue CO binding. Ex travascular CO stores in the tissue in smoking than in nonsmoking women. Occurrence of of other organs, particularly the liver, are briefly ex- miscarriage and sterility was again significantly more fre- amined. Processes that influence the body CO stores arc quent in smoking than in nonsmoking women. The spe- discussed, in particular, the relationship of production cific medical bases for nicotine-caused infertility include and excretion, and blood carboxyhemoglobin to endo- (1) hormonal infertility due to glandular malfunction; (2) genous CO production; CO metabolism; rates of endo- vascular cramps in the area of the sexual organs, especiaUy genous CO production at increased levels of carboxy- the ovarian ducts; (3) lack of sexual sensitivity and men- hemoglobin; and a comparison of the rate of CO produc- tal-spiritual disturbances at intercourse; (4) qualitative tion and blood carboxyhemoglobin. deterioration of the ovaries; (5) damage to the ovarian ducts; (6) damage to the uterine mucosa as receiver of the . ovaries; and (7) damage tothe placenta. Some federal 71-0720. Das, P. K., Rathor, R. S., Sinha, P. S., Sanyal. A. communal hygienic demands to combat tobacco smoking K. Effect on Ciliary Movements of Some Agents Which are included. Come in Contact With the Respiratory Tract. Indian Journal of Physiology and Pharmacology 14(4):297-303, October 1970. 71-0718. Bilimoria, M. H.. Nisbet, M. A. The Effect of Acrolein on LAspuaginase 2 from Escherichia Coli.Pro- The effect of a number of agents which are either ceedings of the Society for Experimental Biology and inhaled or excreted through the respiratory tract or are Medicine 136(3):698 -700, March 1971. used for the treatment of inflammatory conditions of the respiratory tract was studied on ciliated epithelium of Inhibition studies, carried out using a partially purified frog's esophagus. AU the agents studied were dissolved in Lasparaginase 2 preparation, have indicated that tobacco normal Ringer solution. The ciliary motility was found to smoke and a number of reactive smoke components do be stimulated by very weak solution of ethanol (0.02 per- not cause inhibition. Of the smoke components studied, cent), ether, paraldehyde, oil of peppermint. menthol only acrolein was inhibitory and this inhibition was found guaiacol, creosote, oxygen, carbon dioxide and cigarette to be more marked at pH 8.4 than at pH 5.0. The -SH smoke. Relatively higher concentrations of ethanol (0.1 specific reagents, sodium arsenite and p-hydroxymercuri- to 1.0 percent), chloroform, thymol. petrol gas. potas- benzoate did not inhibit the enzyme. (Auth. Abs.) sium iodide and potassium bromide were found to depress ciliary motility. The stimulant actions did not appear to be mediated by neuro-humoral mechanisms. The action of 71-0719. Coburn, R. F. The Carbon Monoxide Body carbon dioxide was not due to any change in hydrogen Stores.Annals of the New York Academy of Sciences ion concentration, and the effect of cigarette smoke was 174(Art. 1):11-22, October 5. 1970. possibly not due to the presence of nicotine. Of the three anions, (chloride, bromide and iodide). the iodide ion was Computations of the partial pressure of carbon mon- the most depressant. (Auth. Abs. Mod.) oxide (CO) in various tissues, factors influencing CO bind- ing in tissues at a given tissue CO tension, and the effects of increasing the body CO stores on the distribution of 71-0721. Forbes. W. H. Carbon Monoxide Uptake Via the CO between blood and muscles or other extravascular Lungs. Annals of the New York Academy of Sciences

129

is 132 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

174(Art. 1):72-75, October 5, 1970. tation of tobacco on the catecholamine granules of the cells of the medullar part of the suprarenals in rabbits was The balance between the taking up and the giving off investigated. Results showed that on the 5th day of the of carbon monoxide (CO) in the lungs is reviewed and a effect, the catecholamine positive granules were markedly numerical example of a common type of CO exposure is decreased, while after the 10th day, total degranulation described. The details of the movement of atmospheric took place. The catecholamine degranulation was due CO on its way to combine with hemoglobin are discussed either to the increased secretion of catecholamines princi- and probable reasons for the rather large differences in pally under the effect of nicotine or to the dystrophic and carboxyhemoglobin between individuals are suggested. metabolic changes of the suprarenal medullar part under The elimination of CO from the blood and resuscitation the effect of other toxic substances. of persons with carbon monoxide poisoning are men- tioned. 71.0725. lvanov, N. G., Mokhachev, I. G., Astalchova, L. G. Volatile Fatty Acids in Tobacco. Complete English 71-0722. Gothert, M., Lutz, F., Malorny, G. Carbon Mon- translation of "Letlivi Mastni Kiselini v Tyulyuna."Bul- oxide Partial Pressure in Tissue of Different Animals. En- garrki Tyutyun 14(4):60-62, 1969. vironmental Research 3(4):303-309, 1970. Gas chromatography was used to determine the quali- A pneumoperitoneum of nitrogen was set to rabbits, tative structure and quantity of volatile acids in fer- guinea pigs, and rats, and the CO partial pressure was mented Bulgarian tobacco of the following types: Asenov- measured in this tissue model of the animals, breathing grad Ill class, Momchilgrad Ill and V classes, and Ostrolist 86, 300, 700, and 1000 ppm CO. After diffusion equilib- 450. The following acids were identified: formic, acetic, rium had been reached, the following results were ob- propionic, isobutyric, acrylic, normal butyric, isovaleric, served: (1) the CO partial pressure in tissue is only 42-69 isocaproic, beta-methylvaleric, normal caproic and two percent of the CO partial pressure in the inspired air; (2) unidentified. Acetic acid was found in the largest quanti- the percentage CO partial pressure in tissue compared ties. Its quantity decreases in relation to other acids as the with the CO partial pressure in the inspired air is lower, quality of the tobacco, in particular the smoking quality, the higher the CO content of the inspired air; (3) the CO increases. Formic acid follows a similar pattern. In terms partial pressure in tissue of a tpecies of animal is lower, of total quantity of volatile acids, acetic and formic acids the higher the CO affinity of hemoglobin. The results can comprised 33.3 percent in the Momchilgrad Ill class, 41.6 be explained by the competition of CO and 02 for the percent in the Momchilgrad V class, 51 percent in the receptor hemoglobin. The CO partial pressure in tissue is Asenovgrad Ill class, and 70.3 percent in Ostrolist 450. influenced decisively by the different CO and 02 affini- The C3-C2 acids, and particularly beta-methylvaleric acid, ties of hemoglobin. (Auth. Abs. Mod.) appear to be related to the aromatic qualities of tobacco.

71-0723. Hess, H. A Contribution to the Problem of "Pas- 71-0726. lzard, C., Moree-Testa, P. Activite Mitoclasique sive Smoking." Complete English translation of "Zum et Aberrations Chromosomiques Induites par l'Alpha et le Problem des 'Passiv-Rauchens'," Munchner Medizinische BetaNaphtonitrile, Identifies. Dana une Fraction de Goud- Wochenschrift 113(18):705-706, April 30, 1971. fon de Fumee de Cigarette. [Mitoclastic Activity and Chromosomal Aberrations Induced by Alpha and Beta A rebuttal by H. Hess to H.-P. Harke's criticisms of his Nsphthonitrile Identified in a Cigarette Smoke Tar Frac- paper on passive smoking is presented. Harke's main criti- tion.]Comptes Rendues Hebdomadaires des Seances de cism concerned Hess's estimation that a nonsmoking l'Academie des Sciences; D: Sciences Naturelles Tess working in a-heavy smoke-infested restaurant inhales 272(20):2581-2583, May 17, 1971, French. in one hour an amount of nicotine equivalent to that obtained by smoking one cigarette. The measuring values Alpha and beta-naphthoniuile have been identified in on which these calculations were based are discussed and the 11 fraction of cigarette smoke. They are in part re- it is shown that even if these values are substituted by sponsible for its mitoclastic activity. From this point of those used by Harke, the results are still equivalent to the view, the beta derivative is the less active. Otherwise, both nicotine volume of one cigarette per hour. Hess also ar- nitrites have an equal activity at the G2 and prophase gues that in Harke's study, the unventilated room test was levels. stopped at a point when passive smoking had just reached its peak and the passive smokers could only have inhaled a small amount of nicotine by that time. In Harke's venti- 71 -0727. Jacotot, B., Rambaud, J., Denis, 3.-C., Cahn, J., lated room test, passive smokers excreted almost 50 per- Buxtorf, Patois, E., Beaumont, J.-L. Prevention par cent more nicotine than in the unventilated room test, a IaN-Acetyl-hydroxyproline de Certain Effets Aigus et descrepancy that was ignored. Hess also views some of his Chroniques de la Nicotine. [Prevention of Certain Acute own results as evidence of vascular damage due to passive and Chronic Effects of Nicotine With N-Acetyl-hydroxy- smoking. proline.]Pathologic Biologie19(9/10):497-502, May 1971, French.

71-0724. lvancev, V., Dragiev, M. Experimental Investiga- N-acetyl-hydroxyproline has been shown to reduce or tions on the Microclimate of Tobacco Fermentation inhibit certain cardiovascular or convulsive effects of nico- Chambers. IV. Histochemical Changes in the Catechola- tine in animals and man. This protective effect was noted mines of the Medullar Part of the Suprarena:4 in Rab- particularly on the Immediate effects of injection of nico- bits. Folio Medico (Plovdiv) 11(6):388- 392,1969. tine in animals, e.g., convulsions in the rabbit and mouse, The effect of toxic substances formed during fermen- electrocorticographic changes in the rabbit, and .the int- 133 130 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

shown that cigarette smoking contributes to the onset and proper size precipitator will remove a major percentage of progression of cardiovascular disease, especially to death submicronic-size particulate matter, thus freeing the air of from coronary heart disease. Smoking has also been re- tobacco smoke as well. The precipitator, however, has lated to peripheral vascular conditions, blood changes, little effect on the gaseous phase of the air. Theoretically chronic obstructive pulmonary disease, lung cancer, oral and from a public health viewpoint, widespread use of cancer, laryngeal cancer, urinary tract cancer, and pan- electrostatic precipitators would in some degree diminish creatic cancer. Tobacco smoking during pregnancy leads outdoor air pollution. to increased prematurity and decreased birth weight. Smoking contributes to peridontal disease and gingivitis, alveolar bone loss, stomatitis nicotina and may be associ- 71-0739. U.S. Department of Health, Education, and ated with delayed socket healing and edentulism. The Welfare, Public Health Service, National Clearinghouse for senses of smell, taste, hearing and sight are also affected Smoking andHealth. Bibliography on Smoking and by smoking. The synergism between air pollutants and Health-1970. U.S. Department of Health, Education, smoking does not involve two separate etiological group- and Welfare, Public Health Service, Health Services and ings but variations in concentration and mode of delivery Mental Health Administration, National Clearinghouse for of respiratory irritants to the lung. Some of the synergists Smoking and Health, Rockville, Maryland, Public Health of tobacco smoke briefly discussed include beryllium, Service Publication No. 1124, Public Health Service Bibli- molybdenum, vanadium, arsenic, asbestos, sulfur dioxide ography Series No. 45, April 1971, 351 pp. and gasoline combustion products, particularly carbon monoxide, lead and nitrogen dioxide. This bibliography contains over 1300 items which are categorized into the following aspects of smoking and health:1) chemistry, pharmacology and toxicology; 2) 71-0738. Swartz, H. Tobacco Smoke: A Noxious Air mortality and morbidity; 3) neoplastic diseases; 4) non- Pollutant. A Review (and Comment). Part II of II. Re- neoplastic respiratory diseases; 5) cardiovascular diseases; view of Allergy 25(5):490-505, May 1971. 6) other diseases and conditions; 7) behavioral and educa- tional research; 8) tobacco economics; 9) smoking cessa- The combustion products of tobacco are a melange of tion methods; 10) bills and legislation; 11) general. An particulate and gaseous substances derived from tobacco author and organizational index, which includes titles, itself, its additives, preservatives and pesticides. The par- and a subject index are appended. ticulate phase isa multifaceted mixture of alkaloids, bases, acids, phenols, alcohols, ketones, hydrocarbons, complex neutral tars and pyridine. The gaseous phase con- sists of nitrogen dioxide, carbon monoxide, hydrogen sul- 71-0740. Yamamoto, I., lnoki, R., Kojima, S., Tamari, Y. fide, hydrocyanic acid, arsenic as triphenyl arsene and Action of Tramine on the Salivary Amylase Secretion other compounds. The particle size in tobacco smoke is From Rabbit Parotid Gland in Reference to That of Nico- important since the efficiency of lung clearance of partic- tine. Japanese Journal of Pharmacology 21(1):13-22, ulate matter is in part determined by particle size. Various February 1971. effects of tobacco combustion products on the broncho- pulmonary apparatus and the carcinogenicity and toxicity The present experiment was mainly carried out to of various smoke constituents are discussed. One etiologic clarify difference in mechanism of actions between nico- aspect of tobacco smoke which has been little investigated tine and tyramine on amylase and protein secretion in- is its allergenicity, an aspect which when better delineated duced by auriculotemporal nerve stimulation in rabbit may lead to a better understanding of the relationship parotid glands. The increases in amylase secretion pro- between smoking and health. The synergism between vari- duced by tyramine and nicotine were inhibited by pro- ous other-source air pollutants and tobacco smoke have pranolol, but not by phenoxybenzamine. Bretylium did been shown to lead to more certain deterioration of not inhibit the actions of either tyramine or nicotine. health in general. And although most studies have dealt Sympathetic denervation predominantlyinhibited the with the smokers themselves, there is evidence that the action of tyramine, but not that of nicotine. In reser- nonsmoker in smoke-contaminated air may become its pinized rabbits, the increasing action of nicotine was not victim. Tobacco smoke, although largely an indoor air suppressed, but that of tyramine was. Adrenalectomy pollutant, plays a role in the overall pollution of the out- showed a complete inhibition of the nicotine action, but door air. The ideal method to control air pollutants is to the action of tyramine still remained. From these results, eliminate their caw.: but in the case of smoking this is a the effect of tyramine on amylase secretion is due to practical impossibility. For the home, the office and other catecholamine released from the store of sympathetic relatively small indoor areas, the two-stage portable elec- nerve terminal, while that of nicotine is due to catechola- trostatic precipitator is the air cleaner of choice. The mine released from adrenal glands. (Auth. Abs.)

See also. 71-0755, 71-0768

136 133 CARDIOVASCULAR DISEASES

from the tobacco smoke, the pathogenesis being increased be achieved, vulnerable persons will have to be detected endothelial filtration and permeability. (Auth. Abs.) and placed under continued surveillance and prophylactic management. The background of the potential coronary candidate has been delineated and a profile capable of 71-0776. Brown, J., Bourke, G. J., Gearty, G. F., estimating risk over a wide range devised. One of the most Finnegan, A., Hill, M., Heffernan-Fox, F. C., Fitzgerald, potent contributors to this profile is the scrum lipid value. D. E., Kennedy, J., Childers, R. W., Jessop, W.J.E., Although any lipid or lipoprotein can be used, none is Trulson, M. F., Latham, M. C., Cronin, S., McCann, M. B., more convenient than or superior to a simple total Clancy, R. E., Gore, J., Stoudt, H. W., Hegsted, D. M., cholesterol determination. For determining the nature of Stare, F. J. Nutritional and Epidemiologic Factors Re- the lipid disorder and choosing the most appropriate lated to Heart Disease.World Review of Nutrition and therapy, alipidprofileismost useful. Therapyis Dietetics it 1-42, 1970. definitely indicated in moderate hypercholesterolemias (in the range of 250 to 350 mg per 100 ml), particularly There 13 a higher mortality rate from arteriosclerotic when associated with other abnormalities such as hyper- heart discase in Massachusetts than in Ireland. A compara- tension, electrocardiographic evidence of left ventricular tive epidemiological study of possibly related factors was hypertrophy, or diabetes. Even though asymptomatic, made using 1994 middle-aged men, including over 500 such persons are extremely vulnerable to lethal coronary pairs of brothers, one of whom lives in Ireland and the attacks. These findings must not be regarded as medical other in. Boston. The intake of calories, complex carbo- trivia. If the physician accepts the challenge to seek out hydrates, magnesium and fluoride (from tea) was higher and cope with coronary precursors, the clinical patholo- in Ireland. The proportion of calories derived from fat gistwill be called on increasinglyto perform lipid assessments in asymptomatic persons and to provide andsaturated fat, the serum cholesterol,the blood pressure levels and the amount of cigarette smoking did expert consultative assistance in interpreting the lipid not differ markedly. The weight, skinfold thickness and findings. (Auth. Abs.) number of abnormal electrocardiograms were higher in the Boston subjects. A study of the pathology of coronaries and aortas from autopsies revealed much 71-0779. Keys, A., Taylor, H. L., Blackburn, H., Brozek, earlier serious atheromatous involvement in the Boston J., Anderson, J. T., Simonson, F. Mortality and Coronary than in the Irish specimens. Increased physical activity Heart Disease Among Men Studied for 23 years. Ar- appears to be important in reducing the risk of coronary chives of Internal Medicine128(2):201-214, August heart disease in Ireland. (Auth. Abs.) 1971. Twenty-year coronary heart disease (CHD) incidence 71-0777. Estandia Cano, A., Esquivel Avila,J., Maio is analyzed for 279 men, CHD-free at the ages of 47 Camacho, R., Ferez Santander, S., Leon Montanez, E. through 57 years and characterized by three examinations Inrarto. Juvenil del Miocardio. (Myocardial Infarction in before 20 annual follow-up examinations. Sixty men the Younger Age Groups.]Archivos del Institute de developed CHD, 42 dying or suffering infarction. Among Cardiologia de Mexico 41(2 ): 137-150, March-April 1971, 20 entrycharacteristics,three had major predictive Spanish. power, especiallyfor CHD death or infarction: cold pressor test, a high level of serum cholesterol and systolic Sixteen years of clinical material were reviewed in blood pressure. Smoking and relative weight seemed ordertodetermineif theincidence of myocardial unimportant. Major CHD incidence was proportional to infarction in subjects under 40 years of age has increased. cholesteroltothe3.4 power. Five-variable multiple Although this fact was confirmed from the data, the logistic analysis permitted placement of men into deciles increase is not significant because it parallels the incidence of estimated risk differing more than tenfold in CHI) of myocardial infarction for all ages, and in general, of incidence. The combination of only cholesterol and arterioslerosis cardiopathy. Results are presented from a systolic pressure was nearly as good. The multiple logistic study of a group of 84 cases of myocardial infarction in coefficients applied to five-year data on 1,287 men among subjects 39 years of age or under. Clinical aspects of this whom 182 CHD developed in 182 yielded satisfactory group which could indicate predisposing factors to myo- agreement between observed and predicted distributions cardial infarction in young people as compared to those in of CHD cases in classes of estimated risk. (Auth. Abs.) older people were investigated. The significant factors found were: minimal physical activity, intense or moder- ate intellectual activity, major emotional tension, and 71-0780. Knappc, J., Erbstosser, H., Strube, G., Knappe, heavy smoking habit. Incidence in males predominated. G., Duck, K.-D. Gezielte Prevention bei der Ischamischen Family history was significant regarding diabetes mellitus Herzlczanldteit in Rahman ether experimentellen epidenti- and arteriosclerosis cardiopathy; in these cases precordial ologischen Studie. (Ditected Prevention of Ischemic Heart pain in the acute stage of longer duration and greater Disease in the Framework of an Experimental Epidemi- severityis more frequent. Cardiogenic 'shock' was also ologicalStudy.]DeutscheGesundheitswesen more common in young persons. However, there were no 26(15):678-681, April 8, 1971, German. observed differences in mortality. Within an experimental epidemiological longitudinal study,thepossibilitiesof a directed prevention of 71-0778. Kennel, W. B., Garcia, M. J., McNamara, P. M., ischemic heart disease by exerting a direct and an indirect Pearson, G. Serum Lipid Precursors of Coronary Heart influence upon its so-called risk factors are examined. An Disease. Human Pathology 2(1):129-151, March 1971. epidemiological cardiac-circulatory examination applying the examination methods recommended by the World If a substantial reduction in coronary mortality is to Health Organization is first carried out. The selection of

141 144 CARDIOVASCULAR DISEASES subjects suffering from ischemic heart disease, as well as nervous-psychic stress also further the development of of the control group, and the detection of the presence of atherosclerosis and ischemic heart disease, but these the so-calledriskfactors within this group, including factors require further study. Continued observation of statistical checks for significant correlations are carried the application of a hypercholesteremic diet and hypo- out by means of a storage-programmed digital calculator. tensive preparations appear to prevent the development of Among the several risk factors studied are genetic factors, these diseases, especially when application is begun when elevated serum lipids, obesity, heavy smoking habits, and the individuals are in the younger years. Prophylaxis of pathological drop in glucose tolerance. Subjects manifest- arterial hypertension requires treatment of diseases of the ingclinical and, above all,subclinical symptoms of kidneys and urinary system. The solution to problems of ischemic heart disease as well as patients endangered by prophylaxis of hypertensive diseases and ischemic heart cardiac infarction are subjected to an individual program disease lies in modifications in living conditions, partic- of health education and therapy corresponding to the risk ularlytowards a rationalnutrition with lowering of factors detected. This program is mainly based on dietetic general caloric intake and of animal fats,.a light intake of guidance, a circulation-promoting physical training, and carbohydrates and possibly salt, a rational combination of psychotherapeutic measures during a four- to six-week mental work with physical activity, and a renunciation of hospital treatment in a ward specializing in preventive and smoking. rehabilitative cardiology. 71-0783. Shappell, S. D., Murray, J. A., Nasser, M. G., 71-0781. Prior, I.A.M., Evans, J. G. Current Develop- Wills, R. E., Torrance, J. D., Lenfant, C.J.M. Acute ments in the Pacific. In: Jones, R. J. (Editor).Athero- Change in Hemoglobin Affinity for Oxygen During sclerosis: Proceedings of the Second International Sym- Angina Pectoris.New England Journal of Medicine posium.Chicago, November 2-5,1969. New York, 282(22):1219-1224, May 28, 1970. Springer-Verlag, 1970, pp. 335-342. The hypothesis that a decrease in hemoglobin affinity Highlights of various studies being conducted through- for oxygenisa compensory mechanism to increase out the Pacific dealing with coronary heart disease risk oxygen delivery to ischemic myocardium was tested in six factors, such as weight, blood pressure, cholesterol and patients with angina pectoris. Blood was drawn simul- smoking, and their distribution among the scattered taneously from radial artery and coronary sinus. Oxygen populations are presented. tension at 50 percent saturation (Pso) and erythrocytic 2,3-diphosphoglycerate, adenosine triphosphate and pH measured before, during and after angina pectoris pro- 71-0782. Ryvkin,1.A. Faktory Risks i Pervichnaya duced by atrial pacing showed no significant difference at ProfilalctilcaArteriarnoy GipertonliiIschemicheslcoy rest. The longer the duration of anginapectoris, the more Bolezni Seidtsa. [Risk Factors and Primary Prevention of coronary-sinus Pso exceeded arterial Pso. After four to Arterial Hypertension and Ischemic Heart Disease.]Kar- 10 minutes of angina, the difference was 0.6 to 2.9 mm of diologlia11(1):140 -151, January 1971, Russian. mercury. One patient, in whom ST-segment depression and lactate production but no angina pectoris developed, Factors promoting the development of arteriosclerosis had no change in hemoglobinaffinityfor oxygen. and ischemic heart disease appear to be the disruption of Decreased hemoglobin affinity for oxygen was notac- lipid and carbohydrate metabolism, arterial hypertension companied by change in erythrocytic. 2,3-diphospho- and smoking.Inrecent years the importance of a glycerate, adenosine triphosphate and pH. The rapid hereditarypredisposition and obesity has also been decrease in affinity enhances myocardial oxygen delivery established. Insufficient physical activity and systematic during angina pectoris. (Auth. Abs.)

See also,71-0760, 71-0787

OTHER DISEASES AND CONDITIONS

7141784. Ainley, R. G. The Farnsworth-Munsell 100 Hue cigarettes per day) and one whose tobacco consumption TestinTobacco Amblyopia.nansactions of the was negligible. The latter turned out to be a vegetarian OphthalmologicalSocieties of theUnited Kingdom with a vitamin B52 deficiency and so was predisposed to 90:765-772, 1970. amblyopia with a smaller tobacco consumption than usual.Allweresuccessfullytreated with hydroxo- The Farnsworth-Munsell 100 hue test was adminis- cobalamin and/or tobacco abstention.. A control group tered to 15 males, ages 45 to 83, with tobacco amblyopia. showed that familiarity with the test had no effect on All were pipe smokers except for a cigarette smoker (20 performance. In patients with tobacco amblyopia, the 145 142 OTHER DISEASES AND CONDITIONS

highestpartial error scores are concentrated inthe tissue for the daily calorie needs which is consistent with yellow-red and yellow region centered in hue 15, and in a simulated high rat/low carbohydratediet. A new the blue and purple-blue region between hues 54 and 68, formula for the basal metabolic rate is given. giving a bipolar shape to the color profile which persists during treatment. Apparently, in tobacco amblyopia color 71-0788. Kulayskiy, V. A. Kureniye i Beremenmose discrimination is the last visual function to recover and is of probably the first to be affected. The 100 hue test may (Obyor Literatury). [Smoking and Pregnancy (Review IGtnekologiia more easily detect tobacco amblyopia in its earlier stages theLiterature).]A kusherstvo than other tests and may provide valuable diagnostic 46(6):68.70, June 1970, Russian. evidencein patients whose central fields cannot be of plotted reliably. The literature survey lists the different effects maternal smoking on the fetus and neonateincluding prematurity and low birth weight, asphyxiationand J.H., Grant, A. K. perinatal mortality, neonatal complications, poorappetite 71-0785. Alp, M. H., Court, transplacental Personality Pattern and Emotional Stress in the Genesis of in pregnant women which can affect Gastric Ulcer. Gut 11(9):773-777, September 1970. exchange, effect of carbon monoxide on oxygen transport inthefetus, and theteratogenic effect of carbon In a group of 181 persons with a past history of monoxide. Currently there is much interest not onlyin the transplacental effects of nicotine but its presencein chronic gastric ulcer, a greatly increased incidence of smoke domestic and financialstress has been found, when the mother's milk. The negative effect of tobacco and tobacco dust on workers in the tobaccoindustry and compared with age- and sex-matched persons with no also under previous history of gastric ulcer. The consumption of on the reproductive cycle of women are aspirin,alcohol and cigarettes was also significantly investigation. increased. Persons with chronic gastric ulcer were charac- terized by a personality pattern of independence and self-sufficiency, and they are prone to anxiety and 71-0789. Luthra, U. K., Woods, D. A., Wahi, P. N., Gupta, depression. This pattern was three times more common in M. Ultrastructure of Human Oral Mucosa After Prolonged the ulcer group than in matched individuals without Expoenue to Tobacco. Indian Journal of MedicalRe- chronic gastric ulcer. It is possible that internal conflict search 59(1):157-162, January 1, 1971. between a genetic and an environmentally induced sex role, together with an inability to externalize aggression, Detailed light and ultrastructure studies of human oral may be significant factors in the causation of chronic mucosa after prolonged exposure totobacco are des- gastric ulcer. (Auth. Abs.) cribed. Distinctive ballooned cells in the epithelium were an important feature. These are describedin detail. A most noticeable feature in tobacco treated mucosa was at the 71-0786. Chisholm, I. A., Pettigrew, A. R.Biochemical the development of a submicroscopic lesion epithelial-connective tissue junction. Structural similarity Observations in Toxic Optic Neuropathy. Transactions of the Ophthalmological Societies of the United Kingdom of this abnormality is discussed. (Auth. Abs.) 90:827-838, 1970. the complex metabolicinter- 71-0790. Menges, R. W., Selby, L. A., Marienfeld, C. J., 'Investigationsinto Epidemic of relationships between cyanide and vitamin B1 2 in tobacco Aue, W. A., Greer, D. L. A Tobacco Related amblyopia are discussed. Tobacco amblyopia and Leber's Congenital Limb Deformities in Swine.Environmental hereditary optic atrophy are shown to be diseases in Research 3(4):285.302,1970. which a defect in the cyanide detoxication mechanisms is present. Hydroxocobalamin therapy facilitates the ex- An epidemic of congenital limb deformitiesin swine is certion of thiocyanate by a mechanism which is not yet described. The epidemic occurred among 79Duroc sows clear but which may be sited in the kidney. Preliminary and gilts on a farm in Howard County,Missouri, during results in using oral cystine have also been encouraging. the period September 11, 1967, to March 3, 1968.The 79 females farrowed 782 pigs: 742 (95 percent) wereborn alive, 40 (5 percent) were born dead, and 59 (7.5percent) 71-0787. Dalderup, L. M., Van Heard, W. B., Zwartz, J. were born with congenitalabnormalities. The abnormal A., Keller, G.H.M., Drion, E. F., Schouten, F.J.M., Van pigs were farrowed by 14 sows. These sowsfarrowed 149 Dam, B. E. Serum Lipids and Energy Expenditure in OM pigs and 59 (40 percent) were abnormal. Tobaccostalks Men. Voeding 32(6):291-305, June 15, 1971. were placed in a swine lot and pasturebetween October 25, 1967, and December 7, 1967, and someof the sows Serum lipid patterns, diet and activity were studied in were observed eating the stalks.On December 7, 1967, a group of 61 aged men (mean age 81 years). The men four sows had an illness which lasted 2448hours. The were found to have, on an average, low serum lipid levels first 38 days of pregnancies in those sowswith the similar to those of young adults, and low blood pressures. affected progeny occurred during the time whenthe They had as much body fat as normal young women and tobacco was available to them. Other animals not exposed ate what others ate as far as quality was concerned, but to the tobacco stalks as a food sourcehad no birth ate much less in quantity than younger and active men. defects. The animals involved in the epidemic duringprior Physical activity and smoking did not affect serum lipid and later reproductive periods had no abnormalitiesin levels to such an extent as in younger age groups, their litters. The tobacco stalks, therefore, appeared to although smoking did affect the serum "large particle" have some association with the epidemic. Thetobacco fraction. The blood lipid pattern was influenced by a stalks were tested for nitratenitrogen, pesticides,fungi, negative calorie balance resulting in consumption of own nicotine, and maleic hydrazide. The nitratenitrogen

143 146 OTHER DISEASES AND CONDITIONS varied from 20 to 1390 pr, and no significant amounts The findings of a number of investigators are summar- of aldrin, dicldrin, or pp -DDT were found. The fungi ized in a table, showing the distribution of the PTC consistently isolated included a species of Penicillium (plasma thromboplastin component) nontasters in middle- identified as a variant of Penicillium cyclopium. Other European smokers and nonsmokers arranged by sex. No species of fungi were isolated only sporadically, and no concluskve results could be obtained from a comparison of Aspergilliwerefound.Nicotine. otheralkaloids or the chi s. Whether ethnic considerations might account components of the tobacco stalks, appeared to be the for the discrepancies in the results await further research. most likely cause of the epidemic. The tobacco stalks eaten by the swine contained 1058 ppm of nicotine and 115 ppm of malcic hydrazidc. The possible relationship of 71-0794. Toporkova, 1. B. Vitamin C Balance in Connec- this epidemic of birth defects in swine associated with the tion With Chronic Exposure of Tobacco Industrial ingestion of tobacco stalks to the increased fetal loss Workers to Tobacco Dust. Complete English translation described among smoking mothers is discussed. (Auth. of "Sostoyaniye C-Vitaminnogo Obmena v Svyazis Abs.) Khronichcskim Vozdcystiviyem Tabachnoy Pyli u Rab- ochikh Tabachnoy Prom yshlennosti", Leningradskil Sani- tarno-Gigiencheskii Med itsinskiiInstitut.Trudy 71-0791. Plackova, A., Medak, H.. Meyer, J., Waterhouse, 47:243.253, 1959. J. P. Ultrastrueture of Surface Cells of the Oral Mu- cosa. Folio Morphologica 19(2):165-170, 1971. This study deals with the effect of tobacco dust on the vitamin-C balancein tobacco industrial workers. The A method is described for the electron microscopic determination of the saturation of the organism with examination of smears taken fromoral lesions. The vitamin C in workers who were examined was carried out method is applied to the determination of whether the by the R. S. Harris's big doze test and I. I. Matusis's demonstrable ultrastructural detail can be used to advan- modification. The vitamin C content in persons connected tage to increase the diagnostic precision of exfoliative with the treatment of tobacco and in those of control cytology. Smears and incisions or excision biopsies of groups was investigated in their usual working conditions normal human buccal mucosa and of tobacco-associated as well as in a C-vitaminizing process. A person exposed to white lesions from the same region of the check were the effect of tobacco dust showed a significant vitamin C processed for electron microscopy. The subjects included deficiency. To control this effect and to increase the two heavy cigarette smokers and four tobacco chewers, all resistance of the organism to the toxic influence of the of whom had been using tobacco for a long period (from nicotine in the tobacco dust, a prophylactic C-vitamin- 20 to 50 years). izing process should be carried out by daily administra- tion of a 100-mg dose of vitamin C to each worker. 71-0792. Roy, F. H., Kelly, M. L. Chronic Maternal Cigaret Smoking and Infant Retrolental Fibroplasia: NegativeResults.Annals of Ophthalm ology 71-0795. Wilson, J., Matthews, D. Recent Research in 3(7):693 .694, July 1971. Some Optic Neuropathies. Transactions of the Ophthal- mological Societies of the United Kingdom 90:733 -737, Chronic maternal smoking may be a contributing 1970. factor in infant retrolental fibroplasia (RLF). The chronic and repeated fetal vasoconstriction of maternal smoking InLeber'sopticatrophy, both in smokers and combined with fetal carbon monoxide buildup produces nonsmokers, there is a substantial absolute increase in fetal anoxia. Retinal anoxia is thought to be a precipi- cyanocobalamin concentration in the plasma. Since this a tating factor in RLF. It is hypothesized that RLF in parameter of cyanide metabolism not directly dependent smoking mothers can be produced with no oxygen greater on thiocyanate levels, it must be considered as confirm- than is necessary in nonsmoking mothers. A retrospective atory evidence of a disturbance of cyanide metabolism. questionnaire study of 26 RLF patients of the Arkansas This abnormality is not invariably present in all cases, and School for the Blind did not statistically support this therefore is thought to be not a primary but a secondary hypothesis. Limitations of this current study and future metabolic derangement. In some patients with dom- studies are mentioned. (Auth. Abs.) inantly inherited optic atrophy, cyanocobalamin was present in very high concentrations. The difference in this respect between nonsmokers and smokers isas yet 71-0793. Schott, L. Vergleichswerte zur Frage der Beein- unexplained;itis noteworthy that most of the non- flussbukeit des PTC-Sduneckvermogens durch Tabak- smokers were children, whereas all the smokers were genus. (Comparative Values on the Question of the adults. This disease, which clinically resembles tobacco Influence of Tobacco Consumption on the Fit Taste amblyopia, may also reflect an inborn error of cyanide Capability.)Blologische Rundschau 7:261-263, 1969, metabolism. The possibilitythat Leber's diseaseis a German. maternally transmitted viral infection is discussed.

See also, 71-0735

147 144 GENERAL

71-0805. Igiene c Sanita Pubblica. Campagna di Ed- program was directed primarily to schoolchildren so that ucazione Sanitaria Contra 8 Fumo de Tabacco Nel the health hazards due to smoking could be explained to Comune di Bologna.[Educational Health Campaign the young before a habit was established. Health educa- Against Smoking in the Town of Bologna.)Igiene e tors participated in the health programs established in Sanita Pubblica 27(1-2):39-41, January-February 1971, each school. A series of lectures by university professors Italian. and doctors was also offered in which the scientific, medical, and psychological aspects of the smoking habit The antismoking campaign carried out by the Public were discussed. Health ServiceinBologna.Italy,is described. The

147 150' ' CHEMISTRY, PHARMACOLOGY ANDTOXICOLOGY

phenol was lower and that of p-substituted phenols was mice and Golden hamsters were investigated. In each of 20 experiments a minimum of six groups was used, each higher for Milo No. 3 (Burley) tobacco smoke. The major volatile phenols in smoke were phenol, 3 isomers of group consisting of four matched cultures: two controls. cigarette cresol, guaiacol, p-ethylphenol and 2,4-xylenol, which one exposed to whole charcoal-filtered (WCF) amounted to about 90 percent of the total volatile phenol smoke, and one exposed to the gas phase (GCF) of estimated. Concentration of volatile phenols in crude charcoal-filtered cigarette smoke. Each culture was ex- condensate of smoke was higher in that of Bright Yellow posed daily to 2.4 puffs of 8 ml, each of 2-second and Izumir A tobacco than native and Burley tobacco. duration, with an interval of 58 seconds between each puff. Results showed that after 4.6 days of exposure to (Auth. Abs. Mod.) WCF smoke, the number of outgrowing macrophages was markedly reduced, while after exposure to GCF smoke, 71-0823. Kaburaki,Y., Sugawara, S.,Kobashi, U., the number was essentiallythe same as incontrol Doihara,Y. Tabako no Kemuri Seibun ni Kansuru cultures. This reduction of cells following WCFsmoke did Kenkyu. XIV. Nikochin no Netsubunkai ni OkeruPin- rot involvethe epithelioidcells but was a selective jinuri no Seisei ni Tsuite. [Composition ofTobacco damage to alveolar macrophages. Sincethe gas phase Smoke. Part XIV. Formation of Pyridines in Pyrolysis of alone did not have this effect, it wasassumed that the Nicotine.]Nogyo Denka44(5):224 -231, May 1970, damage was due to particular matter in thecigarette Japanese. smoke. Although WCF smoke did notdirectly affect the number or morphology of the epithelioidcells, there was Nicotine and various pyridine homologues were pyro- a gradual alteration in theirgrowth behavior. Specifically. inhibition, an lyzed inthe nitrogen and air atmosphere using an thesecells displayed a loss of contact unpacked quartz tube as a reactor. All kinds of isomers of increaseinsize of cells,nuclei and nucleoli, and a lutidine and 2- and 4-picolines were identifjed in the tendency for sheet and criss-cross formation.A stimula- pyrolytic products of nicotine at 600.800 C besidcs tion of DNA synthesis of alveolar macrophagesdue to the 3-substituted pyridines and other products reported by GCF smoke was observed. These resultspoint to the earlier workers. Upon pyrolysis at 700-800 C, any kinds greater sensitivity of alveolar macrophages tofactors from of picolines yielded all kinds of picoline isomers,luti- charcoal-filtered cigarette smoke. They also showthat the dines, pyridine, quinoline, isoquinoline and 2,2 -dipyridyl. particulate matter of smoke has a biologicalactivity quite Ethylpyrci;dines and vinylpyridines, being interconverted at different from that of the gas phase. 700-800 C, yielded mainly the corresponding picolines and pyridine. The yield ratio of quinoline to isoquinoline tothe substituted position of the varied according Patrick,R.L.(Jr.), ethylpyridinesandvinylpyridinespyrolyzed.3- 71-0826.MacKenzie, W.F., Monteleone, P. N. (Jr.). Pathology in Animals Exposed to Acetylpyridien was produced from 3-ethylpyridine in air for Six atmgsphere at 700 C. 3-Cyanopyridine was pyrolyzed at HighConcentrations of Carbon Monoxide 800 C to yield low molecular weight compounds without Months. In: Proceedings of the 1st Annual Conference pyridine nucleus. It seems to suggest that no intermediate on Environmental Toxicology,9-11 September 1970. pyridine compounds are involved in the pyrolysis. From Aerospace Medical Research Laboratory, Wright-Patterson Air Force Base, Ohio, AMRL-TR-70 -102, December thesefindings,thethermaldegradation pathway of nicotine was proposed. It was concluded that the poten- 1970, pp. 23-29. tial source of pyridines including pyridines other than 3-substitution in tobacco smoke is nicotine in tobacco Rats, mice, baboons, rhesus monkeys, and beagle dogs days followed by leaf. (Auth. Abs. Mod.) were exposed to 460 mg/M* CO for 71 575 mg /MCO for 97 daysina 68-percent 02, 32-percent N2, 5-psi environment. Anatomic changes 71-0824. Lazzarini, L. Medical-Legal Aspects of Smoking found were confined to rodents and consisted of an heart and spleenweights. This can be in a Closed Environment. Complete Englishtranslation increasein del Fumare in Ambienti explained on the basis of increased RBC volume and of "Aspetti Medico- Lcgali blood viscosity. The possibility that the rats had begun to Chiusi,"Economia Umana6:20, 1955. reach the maximum tolerable compensatoryincrease in death of public RBC volume must be considered based on the Smoking ina closed environment, such as with lesions entertainment and meeting places, is shown to expose two rats on the 166th day of exposure suggestive of circulatory complications. No anatomic both smokers and nonsmokers to harmful tobacco com- the bustion products. The nonsmoker may breathe in up to a changes were found in the other species. Based on pathologic studies, it is indicated that CO has no direct thbd or more of the smoke produced by the smoker. effect on the body that produces a degenerative anatomic change. The animals at risk in this experiment were young 71-0825. Leuchtenberger, C., Leuchtenberger, R. The healthy adults in the case of the rodents and dogs and Behavior of Macrophages in Lung Cultures After Ex- healthy adolescent primates. They are not representative of the human population at risk in a civiliancommunity. posure to Cigarette Smoke. Evidencefor Selective Inhibi- tion by Particulate Matter and Stimulation by the Gas However, it does seem that the body's ability to adjust to high CO levels is much greater than had been previously Phase of Cell Metabolism of Alveolar Macrophages.Ad- vancesinExperimentalMedicineandBiology suspected and is limited mainly by available circulatory 15:347-360, 1971. reserve. (Auth. Abs. Mod.)

The biological effects of charcoal-filtered whole ciga- rette smoke or its gas phase on alveolar macrophagesand 71-0827. Maly, E. A Simple Test for Exposure to epithelioid cells in cultures of lung explants fromSnell's PolycyclicHydrocarbons,Bulletinof Environmental

151 154 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

Contamination andToxicology 6 (5 ):422-425, 71-0830. Murphy, J. F., Mulcahy, R. The Effect of Age. September-October 1971. Panty, and Cigarette Smoking on Baby Weight. Amer- ican Journal of Obstetrics and Gynecology 111( I ): 22-25 . A procedure is described for determining polycyclic September I, 1971. hydrocarbons in the urine of smokers or workers exposed to airborn particulates containing high temperature tar. The effects of maternal age, parity. and cigarette The procedure involves the isolation of a polycyclic smoking on baby weight are reported in 10,692 mothers. hydrocarbon mixture from a urine sample, separation of Maternal age and parity have no significant effect. but the hydrocarbons by paper chromatography, and semi- cigarette smoking is ashociated with a highly significant quantitative determination of the amount of certain reductionin babyweight. The effect of smoking is hydrocarbons by measuring the horizontal diameter of dose-related up to a consumption of 10 to 12 cigarettes the ultraviolet fluorescent spots, in particular that due to per day. Some possible mechanisms of the action of 1,2,3,4-dibenzopyrene. Other spots which can be identi- cigarette smoking are reviewed. The adverse effect of fied include those due to 3,4-benzfluoranthene, fluor- increased carboxyhemoglobin in the fetal blood in the anthene, and 3,4-benzopyrene. earlier months of pregnancy is considered as a possible abuse of later retarded fetal growth and development. (Auth. Abs.) 71.0828. Mann, P.E.G Cohen, A. B., Finley, T. N., Ladman, A. J. Alveolar Macrophages. Structural and Functional Differences Between Nonsmokers and Smok- 71-0831. O'Donnell, R. D., Chikos. P. M., Theodore. J. ers of Marijuana and Tobacco. Laboratory Investigation Human Sleep Patterns and Psychomotor Performance 25(2): I I 1-120, August 1971. During Exposure to Moderate Concentrations of Carbon Monoxide.In: Proceedings of the 1st Annual Conference Alveolar macrophages for functional study were ob- on Environmental Toxicology, 9-11 September 1970. tained from nonsmokers, marijuana smokers, and tobacco Aerospace Medical Research Laboratory, Wright - Patterson smokers. Morphologic comparisons were made of macro- AirForceBase, Ohio, AMRL-TR-70-102, December phages from nonsmokers and marijuana smokers. These 1970, pp. 31-47. comparisons of marijuana smokers' and nonsmokers' macrophages revealed ultrastructural differences confined Four healthy nonsmoking males were allowed to sleep to the cytoplasmic inclusions. Needle-shaped structures for a normal period of time in the presence of carbon and pale, often circular areas within inclusions were monoxide (CO) at a level up to 150 ppm. There were no common in macrophages recovered from the lungs of major disruptions of either their sleep patterns or subse- marijuana smokers but were rarely observed in the cells of quent psychomotor performance involving time estima- nonsmokers. Large pale areas within inclusions and highly tion, mental arithmetic, tracking, or vigilance under either electron-dense areas within inclusions were virtually con- moderate or high workloads. With respect to the perfor- fined to the cytoplasm of macrophages from marijuana mance measures, no patterns sl,ere isolated which would smokers. Functional comparisons of macrophages from indicate that more detailed study under the same condi- nonsmoking volunteers and from smokers of either tions would yield any significant effects of CO exposure. marijuana or tobacco showed that these cells have similar Some extremely tenuous indications of possible changes capacities to ingest heat-killed Candida albicans. However, in the mobility of subjects during their early stages of a higher percentage of macrophages from smokers of sleep were found. marijuana and tobacco adhered to glass than did those from nonsmokersperhaps indicating a difference in net negative surface charge. The functional differences found 71-0832. Rose, C. S. Acute Toxicity of Carbon Monoxide between the macrophages of tobacco and marijuana Under Hyperbaric Conditions.In: Proceedings of the 1st smokers and nonsmokers do not indicate a diminution in Annual Conference on Environmental Toxicology, 9-11 the defensive capacity of these cells. However, fewer September 1970. Aerospace Medical Research Labora- macrophages were recovered from marijuana smokers tory, Wright-Patterson Air Force Base. Ohio, AMRL-TR- than from nonsmokers. (Auth. Abs.) 70-102, December 1970, pp. 77-85.

The toxicity of carbon monoxide (CO) was evaluated 71-0829. Mokhnachev, I. G., Popova, L. P., Sirotenko, A. under conditions of elevated pressure to determine if a A., Dulan, L. A., Kamenshehikova, S. V., Kanevcheva, I. pressurized environment would result in an altered re- S., Kovtunov, V. S., Lateyeva, D. N., Pisklov, V. P., sponse of an animal to the gas. The animals used were Serdyuk,L.G. SovremennyyeFiziko-Idtinticheskiye male Sprague-Dawley-derivedrats, male Swiss albino Metody Analiza Tabaka i Yego Dyma. [Current Physico- mice, and male Hartley-derived guinea pigs. Two criteria chemical Methods of Analyzing Tobacco and Tobacco were used to evaluate CO toxicity: I) a comparison of the Smoke.] SbomkiNauchno-IssledovatersIdkhRobot, LCso of CO at ambient atmospheric pressure and at Vsesoyuznyi Nauchno-Issledovaterskii Institut Tabaka elevated pressures, and 2) the percent of hemoglobin in Makhorld im.A.I.Mikoyana154:197-222,1969, animals which died during exposure. There was little Russian. variation in the absolute amount of CO at the 50 percent mortalitylevelinthe animals as the pressure was Current application of the varied types of chromato- increased from 0 to 100 prig. The guinea pigs were graphy (gas, paper, thin-layer and column). mass spec- considerably less susceptible to CO intoxication at all trometry and spectrophotometry are reviewed. The ad- pressures than were the rats and mice. This phenomenon vantages of each method fortheidentification and correlates with the lower affinity constant of hemoglobin determination of volatile and non-volatile components are for CO in guinea pigs than in either rats or mice. The noted. carboxyhemoglobin levels producing death in rats and

155 152 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

long-time guinea pigs and the partial pressure gas ratiosexhibited sound discouraging to a person, like a heavy and smoker, who has undergone severe carcinogenic exposure. littlevariation regardless of the total pressure of the of cancer exposure environment. The results indicatethat the Statistics show, however, that the incidence smoking drops more toxicity of CO is not altered by increases inambient among heavy smokers who stopped provided the partial dramatically than was anticipated. This is due tothe pressure up to approximately 8 ATA of both initiators (hydro- pressure of oxygen in the atmosphereremains constant. presence, in tobacco smoke, carbons) and promoters (phenols). Thus,when both factorsare removed, theirreversible effects of past of a 71-0833. Rose, E. F., Rose, M. Carbon Monoxide: A initiation may remain unexpressed for the rest lifetime. This should encourage cigarette smokersof all Challengeto thePhysician. ClinicalMedicine 78(8):12-2I, August 1971. vintages to kick the habit.

Carbon monoxide (CO)isthe most common air 71-0835. Sanyal,R.K.,Khanna, S.K. Action of pollutant in the U.S. and atmospheric concentrations are Fertility increasing. The insidiouseffectof low atmospheric Cholinergic Drugs on Motility of Spermatozoa. concentrations of CO in producing or accelerating chronic and Sterility 22(6):356 -359, Junc 1971. ailments should be kept in mind by the physician. The in low concentrations produced an amount of CO in cigarette smoke variesbetween I and Acetylcholine the CO increase in the motility of oval cell spermatozoa.Similar 2.5 percent by volume and in the average smoker, either no effect or a slight concentration reaching the alveoli is about 0.04 percent. concentrations produced decreasein motility of round cell spermatozoa. The Smokers of from 20 to 30 cigarettes daily have carboxy- of hemoglobin (COHb) levels ranging from 3 to 10 percent, stimulant effect was most marked in a concentration since le g/ml and was slow to develop, though it lasted for but CO from the ambient atmosphere is not additive eserine and CO is absorbed into the bloodstream only whenthe 4-5 hours. The action was potentiated by pressure of CO in the ambient airexceeds that in the blocked by atropine. Low doses of nicotine and carbachol had similar actions, but they were quantitativelyweaker pulmonary capillary blood. High COHb concentrations reduced lower the altitude 'tolerance by about 335 feet for every than those of acetylcholine. Pilocarpine markedly produced percent of COHb, and explains whysmoking isnot the motility of round cells, at the same time, it recommended for athletes. The significance of CO as a some stimulation of oval cells. (Auth.Abs.) contributing or causative factor in automobile accidents, smoking, both as a result of exhaust leakage and cigarette 71-0836. Scassellati Sforzolini, G., Savino, A. Azione should be considered. Epidemiological studies ofcigarette smokers indicate that the death rate from coronaryheart Dell'Ozono su Alcuni Indici Chimici di lnquinamento considerably higher for smokers thanfor Degli Ambienti Confinati. [Action of Ozone onSeveral diseaseis Re- nonsmokers and in patients with heart disease there is a Chemical Indices of Air Pollution in Closed Areas.) deterioration of cardiac-function indices at COHb levels vista Banana dlgiene 29-30(3/4):174.188,May-August of 7 to 9 percent. Anginal symptoms associatedwith 1970, Italian. cigarette smoking have been observed in anatomically of normal individuals. The role of cigarettes in birthweight The action of ozone on several chemical indices environmental contamination by cigarette smokeand and in abnormal births and development has notbeen automobile exhaust gases has been studied. Using ozone defined, for although CO may be implicated, nicotine and allowable other smoke components, or other as yetunidentified in a concentration of 0.05 ppm (maximum concentration), the ozone was found to considerably factors, may be responsible. Drunken drivers should be reduce (32 percent) the carbon monoxide contentof examined for the alternative possibility of CO intoxica- slighter extent tion. The effects of alcohol are aggravated by theeffects room air and to oxidize formaldehyde to a (18 percent). Ozone had no effect on the concentrations of CO, for both influence the mind and impair muscular of coordination and control. Neurological complications of nicotine. In garage air, the same concentration ozone exercised a remarkable oxidizingaction on carbon occasionally follow apparently complete recovery from index of CO poisoning. All CO poisoning must be vigorously monoxide (37-percent reduction), taken as the treatedwith100 percent oxygen, under hyperbaric ambient contamination. conditions where possible. 71-0837. Schmaltz, 1. Cigarette Smoke: Formationof 71-0834. Ryser, J.J.-P. Chemical Carcinogenesis. New Components and Modification of Composition by theUse England Journal of Medicine 285(13):721 -734, Septem- of Additives. International Scientific TobaccoCongress, ber 23, 1971. 5th, Hamburg, 1970, pp. 85-94. This report summarizes the major contributionsof The origin of various cigarette smoke components, chemical carcinogenesis to the understanding of cancer. including phenols, pyridine bases, polynuclear and other The article attempts to place recent contributionsin the aromatic hydrocarbons, indoles, alkenes and smoke gases, perspective of the classic data of the past, discuss the is discussed. Special attention is given tostudies in which biologic characteristics of carcinogenesis, describe the specific tobacco leaf constituents, related compoundsand chemical interaction between cells and carcinogens, and tobacco leaf extracts were pyrolyzed to determine which postulate the sequence of events that may leadfrom leaf constituents serve as precursors forthe various exposure to clinical cancer. It isemphasized that weak substances found in smoke. Thus, phenols were shown to and others; carcinogenicexposures have irreversible and additive arise from carbohydrates, pigment, lignin effects and cannot be dismissed lightly as standing 'below pyridine basesessentiallyfrom nicotine; indole and acids a threshold of action.' Theirreversibility of initiation may related compounds from tryptophan, other amino CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

and protcinaceous materials; alkenes from long chain arealso prevented by morphine suggesting that they paraffins and similar substances; and smoke gases from a might represent a reaction to a nociceptive stimulus. variety of sources. In addition, the report describes the (Auth. Abs.) modification of cigarette smoke by the use of additives. Additives discussed include those whose effects were measured by noting resulting changes in:I) the burn 71-0841. Tamura, K., Endoh, M., Hashimoto, K. Pharma- temperature of cigarettes; 2) the smoke composition, in cological Features of the Gall Bladder and Its Vascular the particulate or vapor phase; and 3) the pH of smoke. Bed of the DogIn Situ. Tohoku Journal of Experimental Data presented compare the burn temperature of ciga- MedicineI04(2):157.169, June 1971. rettes containing certain additives with the bum tempera- ture of reference cigarettes. Levels of certain significant Pharmacological features of the gall bladder and its components of the vapor and particulate phases are vascular bed were studied by means of the intra-arterial tabulated for both additive-treated cigarettes and refer- administration of various substances in the dogin situ. ence cigarettes. The mechanism by which certain additives The contraction of the gall bladder was produced by exert their effects is also discussed. (Auth. Abs.) various compounds as follows: cholinergic drugs, kinin substances, histamine, ganglion stimulants, ouabain, BaCl2 and CaCl2. Meanwhile, adrenergic drugs ganglion 71-0838. Schmidt, F. Concerning the Problem of Passive blocking agents, lys-vasopressin, smooth muscle relaxants. Smoking. Complete English translation of "Zum Pro- KCI and MgCl2 relaxed the gall bladder. DMPP, 5-HT, blem des 'Passiv-Rauchens',"Munchener Medizinische nicotine, lobeline, angiotensin and ATP caused a biphmic WochenschriftI13(18):702-705, April 30,1971. response, i.e., a contraction followed by a relaxation ov a relaxationfollowed by a contraction. The pharmaco- Criticism of a study by H. P. Harke concerning the logical features of cholecystic arteries are not the same as problem of passive smoking is offered by F. Schmidt. The those of the gall bladder: cholinergic and adrenergic drugs latter strongly questions Harke's conclusions which seem except isoprenaline, and ganglion stimulating and 'Moc'k- to infer that the dangers of passive smoking are minimal ingagents produced opposite effects, while smooth and which are based on what Schmidt considers to be muscle stimulants and relaxants acted similarly on both. inadequate experimental methods and incomplete publi- Among polypeptides.lys-vasopressinrelaxedthe gall cation of data relating to the subject. A rebuttal to these bladder, cholecystokinin constricted it, and gastrin and criticisms is presented by Harke in another publication. oxytocin caused no response, while the former con- (SeeAbstract 71-0023 of Harke's original publication and stricted the artery and the latter three dilated it. (Auth. Abstract 71-0819 of his rebuttals.) Abs.)

71-0839. Schulte, J. The Effect of Exposure to Low 71-0842. Vapaatalo, H. I., Neuvonen, P. J., Tissari A., Concentrations of Carbon Monoxide. In: Proceedings of Man sner, R., Paasonen, M. K. Effect of Cigarette Smoking on Diuresis Induced by Furosemide.Annals of Clinical the 1st Annual Conference on Environmental Toxicology, Research 3(3):159.162, 1971. 9-11 September 1970. Aerospace Medical Research Labo- ratory, Wright-Patterson Air Force Base, Ohio, AMRL- The effects of smoking were compared on water- and TR-70-102, December 1970, pp. 87-91. furosemide-induced diuresis in 170 healthy student volun- teers. Smoking of one cigarette at the beginning of the Some research projects concerning the effects of low experiment, or six cigarettes (one every 30 minutes) concentrations of carbon monoxide (CO) are briefly during the experiment, did not affect the total 3-hour described. One study showed that exposure to different water diuresis. The 3-hour diuresis induced by furosemide CO concentrationsresultingincarboxyhemoglobin (COHb) levels of 5, 10, 15 and 25 percent caused an in nonsmokers was not significantly differentfrom that of increase in errors in an arithmetic test. Another experi- smokers. However, after six cigarettes the mean value in nonsmokers (who temporarily smokedlessthan10 ment revealed that drivers with COHb levels of between 5 cigarettes daily) was 909 ml which is significantly less and 10 percent had an increase in judgmental error, than the corresponding figure 1361 ml in routine smokers especially in maintaining and closing distances. Possible (more than10 cigarettes daily). In two nonsmoking explanations for the differences in the findings among authors, three cigarettes at the beginning of the experi- researchers in the area of CO effects are discussed. ment caused a transient delay in the diuresis induced by furosemide, but, if anything, increased the total diurbsis. The effect of smoking on the furosemide diuresis was 71-0840. Sotgiu, P., Ruffi, A., Pepeu, P. Behavioural concluded to be of negligible significanceinclinical Effects Caused by Intra-arterial Injection of Acetylcholine practice. However, increased smoking may somewhat and Nicotine in Conscious Rats.Pharmacological Re reduce the effect of furosemide. search Communications3(1):45-53, March 1971.

The effects of acetylcholine and of nicotine injected 71-0843. Vernot, E. H., MacKenzie, W. F., MacEwen, J. retrogradely into the right carotid artery in conscious, D., Monteleone, P. N., George, M. E., Chikos, P. M., Back, freely moving rats were investigated. Acetylcholine and K. C., Thomas, A. A., Haun, C. C. Hematological Effects nicotine caused two completely different syndromes, the of Long-Term Continuous Animal Exposure to Carbon first characterized by flexion of the forelimb, rotation of Monoxide. In: Proceedings of the 1st Annual Conference the head and squeaking, the second by a fall on the left on Environmental Toxicology, 9-11 September 1970. side with extension of the right forelimb. Both syndromes Aerospace Medical Research Laboratory. Wright-Patterson are prevented by pretreatment with mecamylamine but Air Force Base, Ohio, AMRL-TR-70-102, December not with atropine. The effects elicited by acetylcholine 1970, pp. 7-22.

157 154 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

Triethylene Glycol in Tobacco.Journal of the Assocks- Long-term continuous exposures of dogs and monkeys 54(3):56I-564, 1971. to carbon monoxide (CO) produceseries of measurable lion of Official Analytical Chemists changes resulting from the development of normocytic, hemato- A continued collaborative study of the gaschromato- normochromic polycythemia. An increase in graphic determination of humectants in tobacco is re- logical parameters appears to be a linear functionof CO the ported. Sixcasedcigarettecut tobacco samples, 2 concentration from the, lowest, 57.5 mg/m, to humectant mixture samples, and 2 ground and blended highest, 575 mem', tested. The monkeys responded relatively more profoundly than dogs by increasesin cased tobacco samples were sent to 13 collaborating laboratories. Results for propylene glycol and glycerol hematological values. The Haldane M constant applies to gave coefficients of variation of less than 10percent. thein vivoformation of carboxyhemoglobin, and can be calculated using inhalation data. The effect of exposure to Triethylene glycol in cut tobacco at mean concentration high CO concentration on the oxygen dissociation curve levels of 0.95 and 1.30 percent gave coefficients of Roughton's variation of 9.24 and 6.93 percent, respectively. At a appears to be explainable on the basis of level of 0.54 percent triethylene assumptions alone, the curve does not show anyright mean concentration shift attributable to adenosine triphosphate or 2,3dip- glycol, the coefficient of variation was 20.8 percent. The hosphoglycerate. The polycythemia developed as a result method has been adopted as official first action by the of chronic exposure to high CO concentrationsdoes not AOAC. compensate completely in blood oxygen transport.Under the conditions of this study, arterio-venousdifference in 71-0846. Williamson, T. G., Jenkins, R. W., Newman,R. oxygen content provides no evidence of tissuehypoxia in H., Carpenter, R. D. Analysis of Tobacco andTobacco equilibrated dogs. The increase in hematocrit in acclima- Smoke by Neutron Activation.Transactions of th,e tized dogs and monkeys is matched by equal increasein American Nuclear Society14(I):110-111,1971. total blood volume. The viscosity of polycythemicblood can be explained on the basisof hematocrit increases A neutron activation analysis technique isdescribed alone. (Au th. Abs. Mod.) for the analysis of 10 elements in main-streamsmoke of a single cigarette, 6 of which have not beenpreviously found using neutron activation methods. In this techni- que, no transfer of the smoke condensatepriorto 71-0844. Walton, F. P. Carcinogens in Cigarette Smoke. activationis necessary, thereby minimizing losses and (Letter)Chemistry in Britain 7(5):220.221,1971. contamination. The major advantages of the technique are 1) ability to assay single clgarettes,2) adaptabilityfor This letter-to-the-editor suggests that lung cancer may routine analytical determination, and 3) speed of sample be due to repeated and prolonged exposure of the lungs preparation for activation. to a tissue irritant such as acrolein which isformed by decomposition of glycerine or similar substances during burning. Acrolein is also suggested as a causativelactor in 71-0847. Yacoub, M. Faure, J.Mallion, J.-M., Cau, J. bronchitis, coronary thrombosis and the rapid spread of Can the Tobacco Origin of Chronic Carbon Monoxide cancer throughout the body. intoxication Be Determined? Complete English transla- tion of "Peut-on Determiner l'Origine Tabagique de l'OxycarbonismeChronique?"MedecineLegaleet 71-0845. Williams, J. F. Collaborative Study of the Dommage Corporel3(3):262-265, July-August-September Determinationof PropyleneGlycol,Glycerol, and 1970. SeeAbstract 71-0041.

See also71.0870, 71-0883, 71.0888, 71-0922, 71-0927, 71-0942

155 158L MORTALITY AND MORBIDITY

71-0848.Elmes,P.C., Simpson, M.J.C.Insulation the lung, mesothelioma of the pleura and peritoneum. Workers in Belfast. 3. Mortality 1940-66.British Journal cancer of the gastrointestinal tract, and fibrotic lesions of of Industrial Medicine 28(3):226-236,July 1971. the lungs. The ratio of observed over expected deathswas 2.6 for all causes, 3.9 for all cancers. and 17.6 forcancers One hundred and seventy men were identified as of the lower respiratory tract and pleura. Thosemen making up the total population of insulation workers in finallyclassifiedas dying from lung cancer showed Belfast in 1940. This is an analysis of all the information evidence of lung fibrosis whereas those classified as dying about deaths that has emerged from tracing these men up to the end of 1966. Five remain untraced, and the from mesothelioma did not. Comparisons within the mortality experience of the remainder is compared with group fait:A to show any relationship between age at first that of other men in Northern Ireland over the period. exposum or duration of exposure and the excessive There were 98 deaths when only 37 were expected. The mortality. Taking those whose smoking habits were number of deaths occurring exceeded those expected known (114) and comparing them with people surveyed throughout the period 1940-66 and the increase was by Wicken (1966) in Inner Belfast, it is evident that the statistically significant during the period 1950-55 and insulators were heavy smokers. However, there were too onwards. There was an especially high mortality (com- few nonsmokers (5) to show the significance of smoking. pared with other Northern Ireland males) due to cancer of (Au th. Abs.)

See also71-0811

NEOPLASTIC DISEASES

71-0849.Auerbach, 0. Lung Cancer From Cigaret genic carcinoma. To determine if there was any difference Smoking.New YorkStateJournalof Medicine inthe changes inthe bronchial epithelium between 71(17):2039-2040, September I, 1971. ex-smokers and smokers, slides from the lungs of 758 subjects (456 men and 302 women) who had died of Microscopic examination of lung sections from 402 cancer other than lung cancer were examined. Of the 456 male smokers and nonsmokers showed lesions with cilia males, 72 were ex-smokers who had smoked for at least present in 11.8 percent of sections of nonsmokers, in 88 10 years, were primarily cigarette smokers, and had not percent of sections from smokers of under one-half pack a smoked for at least 10 years prior to death. Atypical cells day, and in 98.5 percent of sections from smokers of two were observed in 93.2 percent of smokers, in 6 percent of or more packs a day. Lesions with cilia absent increased ex-smokers and in 1.2 percent of nonsmokers. Carcinoma from 6 percent of sections from nonsmokers to 28.3 in situ was found in only 0.2 percent of ex-smokers. Of percent of sections from smokers of two or more packs a the72 ex-smokers, 43 had one or more sections day. Bronchial epithelial lesions composed entirely of containing cells with disintegrating nuclei. The frequency atypical cells and lacking cilia were termed "carcinoma in ofcells withdisintegrating nuclei may increase for situ." The proportion of sections with such lesions perhaps 15 years after cessation of smoking and then increased tremendously with the amount of smoking, thus decrease gradually. These findings strengthen the con- strengthening the epidemiologic evidence that cigarette clusion that ex-smokers have a reduced risk of acquiring smoking is a major factor in the causation of broncho- lung cancer.

156

15$? NEOPLASTIC DISEASES

smoke, and the mechanisms of theiraction are described. 71-0850. ColeP. Coffee-Drinking and Cancer of the One such model employs a wire-meshpellet impregnated Lower UrinaryTract. Lancet1(7713):1335-1337, June with a pure polycycic hydrocarboncarcinogen that is 26, 1971. impacted in the bronchus of a rat. Thispellet implant model provides prolonged and persistentdose and in this Interviews were conducted with a population-based contaminating series of patients with cancer of the lower urinary tract regard is more comparable to a heavily An smoking exposure. However, it traumatizesthe bronchus and controls drawn from the same population. changes con- unanticipated finding is association of the disease with and induces proliferative and metaplastic ducive to carcinogenic action. In another system,SO2 coffee-drinking. Therelativeriskfor coffee-drinkers, exposure by (p exposure is combined with benzo(a)pyrene compared to non-drinkers, is 1.24 among men and 2.58 of the in inhalation, resulting in squamous cell carcinomas less than 0.05) among women. The association is strong beconsidered disease bronchus. Although this model cannot the sex-age groups in which the associations of the the high with cigarette smoking and occupation are not strong. evidence for air pollution hazards because of concentrations used, it can be applied to thecigarette (Auth. Abs.) smoke problem where exposures to polycyclichydro- carbons is combined with exposure to suchirritants as nitrogen oxides, phenols and aldehydes. Thus,model 71.0851, Cragg, J. Lung Cancer in Jersey: ItsIncidence systems are useful in assembling significantcombinations and Associated Biochemistry.British Journal of Clinical etiology of 25(8):360-365, August 1971. of materials to demonstrate the multifactorial Practice a tumor. Models can alsoisolate a specific carcinogen as is highest rates of illustratedinthe case of chromate. In addition to The island of Jersey has one of the providing information on specific carcinogens and com- lung cancer in the world despite negligibleatmospheric bination effects, models are useful in determiningdose pollution. In 1964-1968, 144 patients withlung cancer distribution responses and both morphogenesis andpathogenesis. werestudied. There was a 4:1 male to female in habits of 113 of Models for environmental pulmonary carcinogenesis of the disease. Records of the smoking and organ cultures have had limited these lung cancer patients showed most wereheavy vitrowithcell smokers, the average duration of smoking being37 years application and success. and the average number of cigarettessmoked daily being predominated in 28. This degree of heavy smoking of the undifferentiated 71-0854. Moore, C. Cigarette Smoking and Cancer patients who developed epidermoid and Study.Jour- of lung cancer Mouth, Pharynx, and Larynx. A Continuing tumors. There was no excessive incidence 2I8(4):553.558, in any particular occupation. The diagnosis-deathinterval nal of the American Medical Association October 25, 1971. was short for all types oflung cancer but particularly so electrolytes and in the case of the oat cell tumor. Altered A total of 203 smokers "cured" of cancersof the oral raised serum calcium levels were common inthe presence evidence of cavity, pharynx, or larynx were divided into two groups: of metastases but there was no clinical stopped. hypercalcemia. Hormonal activity in lung cancer was those who continued smoking and those who hyponatremia in a Within an average follow-up period ofapproximately evidenced by a single case of dilutional who continued to three cases seven years, 40 percent of patients patient with an oat cell tumor; there were also smoke tobacco developed second cancersin tobacco- of gynecomastia. contacttissues,whereas 6 percent of patients who stopped smoking tobacco acquired second cancers.The death rate from second cancers was high;deaths from 70852, Humperdinck, C. Lunge andBerufskrebs. the Medizinische Welt other causes occurred more often and earlier among (Lungs and Occupational Cancers.] continuing smokers. These results strongly support pre- 22(12):459-464,March 20, 1971, German. vious evidence that (I) tobacco plays a majorrole in cancers of the oral cavity, pharynx,and larynx; and (2) A brief review is presented of carcinogenswhich are of cessation of smoking reduces the risk ofsecond such involved in the development of occupational cancers reduce premature deaths arsenic, nickel cancers. Stopping smoking may the lung or respiratory system: radiation, from some other common diseases. (Auth. Abs.) cadmium, chromium, asbestos, aromaticamines, and aromatic hydrocarbons.It was emphasized that the factors manifastation of cancer is dependent upon many 71-0855, Morrow, R. C., Suarez, G. MucosalChanges and such as age at the initial exposure, latentperiod, previous Laryngoscope all of which CancerinIntra-OralSmoking, history of lung diseases and smoking habits, 81(7):1020-1028, July 1971. must be considered. The contentof known carcinogens in tobacco smoke does not fully explainthe carcinogenic Of 79 reverse smokers examined at theClinic "Club de effect of cigarettes. The author citesWynder's experi- Leones" oftheUniversityof Cartagena, Colombia, ments ininducing skin cancer in white mice with of pyrene or between June and December 1970, characteristicchanges benzo(a)pyrene.Largeconcentrations All but seven of fluoranthene potentiate the carcinogenic effectof benzo- of nicotinic stomatitis were found in 78. either of the the subjects were women and they rangedin age from 25 (a)pyrene but lower concentrations of of the subjects noncarcinogens have a carcinogenesis inhibitingaction. to 90 years. Approximately 75 percent had smoked for at least 20 years. Cigars,cigarettes, and cantles (a long, thin home-made cigar) weresmoked and less daily and 710853. Kuschner, M., Laskin, S. ExperimentalModels of the 79 subjects, 73 smoked six or American Journal of two-thirds of these smoked no more' thanthree per day. in Environmental Carcinogenesis. Squamous cell carcinomas were present in 16subjects and 64(1):183-196, July 1971. Pathology were predominantly located atthe base of the tongue, Two identify pulmonary tonsillar fauces and adjacent pharyngeal mucosa. Model systems developed to involved the hard palate and two the soft palate.There carcinogenic agents, particularly thosefound in tobacco 157 160 NEOPLASTIC DISEASES.

was little relationship between either the number of years 82 percent of all men and 17 percent of all women in of indulgence in reverse smoking or the number of cigars Japan smoked in 1967. or cigarettes smoked and the severity of the stomatitis. But there was a definite relationship of cancer to the durationof smoking. Theresultssuggestthat two 71-0859. Wahi, P. N. Recent Trends in Cancer Re- mechanisms may be involved in the pathological changes search. IndianJournalofCancer 7(3):161-173, produced by reverse smoking. One appears to be the September 1970. effect of drying and irritation by the smoke, leading to a nicotinic stomatitis and leukoplakia in the palate. The One of the main trends in cancer research has been the other seems to be a carcinogenic process resulting from a epidemiological approach. Comparative world wide epi- substance or substances collecting in the "draining area" demiological studies have shown a wide variation in the of the mouth. incidence of certain cancers in different countries. Studies on various environmental factors in the etiology of certain cancers have been concerned with lung cancer and 71-0856. Pindborg, J. J. Oral Leukoplakia. Australian smoking, buccal cavitycancer and tobacco chewing, Dental Journal 16:83.93, April 1971. Buddies tumor and virus, cancer of the uterine cervix and marital status of women, breast cancer and lactation, The prevalence and clinical aspects of oral leukoplamia thyroid cancer and diet and radiation, and leukemias and are discussed and the homogeneous and speckled types of radiation. The role of viruses in the production of various leukoplakia are described. A section on etiology deals cancers and the development of cancer chemotherapy are with tobacco habits (in particular cigar and bidi smoking, other significant trends in cancer research in recent years. and snuff dipping) and candida infected leukoplakias. The Inthefieldof cancer control and prevention, the histopathology of leukoplakia is discussed with emphasis understanding of the natural history of some cancers and on the significance of epithelial atypia. Follow-up studies the acceptance of the concept of precancer are significant are mentioned and itis concluded that only 4 to 6 contributions. The results of an epidemiological study on percent of the leukoplakias become malignant. The role oral cancer are briefly described and clearly show that of the World Health Organization with regard to oral tobacco chewing enhances the risk of developing oral precancerous conditions is mentioned. (Auth. Abs. Mod.) cancer with a clear dose-effect relationship. Epidemiologi- cal studies of cancer of the uterine cervix, which have highlighted some aspects of the ecological profile of Indian women predisposing them to a high incidence of 71-0857. Reddy, C.R.R.M., Kameswari, V. R., Raju, cervical cancer, are reviewed. M.V.S. Carcinoma of thePalatein Visakhapatnam Area. Indian Journal of Cancer 8(2):84-91, June 1971. 71-0860. Zacho, A., Nielsen, J., Larsen, V. Smoking Biopsy records from the Andhra Medical College, Habits of Patients With Gastric Cancer. Acta Chirurgica Visakhapatnam, India, from December 1955 to December Scandinavica 137(5):455-458, 1971. 1970 were analyzed for oral, oropharyngeal and hypo- pharyneal cancers according to age, sex and site. Of Five hundred and thirty-two patients with gastric 21,264reportedmalignancies,2280 wereintra-oral cancer (GC) were compared, in respect to smoking habits, cancers, and of these 864 were palatal carcinomas. The with a section of the general population. This investiga- most common sites for the intra-oral cancers were the tion was complicated by the fact that many patients with palate, tongue, hypopharynx and cheek in descending GC had stopped smoking or had reduced their smoking order of frequency. Carcinoma of the hard palate was very common in the Visakhapatnam area as compared to before admksioh. The relative percentage of smokers other regions of India and other countries in the Middle among men and women corresponds in a striking way to the relative incidence of GC in the two sexes. Among the East and South East Asia, and was more common among malesthere was a somewhat higherpercentage women. Carcinomas of all other sites were more common of in males. A brief literature ever-smokers (both present smokers and ex-smokers) in reviewisincluded in a the GC than in the control group. At admission to discussion of the relationship of palatal cancer to reverse hospital smoking. there was a lower percentage, but 5years previously a higher percentage of smokers in the GC group. The percentaldistribution of smokers in the various age groups differed in the two groups. Among the 71-0858. Sato, T. Koto Gan Hassel ni Eikyo wo Ataau women there was a lower percentage of ever-smokers in Inahi. (Causative Factors in Laryngeal Cancer.] Japanese the GC than in the control group, but a higher percentage Journal of Clinical Medicine 27(4):1257-1270, April of smokers at admission, and an even higher percentage 5 1969, Japanese. years before adinission than in the control group. In other words, most female smokers with GC go on smoking until Inareviewpaper,resultsare quoted from a a few years before admission. These investigations have questionnaire survey carried out in Japan in 1967 to shown thatitis not possible to solve the problem determine the incidence of smoking among 355 patients concerning the etiological role of tobacco in gastric cancer with laryngeal cancer. Ninety-seven percent of all patients by simple retrospective studies, because individuals who smoked and 87 percent were heavy smokers. Figures are later develop or who already have gastric cancer often also given for the total numbers of male and female react to a reduced tolerance of tobacco by reducing their smokers in Japan in 1967 by age groups. On the average, smoking or stopping altogether. (Auth. Abs. Mod.)

See also 71-0810, 71-0844, 71-0875, 71.0877, 71-0879,71-0944

158 NON-NEOPLASTIC RESPIRATORYDISEASES

71-0861, Ericsson, P. Importance of Certain Factors for possibility of less 'basal air way closure' in Nigerians. In 5 Physical Work Capacity and Ventilatory comparison with nonsmokers, smokers showed a Changes in percent diminution in VC and their RV/TLC ratio was Capacity During Five Years' Ageing.Acta Societatis 11.5 percent higher. However, these differences were not Medicorum Upsaliensis75:131-149,1970. significant. In a previous study concerning the effect of fiveyears' work aging on the ventilatory capacity and physical M., Auerbach, 0., Parks, V. R., capacity in apparently healthy persons of agesranging 71-0863. Frasca,J. Jamieson, J. D. Electron Microscopic Observations on from 57 to 71 years, representative of the population, a inSmoking decrease of 6-9 percent was obtained in bath sexes for PulmonaryFibrosisandEmphysema MolecularPathology measures of ventilatory capacity, and of 9-13 percent in Dogs.Experimentaland and 10-25 percent in women for measures ofphysical 15(I):108.125, August 1971. work capacity. The individual variation wasconsiderable, Electron microscopic observations in areas offibrosis however. On the basis of these data, complementary lungs of dogs subjected to analyses were performed with the aim ofstudying the and emphysema of the experimental cigarette smoking show that alterations of certain factors for these age-correlated changes and for occur both in the pleura and thelung parenchyma. In the the individual differences in the changes during the thickness of follow-up period. The investigation showed thatthe pleura the major alteration is the increased the stroma due to large amounts of collagenpresent. In decrease in maximal physical work capacity was not due in the highest attainable the lung parenchyma two major alterations appear to any large extent to a decrease in the septa where thewisa heart rate but to a decreased work capacity perheart interstitiumof thealveolar complete loss or a great reduction in thenumber of beat. When the physical work capacity was expressedin a capillaries and a marked thickening of the septadue to lactate concentration dependent variable the reduction the alveolar was greater than when the calculations were based on the increased amounts of collagen. Changes in epithelium are slight; changes in capillaryendothelium, other variable systems. Statistically significant correla- blebbing of the tions were found both between change in measures of such as rarefication of cytoplasm and plasmalemma, are found. More frequently noted arethe physical work capacity and change ht ventilatory capacity alveolar and between change in body weight and change in changes involving the basement membrane of the epithelium which in some places appear to begreatly physical work capacity and ventilatory capacity respec- thickened and in others to be exceptionallythin or tively. There appeared to be some relationship between missing entirely. Another of the moststriking alterations the individual subject's own subjective assessment of his noted in both the pleura and parenchyma isthe presence state of physical fitness and physical work capacityand singly, in ventilatory capacity, respectively. Changes observed in the of large numbers of macrophages occurring smoking habits of some of the subjects showed no clumps, and in granulomas. Although macrophages are found in the lungs of nonsmoking dogs,they are not correlation with physical work capacity or ventilatory found in such numbers nor with the uniquecontent capacity. The hypothesis is presented that the effect of observed in the lungs of smoking dogs.Crystalline-like aging on physical work capacity might be due partly to a structures are found in membrane -boundinclusions and change in circulatory adaptation, with a redistribution of ferritin-like particles occur both in large membranebound the circulating blood and reduction of the nutritive flow Conclusive reduction of aggregates and lying free in the cytoplasm. to exercising muscles. Possible effects of identification of these structures and theirrelationship to physical activity with increasing age are discussed. (Auth. inhalation of cigarette smoke requires furtherstudy. Abs. Mod.) (Auth.Abs.)

71-0862. Femi-Pearse, D., Elebute, E. A. Ventilatory Clinical Science 71-0864. Giammona, S. T., Tocci, P., Webb, W. R. Effects Function in Healthy Adult Nigerian& of Cigarette Smoke on Incorporation of Radioisotopically 41(3):203-211, September 1971. Labeled Palmitic Acid Into Pulmonary Surfactant and on American Vital capacity (VC), forced expiratory volumein one Surface Activity of Canine Lung Extracts. 104(3):358-367, second (FEV1), functional residualcapacity (FRC), ReviewofRespiratoryDisease expiratory reserve volume (ERV), residual volume(RV), September 1971. in 291 and total lung capacity (TLC) were determined palmitic adult healthy Nigerians (174 males and117 females). The incorporation of radioisotopically labeled acid into pulmonary surfactant was studied in control Prediction formulae of various authors on Caucasians and dogs and dogs subjectedtoshort term exposure to South African Bantu were applied to the Nigerian data. acid analysis The results show significantly smaller VC, FEVI ,FRC, cigarette smoke. Au toradiographic and fatty of serum, lung tissue, and lung ex tracts and measurements RV, TLC and RV/TLC in Nigerians than in Caucasians. in these dogs. The VC, FEVI and FRC of Nigerians were similar to of surface activity were also carried out There was no change in surface activity orin the rate or those of South African Bantu. ERV values were similar to in these dogs. those previously reported for Caucasians. The combina- time of incorporation of pahnitic acid tion of lower RV values and similar ERV indicates the (Auth. Abs.)

159

162 NONNEOPLASTIC RESPIRATORY DISEASES

71-0865. Go Ui, V. Epidemiological Study of Non-Specific major role in the causation and development of the Bronchopathies. Complete English translation of "Etude disease, but infection, cigarette smoking and other factors Epidemiologique des Bronchopathies Non Specifiques," interact to produce a pleomorphic clinical picture. Bronches 20(5): 3 I 3-3 30. September-October 1970.

See Abstract 7 I -0442. 71-0869. Mittman, C., Lieberman,J.,Marasso, F., Miranda, A. Smoking and Chronic Obstructive Lung DiseaseinAlpha, -AnntrypsinDeficiency. Chest 71-0866. Hagerup, L.,Larsen, M. Tobaknygning og 60(3):214.22I, September 1971. Respintoriske Symptomer i en Dansk Population. Fla 50 Ass Undersogelseni Glostrup, [Tobacco Smoking and Similar spectra of chronic obstructive lung disease Respiratory Symptoms in a Danish Population. From a were observed in eight patients with severe and 21 with 50-Year StudyinGlostrup.]Ugeskrift for Laeger intermediate alphas- antitrypsin deficiency, but patients I33(27):1302-1306. July 9, 1971, Danish. with intermediate levels of protease inhibitor became ill when older and following greater cigarette exposure. In The relationship of tobacco smoking to pulmonary 61 presumably healthy relatives of these patients, almost function and respiratory symptoms was studied in a one-half of those with intermediate antitrypsin deficiency population of 50 -year -olds (436 males and 366 females) who smoked had spirometric evidence of early airways from Glostrup, Denmark. A significant correlation was obstruction. Relatives with normal antitrypsin activity did found between inhalation of tobacco smoke and morning not show this change, nor were perfusion lung scan or cough in males. Ex-smokers showed a reduced pulmonary diffusing capacity abnormalities as common in normal function as compared with nonsmokers. Pulmonary relatives as in deficient ones. The intermediate deficiency function was poorest in smokers and was related, in a may predisposetolung disease by accentuating an complex manner, to inhalation and quantity of tobacco individual'ssusceptibilitytotheharmful effects of consumed. The effects of the type of smoking, duration external irritants. An interaction of genetic and environ- of smoking, the amount smoked and inhalation arc mentalfactorssuggests that lungdiseasecould be discussed. It was concluded that the pulmonary symp- prevented by identifying asymptomatic, susceptible reb- toms depend upon the quantity and nature of the inhaled ties and counseling them against contact with irritants. cigarette smoke. However, cigar and shag smoking cannot Since antitrypsin deficiency cannot be reliably recognized be entirely acquitted. by any other means, it is advocated that all patients with chronic obstructive lung disease undergo an antitrypsin assay. (Auth. Abs. Mod.) 71-0867. Knorre, G. v.,Lange, U. Ergebnisse finer Reiltenuntersuchung auf Asthma, chronlache Bronchitis and Emphysem. [Results of a Screening Test for Asthma, 71-0870. Passey, R. D., Blackmore, M., Warbrick-Smith, Chronic Bronchitis and Emphysema.]Zeitschrift fur D., Jones, R. Smoking Risks of Different Tobaccos. Bri- Erkrankungender A tmungsorgane mit Folk Bron- tish Medical Journal 4(5781):198-201, October 23, 1971. chi logica 134(2):279-292, 1971, German. Experimentsarereviewed which showthatrats In a rural-small town population of about 35,000 exposed tothe smoke of Englishcigarette tobacco inhabitants above the age of 15 years, a total of 871 (flue-cured) had greatly shortened lives and damaged persons (683 men, 188 women) were found suffering respiratory systems, while animals exposed to the smoke from bronchial asthma, chronic bronchitis and emphy of cigar and Burley tobacco (air-cured) had no detectable sema. The patients were initially processed by standard respiratory disease. These differences are attributed to the questionnaire and arranged into the respective groups methods of curing the tobaccos. according to age, sex and smoking habits. Three-fourths of the men stated that they were smokers but only one-fifth of the women made such an admission. Chronic 71-0871. Penman, R. W. Conference on Pneumoconiosis. bronchitis was found linked with steady smoking whereas A Summary of the Conclusions From an International the emphysematous and asthmatic complaints were Conference on Coal Workers' Pneumoconiosis. American associated withseasonalorweather variations. The Review of Respiratory Disease 102(2):243 -247, August anamnestic, clinical, roentgenological and ECG findings 1970. are discussed in detail. This report summarizes the major conclusions from a conference on coal workers' pneumoconiosis held at 714868- Lee, D.H.K. Coal Workers' Pneumoconiosis Cumberland Falls, Kentucky, September 10-12, 1969. State of Knowledge and Research Needs. Journal of The objectives of the conference were to consider present Occupational Medicine 13(4):183 -192, April 1971. knowledge ofthemedical aspects of coal workers' pneumoconiosis,tosummarizepoints of agreement Appalachian coal miners show a high incidence of concerning certain key questions, and to formulate respiratory disease characterized by dyspnea and bron- recommendations for further research with regard to chitis symptoms, often but not invariably accompanied problems where no agreement could be reached because by radiogn.phx: evidence of changes characteristic of of conflicting or inadequate data. The "Synopsis of the pneumoconiosis. The symptoms and radiographic changes Work Session Proceedings" was processed in a previous tend to progress with years of underground work, and a Bulletin. See Abstract 71-0093. substantial portion of the pneumoconiotic cases develop the lesions characteristic of progressive massive fibrosis about one-third of the affected working miners and about 71-0872. Perlman, L. V., Higgins, M. W., Chiang, B. N., one-half of the affected former miners. Coal dust plays a Ostrander, L. D. (Jr.), Keller, J. B. Electrocardiographic

A ) 160 xt NON NEOPLASTIC RESPIRATORY DISEASES

Patterns in Persons With Bronchitis and Without Bron- 71-0875. Rullicre, R.. Saigot. T. Tabac et Poumons. chitis in Tecumseh. American Review of Respiratory [Tobacco and Lungs.]Vie Medicate 52(251:3009 -30 I 7, Disease 104(3):443-447, September 1971. July 1971, French.

Electrocardiographic (ECG) differences between pa- Chronic bronchopneumopathy and brOnchial cancer experimental tients with bronchitis (95 men and 51 women) and those are discussed based on a review of recent without bronchitis (95 men and 51women) were studies. The effects of smoke on the vibratile cilia of the compared as part of the Tecumseh Community Health bronchial mucosa, the effects of smoke on bronchial Study. Men with bronchitis had significantly faster heart motoricity. and the irritating agents responsible for its rates and greater mean P wave amplitudes anddurations harmful effects are presented, indicating that acetalde- than men without bronchitis; there were no differences hyde and acrolein are the most toxic substances affecting among women with and without bronchitis. Differences ciliary function. Several of the factors which influence the in QRS complexes between bronchitics and nonbron- frequency of bronchial symptumatology are discussed: chitics were not significant among men and women. the total quantity of cigarettes smoked, the average daily consumption, and the duration of the smoking habit. In Chronic bronchitis and ECG changes were associated with addition, statistical, histological, chemical, and experi- ventilatory defect and the lowest FEVI scores were found in men with chronic bronchitis and abnormal ECGs. mental evidence which indicates a causal relationship There were more cigarette smokers among bronchitics between tobacco and bronchial cancer is outlined. than nonbronchitics. Smoking habits of men with ECG changes were not different from those of other men in the same diagnosticclass. Among women bronchitics, all those with ECG changes were cigarette smokers whereas 71-0876. Ryder. R. C., Dunnill, M. S., Anderson, J. A. A only two thirds of those without such changes were Quantitative Study of Bronchial Mucous Gland Volume, smokers. Emphysema and Smokingina NecropsyPopula- tion. Journal of Pathology 104( l):59-71, January 1971.

The percentage volume of bronchial mucous glands 71-0873. Reichel, G., Ulmer, W. T., lkonomides, S. Z. and the volume of pulmonary emphysema have been Influence of Smoking Habits on the Incidence of estimated by the point-counting technique in 353 lungs. Non-specificRespiratoryDiseases.III.Communica- This series comprised 178 females and 175 males, aged tion. Complete English translationof "Einflusse der between 22 and 95 years. In 179 cases a smoking history Rauchergewolnheiten auf die Haufigkeit unspezifischer was available; there were 106 smokers and 73 non- Atemwegserkrankungen. Ill. Mitteilung." Internationales smokers. The mean percentage volume of bronchial Archiv fur Arbeitsmedizin 27(1/2):49.72, October 30, mucous glands was significantly greater insmokers than in 1970. nonsmokers. It was also greater in males than in females taken over the whole series, probably because of the See Abstract 71-0096. higher proportion of female nonsmokers. There was no significant difference between the mucous gland volume in male and female smokers or between male and female nonsmokers. There was averystrikingdifference, 71-0874. Rode, A., Shephard R. J. The Influence of significantinboth males and females,in both the Cigarette Smoking Upon the Oxygen Cost of Breathing in incidence and severity of emphysema in smokers com- Near-Maximal Exercise. Medicine and Science in Sports pared with nonsmokers. In smokers emphysema occurred 3(2):51.55, Summer 1971. at an earlier age, and the severity of the disease increased markedly with age, possible due to longer exposure to The oxygen cost of hyperventilation was measured in tobacco. The incidence of emphysema remained fairly 6 habitual smokers immediately following the smoking of constant between 50 and 90 years. Emphysema in the two cigarettes. Observations were repeated after one day smoker's lung was predominantly of the centrilobular of deliberate abstinence from tobacco. There was a 13-79 type. The mean percentage bronchial mucous gland those cases with percent decrease in the oxrgen cost of breathing during volume was significantly greater in the periods of abstinence, but in the three heaviest emphysema (18.3) than in those without (14.8). How- ever, there was no simple linear relationbetween the smokers the cost of unit ventilation was still greater than bronchial mucous gland volume and the volume of previously reported values for nonsmokers. The oxygen that usage of the respiratory muscles made a significant emphysema. This adds substance to the view demand upon oxygentransport mechanisms during centrilobular emphysema and mucous gland hypertrophy are two states influenced by a common etiological agent exercise at a nominal 80 percent of aerobic power; in the rather than that they have any direct relation. These heaviest smoker (age 46, smoking 20-30 cigarettes per day for 27 years), the oxygen cost of breathing accounted for findings support the view that tobacco smoking is of 14 percent of aerobic power in "smoking" runs and 9 primeetiological importance in the development of variety, percent in "non-smoking" runs. Abstinence from ciga- emphysema, particularly of the centrilobular rettes had other beneficial effects upon the cardio- whereasitseffect on mucous gland enlargementis respiratory response to exercise; these included a slowing surprisingly small. (Auth. Abs.) of heart rate (9-12 beats/minute) and a decrease of expiratory minute volume. The subjects also sweated less, and found it easier to exercise at a given work load. 71-0877. Shimada, H. Haigan, Toku ni Sono Hasseini (Auth. Abs.) Kansuru 2, 3 no Shiken. (Some Viewpoints on Lung

161 164 NONNEOPLASTIC RESPIRATORY DISEASES

Cancer, Particularly Its Pathogenesis.]Journal of the and Methods of Studying It.] Medical Society of Toho University 17(1):8-12, February Archives Beiges de Medecine SocialeHygiene. Medecine duTravail et 1970, Japanese. Medecine Legate 27:375-387, June 1969, Dutch. Chronic inflammation of the broncho-alveolar system Examination of large populations by standardques- and localized or diffusedfibrosis of the lung often tionnaire and by simple lung function produce a conducive background for pulmonary cancer in tests has contri- buted to the evaluation of the frequency (prevalenceand man. Chronic bronchitis and pulmonary fibrosis caused incidence) of chronic by smoking and air pollution are consideredto be nonspecific respiratory disease (CNRD), to the quantification of certain causalfactors conditions leading to the development of lung cancer in and to a better knowledge of the natural history humans. of this group of diseases. One can estimate that in the European countries one man in three above theage of forty presents some symptoms of CNRD. The most important exogen- 71-0878. Ulmer, W. T., Reichel, G. A Contribution to the ous cause in adults is cigarette smoking. Air pollution Epidemiology of Chronic Bronchitis and to Its Relation alone, particularly in children,can contribute to the to Aix Pollution. Complete English translation of "Zur development of CNRD. Bacterial and viral infectionsof Epidemiologie derchronischen Bronchitis and deren the respiratorytract are probably not important as Zusammenhang mit der Luftverschmutzung." Deutsche primary factors but as causes of complications.The Medizinische Wochenschrift 95(51):2549-2554, Decem- pursuit of epidemiological investigations remains ber 18, 1970. indis- pensible because the techniques of present studies donot permit the detection of the very rust, and possibly See Abstract 71-0103. still reversible functional and morphological alterations,and because the complex interrelation of causal factorscan only be clarified by sufficiently long studieson large 71 -0879. Valdez Ochoa, S., Naranjo, F., Diaz. G. S. numbers of subjects. Simposlo Sobre Problemas Medicos Originados poi el Tabaquismo. I. Alteraciones del Aparato Respiratorio. [Symposium on Medical Problems Originating in Tobac- coism. I. Alterations of the Respiratory System.] Neu. 71-0881. Vidal, J., Cara', P., Robinet-Levy, M., Michel, mologia y CYrugia de Torax 32(1):3-13, January-February F.-B. Bronchopneumopathies Chroniques Familiales et 1971, Spanish. Deficit Homozygote en Alpha ointitrypsine. [Chronic FamilialBronchopneumopathiesandHomozygotic Theirritatingeffectof tobacco smoke onthe AlphasAndtrypsin Deficiency.] Poumon et le Coeur respiratory organs was studied in 100 cases of chronic 27(1):79. 94,1971, French. bronchitisand pulmonary emphysema. The sample consisted of 73 men and 27 women, most of whom were Six cases of homozygotic alphai-antitrypsin defi- over 50 years of age. Of the 70 smokers, 60 were ciency were studied. In the first two cases, which were of determined to be heavy smokers. A direct correlation was the PiZZ phenotype, the deficiency was associated with found between severity of the diseases and intensity of panlobular emphysema in young subjects. Three other smoking habits. Exacerbations of chronic bronchitis and cases corresponded to the PISS phenotype. Of these, two emphysema were more frequent among cigarette smokers. had family histories of chronic bronchopulmonary dis- Respiratoryfunctiontestsindicatedthat respiratory ease, and the third was a healthy subject. The final case insufficiency was more severe in chronic smokers who studied was of the PilS type of deficiency and had also showed carbon dioxide retention and in some emphysema. These six cases resulted from about 350 instances, respiratory acidosis. A second study of 170 investigations.Itissuggested that alpha -antitrypsin patients with bronchogenic carcinoma also indicated that deficiency constitutes an etiological factor in respiratory undifferentiated and epidermoid carcinoma predominated diseases, and although the mechanism of action is not yet in heavy smokers, while adenocarcinoma were more precisely known, it is definitely a factor to be considered frequent in nonsmokers and moderate smokers. among others. A direct relationship was found between respiratory problems and tobacco consumption. Further- more, the presence of respiratory problems in the control 71-0880. Van Ganse, W. De Epidemiologie van CARA: group was less than for the relatives of the patients Probkemstelling en Studiemethodes. [The Epidemiology studied. This difference was particularly marked in men of Chronic Nonspecific Respirator/ Disease: The Problem and in women who did not smoke.

See also 71.0899, 71-0901

165 162 CARDIOVASCULAR DISEASES

infarction 71-0882. Asano, M. Bisai Junkan toKitsuen. [Micro- carriedoutin60 men with myocardial circulation and Smoking.) !gab no Ayumi77(2):65-72, occurring belowthe age of 45. The control group consisted of 120 subjects selected randomlyfrom a 1971, Japanese. similar population. The myocardialinfarction group emphasis on the exhibited a significantly higher proportion ofsubjects A review is presented with particular hours, occu- author's recent work in collaboration withBranemark on with high-school education, irregular work plethysmography to study pational stress and family history of coronary diseasethan the use of microphotoelectric hypertension, and effects of smoking on human microcirculation. the controls. The incidence of arterial serum cholesterol and triglycerides washigher in the patients than inthe controls. A significantly higher with a 71-0883. Bhagat, B., Ruehl, A., Rao, P.,Rana, M. W., proportion of cigarette smokers (97.6 percent) Hughes, M.J.Effect of Cigarette Smoke onthe long history of this habit was found inthe patients than Cardiovascular System inDogs. Proceedings of the in the controls (74.1 percent). The groupsdiffered also in and in selected SocietyforExperimentalBiologyandMedicine the distribution of ABO blood groups 137(3):969-972, July 1971. anthropometric indices. Certain factorsconuilv:!Ing to earlier development of coronaryarterydiseaseare A study of the effect of inhalation ofcigarette smoke discussed. (Auth. Abs. Mod.) on the hemodynamics of thedog is reported. Various known pharmacological agents, such astyramine, pro- used to pranolol, , and nicotine, were Heart modify the response to tobacco smoke in an attemptto 71.0886, Comstock, G. W. Fatal Arteriosclerotic in that effect. It Disease, Water Hardness at Home, andSocioeconomic gain insight into the mechanism involved Journalof Epidemiology was concluded that thereduction in aortic blood pressure Characteristics. American during smoking in anesthesized animals maybe attributed 94(I):1-10, July 1971. in part to the central effects of nicotine andin part to the catechol- Several reports have indicated an inversecorrelation vasodilation caused by the action of released supplies and amines on the peripheral beta-receptors. between the hardness of community water deaths from arteriosclerotic and degenerativeheart dis- ease. An unusual opportunity tolook at this association County, Maryland. 71-0884. Boudik, F. Srdecni lnfarkt a Kotueni.[Myo- in more detail arose in Washington Leitaru Drinking water sources there vary markedlyin hardness, cardialInfarctionandSmoking.]Casopis possible to match Ceskych 110(26):614-620, July 25, 1971,Czech. and a private census in 1963 made it cases and controls from the samedefined population and socioeconomic characteristics. Data on myocardial infarction from thehistories of to study a number of number of 8292 During the next three years, there were189 deaths 611 men ages 52-67 years from a total arteriosclerotic and degenerative heart investiga- attributedto examined were assessed in an epidemiological disease among white males aged 45 to64 who could be tion. With regard to smoking before the onsetof the controls were smoking only identified in the census. For each case, two disease (90.1 percent of ex-smokers stopped randomly selected from the census lists andmatched for after they developed the disease), theprevalence of samples were collected cigarette race, sex and year of birth. Water myocardial infarction was significantly higher in from the residences of cases and controlsand examined smokers than in nonsmokers. In subjects whosmoked of arterio- disease, there for total hardness. No significant association fewer than 24 cigarettes per day before the sclerotic and degenerative heart disease deathscould be was a statistically significant differencein prevalence as were those who stopped found %frith water hardness. Deaths from these causes compared with nonsmokers. In more common among personsof lower socioeconomic smoking after the onset of the disease, theprevalence was persons who statistically significantly higher as compared with non- status, among cigarette smokers, and among attended church infrequently. Theproportion of fatal smokers. cases and controls who had eversmoked pipes was almost the same, while considerably fewer casesthan expected had smoked cigars. The decreased riskof arteriosclerotic 71-0885. Ciswicica-Sznajderman, M., Sznajderman.M., associated with cigar inska, E., and degenerative heart diseases Januszewicz, W., Dzierzyluay-Rogalski. T., Prom smoking was not related to cigarette smoking,since both J. BadaniaKliniczneiMetaboliczre Charzewski, Sena. smokers and nonsmokers of cigaretteshad lower risks if Mezczyzn z Pluebytin w Mlodym Wieku Zawalem they had ever smoked cigars. The riskof arteriosclerotic [Clinical and Metabloic Studies in Men WithMyocardial and degenerative heart disease forcigarette smokers was Infarction at Young Age.) Polski TygodnikLekarski dose-related, and was 26(31):1185 -11$8, August 2, 1971, Polish greater than for ex-smokers, was most marked for those consuming morethan two packs of daily. Although water hardness is notlikely to be a real Detailed clinical examinations and determinations the role of trace certain biochemical and anthropometric indices were risk factor for cardiovascular disease,

163

1 66 CARDIOVASCULAR DISEASES

elements in home drinking water supplies should be throughthe investigated. thromboticmechanism. Hyper- cholesterolemia or other forms of hyperlipidemia, which in turn reflect dietary habits or endocrine imbalance.may affect the tendency to thrombosis through the effect of 71-0887. Corre, F., Lellouch, J.. Schwartz, D. Smoking plasma lipids on blood coagulation, platelet propertiesor and Leucocyte-Counts. Results of an Epidemiological thefibrinolyticmechanism. There Survey.Lancet isevidencethat 2(7725):632-634, September 18, 1971. cigarette smoking can affect platelet behavior and will shorten the thrombus formation time in an artificial A study of 4264 men showed that the number of system. Catecholamines released suddenly into the blood leucocytesisincreasedin cigarette, cigar, and pipe canpotentiatebothplateletaggregationand blood smokers, notably in those who inhale. The increase is coagulation and might therefore be a factor about 30 percent for a heavy smoker who inhales, in the increase in the disease which is attributed to psychological compared with a nonsmoker. Investigation of a subgroup stress. The benefits of physical activity may be related of 483 men of the same population confirmed this finding to more effective fibrinolysis or to better collateral develop- and revealed that the increase was in granulocytes, ment which enables the individual to compensate better lymphocytes, and monocytes. The differential leucocyte- for the various thrombotic events. count showed no real change. (Auth. Abs.)

71-0890. Gross, W., Bialek, R., Schade. G., Juchems R. 71-0888. Fink:ea, J. F., Hasselblad, V., Riggan, W. II., Changes of the Serum Lipids Due to Smoking. Complete Nelson, W. C., Hammer, D. I., Newill, V. A. Cigarette English translation of "Serumlipid-Veranderungen beim Smoking and Hemagglutination Inhibition Response to Rauchen,"DeutschesMedizinischesJournal InfluenzaAfterNatural Disease and Immuniza- 21(6).368-374, March 20, 1970. tion.A mericanReviewofRespiratoryDisease 104(3):368-376, September 1971. SeeAbstract 70-0636.

Vaccination, illness. and smoking history were com- piled for a young adult male population. The relationship 71-0891. Hagerup, L. Tobaksrygning og Koronare Risiko- ofcigarette smoking to hemagglutination inhibition faktorer. Fra SO Ars Undersogelsen i Glostrup. (Tobacco antibody response after exposure to a new antigen was Smoking and the Risks of Coronary Disease. From a assessed in serum specimens collected from 289 volun- 50-Year StudyinGlostrup.]Ugeskriftfor Laeger teers after the 1968 A2/Hong Kong/68 influenza epi- I33(27):1309-1313, July 9,1971, Danish. demic. Titers were minimally increased among smokers who were sick compared with those of nonsmokers. The incidence of the so-called coronary risk factors in Among smokers who remained well. titers were signifi- relation to tobacco smoking was investigated in 50 -yea:- cantly increased, probably because of more frequent olds (436 males and 366 females) in Glostrup. No subclinical infection. The persistence of hemagglutination constitutionaldifferences were found between non- inhibition antibody after natural infection or vaccination smokers, ex-smokers and smokers, but significantly less with A2 antigens was significantly decreased among skin-fold thickness was encountered in smokers of both cigarettesmokers,asweretiterstwo weeks after sexes. As assessed by serum creatinine, a relationship was vaccination. Serologic response to vaccination did not found between smoking and renal funtion. However, no significantly differ between smoking groups. Smoking, relationship was found between smoking and cholesterol vaccine history, and morbidity status during an influenza or scrum triglyceride. An association was demonstrated epidemic were significant factors in explaining variations between the resting pulse and smoking as increased in hemagglutination inhibition antibodytiters. (Auth. cigarette smoking resulted in increased resting pulse in Abs.) males and lowered resting pulse in females. This associa- tionwas connected withthe relationshipbetween smoking and increases in hemoglobin and hematocrit 71-0889. French,J.E.Atherogenesis and Throm- which may result in alterations in the viscosity of the bosis.Seminarsin Hematology8(1):84-94, January blood. This is of significance for tissue circulation and 1971. thus for cardiac function. The effect of smolcing on the heart was demonstrated by increased incidence of angina The evidence indicates that thrombosis can contribute pectoris in smokers whereas ST alterations in the ECG at to the formation of atherosclerotic lesions at all stages of rest and after exertion were not more frequent in smokers their development and emphasizes the crucial role of the than in nonsmokers. The role played by smoking in the blood platelets. The evidence that microthrombi can pathogenesis of arteriosclerosis has not yet been eluci- initiate the lesion is the least substantial but this in no dated. Its combination with other risk factors is presumed way detracts from the undoubted importance of mural to be of significance for the prognosis of arteriosclerotic and occlusive thrombosis in the later stages of the disease. conditions. A consideration of the role of thrombosis in atherogenesis does not preclude the importance of other atherogenic mechanisms. Thus, mechanical factors are important in 71-0892. Horwitz, 0., Long, E. T., Malamed, M., Taylor, the localization of surface deposits, metabolic changes N. Results of Screening Patients for Peripheral Vascular within the arterial wall modify the composition of the Disease by Paramedical Personnel.Transactions of the deposited materialwhilethefiltrationmechanisms, AmericanClinicalandClimatologicalAssociation operating at all stages of the disease, can add plasma 83:218-226, October 26,1970. constituents to the composition of the plaque. Some of the so-called risk factors, which have been shown by A method is described for screening a large number of epidemiological studies to have predictive value in relation subjects in a short period of time for the presence of to the onset of ischemic heart disease, may be operating peripheral vascular disease without the immediate pre-

-167 164 CARDIOVASCULAR DISEASES

sense of a physician. The judgmentof trained paramedical diseases are reviewed. The effects of smoking on blood personnel compares favorably with that of physicians in flow, cardiac rhythm, and on electrocardiographic results this small sphere of interest. Both arterial and venous are described. Tobacco represents an importantrisk factor insufficiency can be demonstrated at an early stage when in coronarydisease. Although the physiopathological prophylactic and often therapeutic measures can be most mechanisms are not yet clear, and the long-term effects of effective. It was observed that age is certainly a factorin the use of tobacco need further investigation, there is arterial disease; nearly half of the positive resultsoccurred sufficient indication from present knowledge to recom- in patients over 70 and nearly two thirds in patients over mend total abstention from tobacco in all those having 60. A higher percentage of patients witharterial disease coronary atherosclerosis. smoked. There was also a higher percentage of malesthan of females having peripheral arterial disease. 71-0896. Koidakis. A. Ai Skhesis tou Kapismatos Pros tiv Artiriosklirotikiv Aggiakiv losou. (Tobacco Smoking and 71-0893. Iglesias Leal, R., Canis, T. N., Lancaster,M. C. AtheroscleroticVascularDisease.]latr iki Infanta del Miocardio Silencioso y Atipico. [Silent and I9(2):169-182, February 1971,Grcek. Atypical Myocardial Infarct.]Archiros del hinituto de Cardiologia de Mexico 4 I (3): 249 -254 ,May -June 1971, The effects of smoking in coronary heart disease and occlusive peripheral arterial disease are reviewed. The Spanish. greaterpart of the epidemiological andpathological In the School of Aerospace Medicine from 1959 to investigations point to evidence that smoking is associated 1968, 520,000 electrocardiograms of members of the U.S. on the one hand, with an increasedincidence of coronary Air Force were analyzed. During this period. 42 cases of heart disease and sudden death, and on the other,with silent myocardial infarction and 44 cases of "atypical" occlusive peripheral arterial disease of atherosclerotic or infarction were detected and evaluated. The general group other origin. The physiological effects of smoking on the was comprised of subjects with a family backgroundof cardiovascular system as well as its probable relationship heart disease, a high percentage of body fat, a heavy to the development of atherosclerosis and coronaryheart smoking habit, and a high incidence of predisposing disease are discussed. In particular, the effect of nicotine diseases, such as diabetes mellitus and arterial hyper- on the sympathetic nervous system andthe release of tension. The clinical picture in the "atypical" group catecholamines, on lipid metabolism, platelet aggregation, simulated diverse ex tracardial disorders; those attributable and blood coagulation mechanism are discussed. Also the to the respiratory and digestive tract predominated.In 17 studiedisthe hypothesis that smoking affects ofthe 86patients,the electrocardiograms became smoker's personality and behavior. Finally, the opinions normalized upon adoption of a program of controlled of many investigators who believe that smoking has dangerous effects especially in persons who have clinical physicalexercise,a low-fatdietweight reduction, suppression of tobacco and control of the associated manifestations of coronary atherosclerosis are quoted. diseases. (Auth. Abs. Mod.)

71-0897. Lilis, R.. Tccukscu, D., Rovnta, A., loncscu, 71-0894.lsager,H., Hagerup,L. Tobalcsrygning og Niveaueme for Haematokrit og Haemoglobin. Fra SO Ars S., Cristescu, 1. Cercetari Epidemiologice Privind Cardio- Undersogelsen i Glostrup. [Smoking and Hematocrit and patia Ischemica in Industrie. Studiul Unui Grup cu Efort Levels. From a 50-YearStudyin Fizic Minim (Ingineri, Tehnicieni, Proiectand). [Epide- Hemoglobin miological Investigations on Ischemic Cardiopathy in Glostrup.]Ugaktift for Laeger133(27):1307-I309, Industry. Study of a Group Involving Minimal Physical July 9,1971, Danish. Work (Engineers,Technicians, Designers).]Medicina In a study of 394 men and 339 women, all aged 50, a Interim 23( 3):273-291, March 1971, Rumanian. positive correlation between cigarette consumption and hematocrit was found in both sexes.In women, a The study included a group of 295 employees of a statistically significant correlation was also found between machine building plant, whose activity was prevalently cigarette consumption and hemoglobin concentration. sedentary (engineers, technicians, designers). The same methods were used as in a previous study including two Hematocrit values above normal range were more com- of work: 286 mon in cigarette smokers than in other kindsof smokers groups of employees with a different level or nonsmokers. This difference was statisticallysignificant forgers and rolling mill workers (heavy work) and 119 milling machine and lathe operators (light work). The in males. A statistically significant negative correlation triglycerides did not between cigarette consumption and lung function (forced mean values of total cholesterol and expiratory volume in one second) was found, but there significantly differ in the group of technicians from those was no evidence of anyrelationship between lung found in the "light work" operatives; the differences function and hematological variables. From these results were, however, statistically different incomparison with it was concluded that the association between cigarette the "heavy work" operatives. The beta/alpha-lipoprotein smoking and hematological variablesis probably not ratio had in general higher values among the technicians secondary tothe relationship between cigarette con- than, in the "heavy work" employees. The incidence of sumption and lung function. (Auth. Abs. Mod.) angina pectoris among the technicians (4.7 percent) did not differ significantly from that of the"light work" operatives (4.2 percent), but was significantly higher than 71-0895. Jan, F., Grosgogeat, Y. Tabac et Cosonaires. inthe "heavy work" operatives (2.2 percent). The andCoronary Disease.] VieMedicale proportion of nonsmokers was greater in the technicians (Tobacco Master test 52(25):3019-3026, July 1971, French. group than in the "light-work" operatives. The was more frequently positive among thetechnicians (4.2 Epidemiological and experimental findings which percent)than inthe "heavy work" operatives (1.6 indicate a relationship between tobacco and coronary percent). The difference was not significant between the

165 168 CARDIOVASCULAR DISEASES

technicians and the "light work" group. The results show monary complications and in nonsmokers than in those the unfavorable effect of reducing occupational physical without this history and in smokers. Alveolar capillary work upon cholesterolemia and triglyceridemia levels, as collapse or occlusion may also have reduced Dm in well as upon the incidence of angina pectoris and positive sickle-cell anemia and accounted for the greater reduc- Master test, significantly higher among the subjects whose tions in those with previous pulmonary episodes and in activity is characterized by reduced physical work. The nonsmokers. (Auth. Abs.) absence of significantdifferences of the risk factors studied and prevalence of ischemic cardiopathy between the"light work" operatives and the engineers and 71-0900. Nieveen. J., Doorenbos, H., Chappin, J.J.M.L., technicians is of particular interest bearing in mind the Hartman, L. A., May, J. F., Temmem-Brak, T. M., Visser steady decrease in the load of physical work in most J.W.E., Wall, E.v.d., Wouda, A. A. Risicofactoren Voor occupations in modern industry. The preventive measures Coronaire Hartziektenbij Jonge Managers. [Coronary necessary for controlling the unfavorable effects of a low Disease Risk Factors in Young Managers.]Nederlands physical activity in industrial employees are emphasized. Tijdschnit Voor Geneeskunde I15(32):1332-1337, (Auth. Abs. Mod.) August 7, 1971, Dutch.

71-0898. Mathiesen, F. R., Larsen, E. E., Wulff, M. R. The risk factors of coronary disease were assessed on Arterial Insufficiency in the Legs. I. A Clinical Statistical thebasis of an enquiry among 605 young managers Analysis.Acta Chirurgica Scandinarica136:477-481, between 30 and 40 years and of an extensive examination 1970. of a group of 36 of these persons. Factors such as lack of exercise, smoking and obesity were encountered in a high A statistical analysis was made of those factors which percentage of those examined. Carbohydrate tolerance may modify the clinical symptoms of ischemia in 333 and lipid levels werc also abnormal in a surpisingly large patients suffering from arteriosclerosis of the legs. There proportion of the group subjected to extensive examina- was a relatively high incidence in ischemic ulceration in tion, whereas electrocardiogram (ECG), vectorcardiogram patients over 65 years of age, in patients witha short and telemetric examination revealed disorders in only a historyof symptoms,indiabeticand hypertensive small proportion. Emphasis is laid on the importance of patients, and inpatients with relative anemia, while preventing coronary disease and advising more exercise, patients with a familial history of arterial disease showed no smoking, fewer calories (especially less saturated fatty a low incidence of ulcer. Sex and smoking habits of the acids and sugar), adequate treatment of predisposing patientsdidnotinfluencethe distributionof the diseasessuchashypercholesterolemia, hypertension, symptoms. Age, length of symptoms, diabetes, hyper- diabetes, etc. The question is raised whether a population tension, sex, hemoglobin percent and smoking habits did study using ECG examinations zxclusively has any value if not effect the localization of the ulcers. A long history of carbohydrate tolerance tests and lipid fraction tests are symptoms was combined with a relatively high incidence not made at the same time. Even if these more elaborate of bilateral symptoms, while age, diabetes, hemoglobin examinations were to be performed, it remains doubtful percent,sex,familyhistory of arterial disease and whether the effects, although somewhat more direct and smoking habits had no certain effects. Nineteen percent personal, would be of much more value than continued of the investigated extremities were presented by patients emphasis on the well-known and generally recommended who did not smoke. measures (to say nothing of the danger of provoking anxiety complexes in unsuspecting people). Prevention based on general advice (especially through parents and 71-0899. Miller, G. J., Serjcant G. R. An Assessment of educators) and on economic measures (diet, tobacco, etc.) LungVolumesandGasTransferinSickle-Cell is of even greater importance than adequate treatment Anaemia. Thorax 26:309 -315, May 1971. andrehabilitation of persons already suffering from coronary disease. (Auth. Abs. Mod.) Lung volumes, gas transfer, and anthropometry were assessed in sickle-cell anemia in 13 patients with previous pulmonary episodes and 12 without this history. Respira- 71-0901. Parade, D. Cor Pulmonale and Smoking. Com- tory symptoms were assessed with a standard question. pleteEnglishtranslationof"CorPulmonale and naire, total lung capacity and its subdivisions, the carbon Rauchen,"Medizinische lainik64(2):80-84, January 10, monoxide transfer factor (TF), diffusion capacity of the 1969. alveolarcapillary membrane (Dm), and the alveolar capillary blood volume (Vc) were measured, and stature, Nicotine abuse in the development of cor pulmonale sitting height and chest diameters were recorded. Total was investigated in 177 patients (135 men, 42 women) lung capacity and vital capacity were reduced because the with EKG signs of right overloading. Twenty-nine patients thorax was small relative to body size in these patients. showed clinically significant signs of a chronic bronchitis TF was reduced by anemia, small lungs, anda low Dm with emphysema. Smokers were relatively more numerous which was not simply a consequence of small lungs. This in this group. The development of cor pulmonale can have reduction tended to be offset by an increase in Vc. The different causes with bronchial asthma, lung emphysema cause of the reduction in Dm above that due to small as well as further parenchymal and vascular changes being lungs was probably located in the pulmonary circulation. very important in this respect. Chronic nicotine abuse Anemia was considered unlikely to be responsible, and plays an important role herein. Inhalation of tobacco although a difference between the reactivity of carbon smoke in nonindustrial areas is the most important factor, monoxide with Hb A and Hb S may have contributed to as compared with other forms of air pollution, in the the reduction in Dm and the increase in Vc, itwas development of cor pulmonale. A relatively high coinci- thoughtunlikelytobetheonly cause: Dm was dence of an obstructive bronchitis with a peptic ulcer was significantly lower in patients with a history of pul- observed. The number of smokers with peptic ulcer

169 166 CARDIOVASCULAR DISEASES

chronic exposure to showing EKG indications of right overloading of theheart present in these places of work the carbon monoxide does not represent a primaryetiological was also relatively high. factor in the development of scleroticchanges of the vessels, but that in persons with sclerotic vessels,the Quintero, A. increase of anoxia associated with a higher exposure to 71-0902. Paras Chavero, E., Mercado, E., carbon monoxide might lead to more serious changesof Simpado Sobre Problemas Medicos Originados poiel the organs. Tabaquismo. II. Aheraciones Cardiovascular.(Symposium on Medical Problems Originatingin Tobaccoism. H. Cardiovascular Alterations.]Neumologia y Cirugia de 71-0904, Reimer, E. E., Tiso, B. DerMyokardbtfarkt. Spanish. Torax 32(1):15-18, January-February 1971, Vergleichende klinische und therapeutischeErgebnisse. Thera- infarction, the [Myocardial Infarct. Comparative Clinical and In a group of 106 men with myocardial peutic Results.]Weiner Zeitschrift fur InnereMedizin relationship of smoking and coronary disease wasinvesti- 1971, German. gated. Thirteen percent of the patients werenonsmokers. und litre Grenzgebiete 52(7):330 -350, The only difference observed betweenthe nonsmoker and end of 1969, a day) and From the middle of 1963, until the the moderate smoker (less than 20 cigarettes per total of 729 patients suffering frommyocardial infarct, the heavy smoker was the degree ofpulmonary emphy- experience gained from 280 nonsmoker, and up to 75 were hospitalized. The sema: 28 percent for the patients between 1963 and 1966 wascompared with that percentforthe heavy smoker. Mortalityinacute infarct during the thy heavy gained for 449 patients with myocardial myocardial infarction was 16 percent for period 1967-1969. Up to 1966 aconsiderable number of smoker and 7.8 percent for the moderatesmoker and number of patients following the rust authors reported an increase in the nonsmoker. Survival after three years with myocardial infarct and ofmyocardial infarct fatal attack was 12 percent lower for theheavy smoker than cases, there have been no reportsof any noticeable for the moderate smoker. Althoughthe patients were increase since then, a fact which isalso confirmed by repeatedly warned of the danger ofcontinued smoking of myocardial of the heavy Austrian health reports. The percentage after myocardial infarction, 50 percent infarct compared with the total numberof patients in the smokers continued their habit. The riskof a second Kaiser Franz Joseph Hospital in Vienna wasbetween 7.7 smoking. In infarction differs greatly if the patient stops and 10 percent during the pastfew years. Among these, a smokers, 32.4 percent suffer a secondinfarction within female and young in non- considerable rise in the number of three years, as compared with 15.6 percent patients was observed. The concurrenceof risk factors smokers. such as obesity, hypertension,diabetes mellitus and hyperlipemia are very important inthis connection. Among the younger patients addedriskfactors are 71-0903. Prerovska,1., Drdkova, S. Der Eilsiluss der nicotine abuse, sues! and focal damage.The percentage of chronischen Einwirkung von Kohlenoxydauf den Mini- smokers dropped from 62 percentin the 1963-1966 schen Zustand und biochemischeVeranderungen urn group to 46 percent in thelater group. The percentage of Serum exponierter Personen in Hinsichtauf die vorzeidge occlusive arteriopathies among infarctpatients is twice as of Chronic Entwicklung der Atherosklerose. (Influence high as in a similar group withintact arteries. About 74 Effect of Carbon Monoxide onClinical State and percent of the patients in theobliterating arteriopathies Biological Changes in the Serum of ExposedPersons With group are smokers. Recenttherapeutic techniques for RespecttoPrecociousDevelopmentofAthero- myocardial infarct are also discussed.It is estimated that sclerosis. InternationalesArchly fur Arbeitsmedizin total mortality can he reduced to23 percent. Excluding 28(2):175-188, 1971, German. patients who are already dead onarrival or prior to the installation of efficient therapeutictechniques, the mor- In 1964 a group of 50 workers (40carbonization tality rate is as low as 12.9 percent. workers of a chemical plant and 10 gasmain workers), age 20 to 40 years was examined, togetherwith an equally carbon monoxide in the large control group. The values of 71-0905. Russek, H. 1. 'Progress' in the Treatmentand atmosphere varied, in some casesmeasuring up to 0.1 Prevention of Coronary Heart Disease. AmericanFamily volume percent, while the level ofcarboxyhemoglobin in Physician 4(3):68-74, September 1971. the blood was between 2-26 percent.The exposure lasted 10.5 years on the average. Internalexamination supple- examination of the Various alternatives available to the physician inthe mented by blood pressure, EKG, particularly in fundus of the eye and determination of serumlipids did drug therapy of ischemic heart disease, alleviating the symptoms and disability and incontrolling not show any deviations suggestingearly development of 1970 both the underlying atherosclerotic process ofthe disease, are atherosclerosis in the exposed workers. In described. Despite significant advances in the treatmentof groups were checked in the same way.During the six-year changed. Of the angina pectoris and myocardial infarction, it appearsthat interval, the degree of exposure had not ischemic heart original group of 50 persons 37 workers,32-48 years of the overall morbidity and mortality from disease has not been appreciably altered is the U.S.in the age, had continued workingin the hazardous environ- of 17.5 years. With past two decades. Evidenceindicates that a high-fat diet ments, the exposure lasting an average starting the exception of two nonsmokers,the exposed persons and stressful living form a lethal combination daily. The clinical early in life. The statistical evidence linkingsmoking to smoked from 15 to 40 cigarettes importance of condition of the workers of the hazardousenvironments coronary heart disease may reflect the substantial arterio- stress rather than cigarettes per se.This is borne out by did not show any earlier or more have practiced sclerotic changes than the population ofsimilar age span. the fact that physicians, who as a group did not exceed the greater tobacco abstinence than any other groupwithin The average values of serum lipids the general population, appear to die at the same average normal range. It is concluded thatunder the conditions

167 170 CARDIOVASCULAR DISEASES

age as before this abstinence trend began. Alterations in nary arteries. Severe atherosclerosis is a metabolic disease diet, physical training and environmental relaxation could of multiple causes in which altered lipid metabolism plays prove effective prophylactically only if instituted early in a crucial role. In terms of primary prevention, there are childhood and maintained as a lifetime practice. four riskfactorsin coronary heart diseasethat are amenable to control: habitual diet high in cholesterol and saturatedfat,hyperchoksterokmia, hypertension and 71-0906. Sartwell, P. E. Oral Contraceptives and Throm- cigarette smoking. In relation to smoking, exposure to boembolism: A Further Report. American Journal of carbon monoxide, in amounts akin to those inhaled by Epidemiology 94(3): 192-201, September 1971. habitual smokers produced more severe lesions in animals Additional fed an atherogenic diet than in controls fed only the findings from a case-control study of harmful diet. However, the mechanisms involved in how thromboembolism and oral contraceptives are presented. smokingaggravatesatherosclerosis remains unsolved. There was some association of smoking with recent use of Whatever the mechanisms. epidemiological studies have orals, but no evidence that smoking enhanced their effect shown that where a population has a high incidence of in producing clotting. Data on frequency of use of all hypertension and cigarette smoking but its dietary pattern contraceptive methods by cases and controls, according to make hyperlipidemia infrequent, morbidity and mortality age and religion. are presented. No evidence was found that other drugs taken by subjects enhanced the risk of for myocardialinfarct and other forms of coronary disease remain generally low. When all three risk factors thromboembolism. Some problems in the design of such are present they have a more than additive impact on studies are discussed. A probable difference in the use of oral contraceptives between those subjects who were coronary morbidity and mortality. Recommended pri- mary preventive measures include dietary changes to interviewed and those who were notis shown. Itis demonstrated that matching on factors associated with prevent or control hyperlidemia, obesity, hypertension the dependent variable can produce a spurious decrease in and diabetes; elimination of cigarette ...molting; and relative risk when the data are pooled. (Audi. Abs.) pharmacologic control of elevated blood pressure.

71-0907, Schwartz, D., Richard, .1. L., LellouchJ., Claude, .1. R. Serum Lipids, Smoking and Body Build, Studyof7,972Actively EmployedMales. Revue 71-0909. Teraslinna, P., Partanen, T., Koskela, A., Oja, P, Europeenne d 'EtudesCliniquesetBiologiques Association of Certain Social Habits and Attitudes With 16:529 -536, 1971. Risk Factors of Coronary Heart Disease. Social Science and Medicine 5(3):243-250, June 1971. Cholesterol measurements were made in 7972 Parisian males; triglycerides were also measured in 1972 subjects A sample consisting of 1314 manager-executives was chosen randomly from the same group. A significant studied to determine whether certain personal habits, real tionship between triglycerides and smoking was found social attitudes and evaluations are associated with risk in the 25-29 age group and a moderate relationship in the factor and estimated risk of coronary heart disease 4044 and 45-49 age groups. Although there was no (CHD) in a cross-section of a male population relatively significant associationforthe other age groups, the homogeneous in social class, status and occupation. The age-adjusted correlation between triglycerides and smok- ing over all age groups was highly significant. As for risk factors studied were systolic and diastolic blood pressures, serum cholesterol, there exists, at least in subjects under 50, a cholesterol, and predicted maximal weak relationship which is revealed particularly when oxygen uptake. Personal habits and attitudes, determined body build is taken into account, because of opposite by questionnaire. were: dissatisfaction with work and associations between body build and either cholesterol (a with family; insufficiency of sleep,leisure time and positive one) or smoking (a negative one). The fact that physical activity ;and current frequency of cigarette age and Cody build were usually not taken into account in smoking, alcoholuse and evenings spentat home. studies reported in the literature could explain their Age-adjusted systolic blood pressure showed the highest apparent discrepancy with the results of the present correlation with infrequency of cigarette smoking. Fre- study. The relationship between smoking and cholesterol quencies of cigarette smoking and alcohol use formed the and its possible disappearance over the age of 50 needs highest correlating combination with systolic blood pres- further investigation. The relationship is, in any case too sure. However, the additional explained variance due to weak for the increased risk of arterial diseases associated alcohol use was not significant. Diastolic blood pressure with smoking to be due to an increase in serum lipids. was relatively independent of the social variables, showing no significant correlation with any of them. Frequencies of cigarette smoking and alcohol use gave the highest 71-0908, Sta..ler, 1. The Primary Prevention of Coronary correlating two - variable function with both age-adjusted Heart Dims:. Hospital Practice 6(9):496 I, September serum cholesterol and CHD risk measure. Increased 1971. frequency in both cigarette smoking and alcohol con- sumption corresponded with increased values of serum In nearly all cases of coronary heart disease, the cholesterol and CHD riskfunction. Maximal oxygen underlying process is severe atherosclerosis of the coro- uptake was associated with frequency of physical activity.

See also 71-0806, 71-0807, 71-0826, 71-0832, 71-0843

171. 168 OTHER DISEASES AND CONDITIONS

Problemas 71-0910. Hauser, G. A. Genussmittel in der Schwanger- 71-0913. Perales Goitia. M. G. Simposio Sobre Medicos Originados pot el Tabaquismo. IV.Alterationes schafs(VoluptuariesinPregnancy.)Therapeutische (Sym- Umschau 28(7):430434, July 197 I, German. Morfologicas en Diferentes Organos y Sistemas. posium on Medical Problems Originatingin Tobaccoism. IV. Morphological Alterations inVarious Organs and The effects of alcohol, tobacco and drugs on the Systems.) Neumologia r Cbugia de Torax32(1):27-29. human system, particularlyin pregnancy, are briefly summarized. Alcohol-consuming women eat less, which January-February 1971. Spanish. possible protein can result in a vitamin deficiency and a A review of several studies onmorphological altera- deficiency in the mother. Passage of alcohol through the Severe athero- placenta can injure the fetus and passage through the milk tions related to smoking is presented. sclerosis is more frequent in smokers 145.9percent) than of mother can also adversely affect the child. Tobacco esophagus, clear smoke, through its chief constituent, nicotine, has a in nonsmokers (15.3 percent). In the changes were observedinsmokers as compared to harmful effect on theneurovegetative system, with has a causal than men. Smoking during nonsmokers. Perhaps pulmonary emphysema women more susceptible relationship with gastric and peptic ulcersand both pregnancy leads to an increased incidence of premature conditions are in turn affected by smoking.Changes births, hyperemesis, preeclampsia and disturbances of found in the respiratory tract are much morefrequent in labor. Passage of nicotine through mother's milk results in smokers. There is increasing evidenceof the association of a lower body weight of the nursing infant.Precise data on the effects of children of mothers under narcotics are tobacco smoking and bronchogenic carcinoma. lacking but some harmful consequences are noted.

71-0914. Richardson, J. F. The Dietary Sugar Intakeof A Businessmen; theResults of a Cross-Sectional Sur- 71-0911. Henry, H. B. Eustachian Tube Blocking: (Supple- Method of Treatment. Journal of theLouisiana State vey.PostgraduateMedical Journal Medical Society I 23(8):286-288, August 1971. ment):423426 , J unc 1971. which Yudkin's questionnaire on the dietary intake of sugar A method of treating eustachian tube blocking self-administration. A can be used in office practice andwhich gives uniformly was given to 415 businessmen for stop significant inverse relationship was found between the good results is described. Patients are advised to of smoking as part of the treatment since tobaccosmoke or total sugar intake and relative weight in this group and the middle-aged men. The mean sugar intake of current allergy to tobacco are felt to cause blocked ears of associated symptoms of sinus trouble and postnasaldrip. cigarette smokers was significantly higher than that the lower Other researchers believethatthetars and carbon current non-cigarette smokers, this was due to monoxide from tobacco smoke are the irritatingfactors sugar intake of the ex-smokers, as there was nodifference those or that the smoke componenthas a ciliosta tic effect in mean sugar intake between current smokers and leading to failure of the middle earclearance. The who never smoked. Part of the variation may be attri- vasomotor effect of nicotine and the localirritative effect buted to the higher age of the ex-smokers and the higher percentagerestrictingtheir sugar intake. The results of the smoke may also play roles. suggest that sugar intake of these subjects varies with time. Consequently, longitudinal studies are indicated to elucidatetherelationship between sugar intake and 71-0912. Khosla, T., Lowe, C. R. Obesity and Smoking ischcmic heart disease. Studies confined to those who Habits. British Medical Journal 4(5778):10-13,October state that they are not restricting their sugarintake may 2, 1971. give misleading results. A large-scale survey of steel workers in South Wales has shown a considerable difference between thebody weights of smokers and of nonsmokers. The difference 71-0915. Rousset. .1.-J.. Lauvergeat, J.-A. Protozoaires Increases with age so that men over 40 years whohave Buccaux. Enquete Epidemiologique. Oral Protozoa. Epi- never smoked bre on average 13 lb(5.9 kg) heavier than demiologic Study.)Presse Medicate 79(33):I495-1497, smokers. EvenL..;, smokers are about 15lb (6.8 kg) July 3,1971, French. heavier than the weight standard considered desirableby the Metropolitan Life Insurance Company, while non- The endemic occurrence of Entamoeba gingivalis and smokers are neatly 30 lb (13.6 kg) heavier. About 20 Trichomonas tenax in 250 young and apparently healthy percent of the men are attempting to give upthe smoking adult males was investigated. The pathogenicity of Tri- habit, Ex-smokers who have given up smoking for more chomonas tenax is discussed as one of the factors of than eight years approach the body weight of menof the alveolodontal pyorrhea. Special emphasis is given to the aggravations by gingival irritants, such as tobacco. Heavy same age who have never smoked.(Auth. Abs. Mod.)

169

172 OTHER DISEASES AND CONDITIONS smokers (over one pack per day) are notably more to the alkaloid resulted in significant secretory inhibition, affected than nonsmokers: 20 percent to 5.2 percent which could be overcome by sub-maximal doses of flagellate protozoa present, respectively. Direct mouth to IC1-50123. The increase in acid output following chronic mouth contamination seems probable. nicotine injections can be further increased by ICI- 50123. Possible mechanisms of both acute and chronic nicotine. induced secretory changes are discussed. 71-0916. Shaikh, M. I., Thompson, J. H., Aures, D. Acute and Chronic Effects of Nicotine on Rat Gastric Secre- tion.Proceedings of the Western Pharmacology Society 71-0917.Waters, W. E.Smoking and Neuroticism. Brit- 13:178-184, 1970. - ishJournalofPreventive andSocialMedicine 25(3):162-164, August 1971. Acute and chroniceffectsof smoking doses of nicotine on gastric juice volume, and acid and pepsin A standard questionnaire, which was completed by output were investigated in two-hour pylons- ligated rats 1,718 individuals (93.5 percent of the available sample) under basal conditions, and following stimulation with selected at random from the electoral roll asked about synthetic gastrin, ICI-50123. One hundred and seventy smoking habits and included questions from which a male Sprague-Dawley rats were chronically injected sub- grade for neuroticism was obtained. The results suggested cutaneously with saline or 100 micrograms of nicotine that, in women, smokers are more neurotic than non- base/ml/kg in saline 3 times daily for 15 days. The smokers, and there was a statistically significant correla- pylorus was ligated and the following drugs were injected tion between the number of cigarettes smoked per day acutely during the two hours of collection: ICI-50123, and the neurotic grade. (Auth. Abs.) 200 micrograms/kg/hour insaline; ICI-50123 control solution, 1 ml/kg/hour; nicotine and nicotine control solutions, similar to those used for the chronic injections. 71-0918.Wilkinson, A. R., Johnston.D. Inhibitory Effect Results showedthatinthe case of acute nicotine of Cigarette Smoking on Gastric Secretion Stimulated by exposure, low doses of the alkaloid produced varying Pentagastrin in Man. Lancet 2(7725):628-632,Septem- depression of basal volume, and acid and pepsin output. ber 18, 1971. Basal gastric secretion was stimulated by nicotine doses of about 150 micrograms/kg/hour, but depression was ob Cigarette smoking produced significant inhibition of servedwithhigherdoses. With ICI-50123-stimulated pentagastrin- stimulated gastric-acid secretion in normal secretion, increasing doses of nicotine produced pro- volunteers and inpatients with duodenal or gastric gressive reduction of gastric juice volume, acid output and ulceration. Secretion of pepsin also diminished Inhibition pepsin output. Transient peaks were produced in all was more pronounced in normal subjects than in patients parameters with a dose of 100 micrograms / kg/hour. These with ulcer. Intravenous infusion of nicotine acid tartrate peaks, although not greaterthan values obtained in produced inhibition of widely varying degree. One ciga- controls (no nicotine), were higher than data from similar rette produced as much inhibition as did two cigarettes. groups in the basal state. and thus reflect a true stimulant Inhibition was as great in habitual smokers as in non- effect of nicotine. Chronic nicotine injections of 300 smokers. The results suggest that smoking after a meal micrograms/kg/day for 15 days resulted in an increased will reduce the gastric secretory response to the meal. The basal gastric juice volume, and acid and pepsin output. benefit derived from giving up smoking by patients with Based on an average "smoking dose" of nicotine, this dose peptic ulcer is unlikely to be due to any decrease in acid approximates the smoking of 3-5 cigarettes per day. secretion. On the contrary, giving up smoking might lead Acute nicotine administration to rats chronically exposed to an increase in gastric secretion. (Auth. Abs.)

See also 71-0842, 71-0855, 71-0861,71-0907

170 BEHAVIORAL AND EDUCATIONAL RESEARCH

71-0919. Althoff, S. A., Nussel, E. J. Social Class Trends 71-0921. Bresard, M., Grenier de Rucre. P. Alimentation. inthe Practices and Attitudes of College Students Boisson. Tabac. Etude d'un Echantillon Representatif de Regarding Sex, Smoking, Drinking, and the Use of 706 Hommes, Ages de 21 a 65 Ans, a Saint-Etienne. Drugs. Journal of School Health 4 l(7):390-394, Septem- Chapitre VI. Alcool et Tabac. [Food. Drink. Tobacco. ber 1971. Study of a Representative Sample of 706 Men, 21 to 65 Years of Age, at Saint-Etienne. Chapter VI. Alcohol and Bulletin de l'Institut National de la Sante et A questionnaire survey of 1296 students atthe Tobacco.] laRecherche Medicale26(l):153-172 January- University of Toledo, Ohio, was conducted during the de February 1971, French. academic year, 1969-1970, to compare the practices and attitudes of students of varying socioeconomic status in relation to sex, smoking, drinking and use of illegal drugs. A very detailed study has been made of the smoking A general social class trend was observed in the practices habits of 706 men in relation to alcohol consumption. and attitudes of these college students regarding sexual food practices and certain sociological factors. Tables give permissiveness, smoking and drug usage. These practices breakdowns of smokers by age. matrimonial status, social and attitudes appeared to be liberal in the lowest class level and alimentary practices particularly caloric, protein, (less than $5000), most conservative in the lower middle lipid, sugar, calcium, and vitamin C intake. It is noted that class ($5000-9999), conservativeinthe middle class in certain instances the emphasis on the harmful effects of (S10,000-14,999), liberalinthe upper middle class smoking has been cited as the cause of alcoholic excesses. ($0,000-19,999) and most liberal in the upper class The present study (Chapter VI) is part of a fuller study ($20,000 and over). Alcohol, on the other hand, was dealing with the consumption of alcohol in Saint-Etienne. found to increase as socioeconomic status increased. The incidence of smoking was found to agree with the reported national average of 20-30 percent. The smallest 71-0922. Cahoon, D. D. Cigarette Addiction andCarbon percentage of smokers was in the lower middle class and Dioxide Inhalation: A Hypothesis. PsychologicalRecord the greatest percentage, exceeding the national average, 21(2):247-249, 1971. was in upper middle and upper classes. As the numberof parents who smoked increased with increase in social status, so did the number of students whosmoked It is hypothesized that chronic cigarettesmoking may increase, with the exception of the lower middle class. lead to a vicious circle of CO2 depletiondue to atypical However, the upper class most closely approximated breathing habits related to chronic smokeinhalation and by a parental smoking. Most of the students believed that exacerbated by the influence of nicotine, followed smoking is harmful to health and the tendency to hold high CO2 intake through cigarette smokeinhalation. CO2 belief increased as social class status increased. imbalance may be only one of the manyvariables possibly this important Cognitive dissonance was apparent in that approximately related to cigarette addiction, but if it is an smoking 87 percent of the upper class students believed smoking factor, its manipulation may help provide a was harmful and yet 46 percent of them smoked. "cure."

71-0923. Cendron, H., Vallery-Masson, J. Tabac etCom- 71-0920. Biener, K. Rauschgiftkonsum bei Rauchem and portement Sexuel Chez l'Homme.(Tobacco and Sexual Nichtrauchem. (Consumption of Drugs by Smokers and Vie Medicale 52(25):3027-3030, July Praxis 60(20):652-654, May 18, 1971, Behavior of Men.) Nonsmokers.) 1971, French. German. A retrospective questionnaire survey of 70 men, ages In Bern (Switzerland), a total of 227 male grammar 45 to 90, is reported which investigates if arelationship school students (28 percent smokers) have been investi- behavior in attitudes and usage of drugs. exists between cigarette smoking and sexual gated regardingtheir men between 25 and 40 years of age.Only those Twenty-three percent of the smokers and only three considered as used a drug, consuming one or more packs per day were percent of the nonsmokers have already smokers while nonsmokers were those who had never the usually hashish, at least once. Sixty-one percent of smoked or smoked a maximum of five cigarettes perday. smokers and thirty-six percent of the nonsmokers stated The men were placed in two groups according towhether that they would like to try a drug. Two-thirds ofthe remained the juveniles, smokers and nonsmokers alike, are in favor of a the rhythm of monthly sexual activity had same or decreased between the agesof 25 to 40. Sexual legal prohibition of the use of drugs; sixty-seven percent todecrease more frequentlyin nonsmokers activitywas found of the smokers and fifty-two percent of the smokers than in nonsmokers. Although a series offactors favor legalization of the use of hashish. Arguments, pro psychologi- concerning the use of drugs arebriefly (age, health, marital status, morphological and and con, calfactors) must be consideredin determining the summarized.

171 BEHAVIORAL AND EDUCATIONAL RESEARCH

importance of and motivation in sexual activity and the smoked frequently contemplated stopping, about half smoking habit, a prolonged action of a toxic agent such as rarely did so and the remainder never considered it tobacco can lead to a diminution of masculine sexuality. Among the ex-smokers, 22 percent had not smoked for several years. The investigation showed a general trend among the younger doctors to regard tobacco smoking as 71-0924. Cotten, D. J., Thomas, J. R., Stewart, D. a serious hazard to health. Immediate Effects of Cigarette Smoking on Simple Reaction Time of College Male Smokers.Perceptual and Motor Skills33(1):336, August 1971. 71-0927. Geller, I., Hartmann, R.. Blum, K. Effects of Nicotine, Nicotine Monomethiodide, Chlordi- The immediate effects of smoking one cigarette on the azepoxide, Meprobamate and Caffeine on a Discrimina- simple reaction time of 15 college males was investigated. tion Task inLaboratory Rats.Psychopharmacologia Before testing, each subject smoked 45 to 55 mm of an 20(4):355-365, 1971. 85-mm non-filtered cigarette containing 29 mg tar and 1.5 mg nicotine. The test, in which the subject pressed a key Hungry rats were trained on a discrimination task in when a light appeared, was administered before smoking, order to obtain food rewards. During each experimental immediately after smoking and at intervals of 5, 15, 25, session, discrete stimuli of 1-minute duration were de- 40 and 55 minutes after smoking. The mean reaction liveredthrough a small speaker inthe experimental times immediately following and 5 minutes after smoking chamber at random intervals on the average of once every were significantly slower than all other test intervals. The 2 minutes. Lever responses in the presence of a light and 40- and 55-minute intervals were significantly faster than tone were correct and produced food rewards. Lever the reaction time before smoking. Cigarette smoking responses in the presence of the light stimulus were impedes simple reaction time for a short period. incorrect and were punished by total inactivation of the experimental chamber. Rats were selected for this experi- ment based on their inability to acquire the discrimina- 71-0925. Coudray, P. Tabac et Comportement Sexuel tion task even after six months of training. Admini- thez la Femme. [Tobacco and Sexual Behavior of strationof nicotine,lobeline,chlordiazepoxide and Women.) Vie filedicale 52(25):3031.3032,July 1971, meprobamate produced an improvement in discrimination French. performance through a reduction of responses to in- correct stimuli. Caffeine and nicotine monomethiodide, Two hypothetical and contrasting types of women are the quaternary salt of nicotine, were without effect on described. The first smokes believing it is fashionable to the discrimination. (Auth. Abs.) do so, does not inhale, and will usually let her cigarette consume itself in the . The second type smokes in an attempt to imitate a masculine habit: she smokes 71-0928. Greenwald, P.. Nelson, D., Greene, D. Smoking nonfilter cigarettes continually and inhales deeply. The Habits of Physicians and Their Wives.New York State psycho-sociological reasons for their behavior are ana- Journal of Medicine 71(17):2096-2098,September I, lyzed. The desire to share a certain type of behavior with 1971. men or to ascertain her own femininity could be basic motivating factors in a woman's smoking habit. A questionnaire survey of 5.264 members of the Women's Auxiliary of the Medical Society of New York was undertaken to study the smoking habits of physicians 71-0926. Egsmose, T., Stokholm, J., Egsmose, R. Danske and their wives. The over-all response rate was 81 percent. LaegersVurderingofTobakkens Skadevirkninger. Results indicate that nearly two thirds of physicians and [Awareness of Health Hazards of Tobacco Smoking over 40 percent of their wives who had ever smoked have Among DanishDoctois.1UgesknftforLaeger now stopped. Twenty-four percent of physicians and 36 133(27):1321 -1326, July 9, 1971, Danish. percent of their wives are still smoking. In every age group except the oldest (65 or more years), more wives than Opinions ofthemedical professionin Denmark physicians are smoking now. The largest numbers of towards the association between tobacco smoking and smokers are in the youngest-age group (25 to 34 years). health haza;ds were elicited along with reasons for Men had a higher cigarette consumption than women; the discontinuing or contemplating stopping smoking. The median number of cigarettes smoked per day was 19 vs. random sample consisted of 977 or 13.2 percent of 15 for women. About 1 in 5 of the women smokers and 1 Danish doctors. As the reason for ceasing smoking or in 3 of the men smoked more than one pack per day. contemplating stopping of the habit, 52 percent reported Couples tended to have similar habits. Physicians who had protection of future health while 16 percent reported never smoked tended to be married to women who also symptoms of disease. The latter reported respiratory never smoked, former smokers were more commonly disorders (37 percent), ischemic heart and vascular dis- married to former smokers, and smokers were married to eases (24 percent), and poor general health (11 percent). smokers. The smoking habits of physicians were not The most important health hazards which could be found to be related to medical specialty. prevented by cessation of smoking were considered to be lung cancer in 52 percent, cardiac disease in 27 percent, chronic bronchitis in 14 percent and other diseases in 7 71-0929. Hasenfus. J. L. Cigarettes and Health Education percent. A definite connection between smoking and lung Among Young People.Journalof SchoolHealth cancer was considered to be proved by 78 percent of the 41(7):372-376, September 1971. doctors whilethecorresponding figures for chronic bronchitis and coronary thrombosis were 74 percent and Although 10 million adults in the U.S. have stopped 37 percent, respectively. One-fourth of the doctors who smoking cigarettes in the past four years, smoking has

175 172 BEHAVIORAL AND EDUCATIONAL RESEARCH

insuuction program in which the content focuses on increased among teenagers in every age level from 12 to At the youth effective physical, social and mental functioning. 18. The methods used to educate children and should regarding cigarette smoking are examined. There seems to junior and senior high school levels instruction phys- health provide opportunities to explore the psychological, be an increasing agreement that knowledge of the making wise hazards of smoking has little influence on thesmoking iological and sociological factors involved in behavior of youth unless the individual already has a good decisions about smoking. The importance of peer accept- of advertising should concept of how health relates to his pursuitof happiness ance, adult mimicking and the effect service and goals in life. If concepts of health can be madedeeply be recognized. Professional preparation and in- felt and idealized by children, specific healthteachings training programs should be required to improve com- petencies for teaching smoking and healtheducation will be recognized by them as important. Foundational exemplar areas relating to the task of educatingthe young in health School personnel who smoke should provide an cigarette smoking, are considered, linageconsistent with currentfacts on smoking and matters, especially policies including the views that smoking among youth is coping health. Recommendations for steps to establish the behavior to stresses in life, and that it is a resultof a and practices consistent with current information on generation gap, especially as it pertains to communica- hazards of cigarette smoking are listed. tion. 71-0933. King, A. J. Stress, Cigarette Smoking and Canadian Jour- 71.0930. Hilton, D. D. Access and Attitudes to Smoking. Snacking Behaviour in Adolescent Males. 62(4):297-302, July-August 1970. (Letter)British Medical Journal2(5757):337, May 8, nal of Public Health 1971. The smoking behavior of male adolescents under stress A survey of two secondary schools inPortsmouth, was compared with that ofunstressed male adolescents. and England, showed 70 percent of 105 boys aged 14had Snacking behavior (the oral consumption of food while beverage items between meals) was also investigatedNo tried smoking and one third were regular smokers, evident 73 percent of 48 girls of the same age had tried a ugarette significant differences in amount of smoking were and 54 percent were regular smokers. Of thoseunder age between the stressed and unstressed subjects although snack 16, 19 percent of boys and 33 percent of girls smokedin stresswas reported. Smokers were found to of significantly more than nonsmokers in both the stressed front of their parents. At the boy's school, 43 percent fruit and the regular smokers (186 out of 614 questioned)wanted and non-stressed groups. Beverages and raw of the vegetables seemed to account for much of thissignifi to give up smoking as compared to 50 percent amounts by regular smokers (85 out of 244 questioned) at the girl's cance as they were consumed in greater smokers. Stressed nonsmokers snacked significantly more school. than unstressed nonsmokers. Unstressed smokerssnacked significantly more than unstressed nonsmokers. Interpre- tation of these results suggested that adolescentsmokers 71-0931. Hirvonen, L., Peltonen, T., Pihlaja, T. L'Enfant, individuals who are in a le Table et le Pediatre. (The Chid, Tobacco,and the may in fact be "high oral" transitional stage from snack* to smoking behavior.The Pediatrician.)Pediatre7(35): 161-170. 1970, French. lack of a significant stress-smokingrelationship was be A brief review is presented of some recent studies on explained partly by the fact that teenage smoking may and the largely a peer pressure phenomenon rather than a stress the smoking habits of children and adolescents adulthood the particular health hazards which smoking presents tothe linked habit. As adolescents approach problem is also an smoking habit increases while the snacking habitprobably young. It is suggested that the smoking that adults who are important problem for the pediatrician, since the habitis decreases accordingly. The fact attempting to stop smoking invariably eat moreleads to usually acquiredin childhood and adolescence. The predict smoking child is more susceptible to respiratorydiseases the suggestion that it may well be possible to characteristics than his nonsmoking friends. His strength andphysical future heavy smokers by their "high oral" predicitions defenses are weakened, and he is less successful inhis in late childhood or early adolescence. Such smoking school work. His habit constitutes a high risk for him later would be valuable in directing a campaign against in life: he will be more easily affected by disease andhis before it begins. (Auth. Abs.) life expectancy will be shorter. Thus, it is achallenge to the pediatrician to try his best to prevent his young Disso- patients from smoking. 71 -0934. Lebedun, M., Donovan. L. P. Cognitive nance and the SmokingBehavior of Researchers on Smoking.Missouri Medicine68(9):700-703, September 71-0932. Journal of School Health. AAHPER Position 1971. Statement. Smoking Education: The Schools Responsi- deter- Journal of School Health41(8):444445, October This questionnaire survey was concerned with biity. mining relationships between cognitive dissonanceand 1971. smoking behavior among researchers recentlyengaged in investigations of smoking-related problems. Ofquestion- The schools should accept responsibility for providing Directory smoking education programs and practices consistent with naires sent to 339 researchers listed in the 1968 Health 184 current information. A program of health instruction of On-Going Research in Smoking and responded. The researchers consisted of34.8 percent throughout the primary grades should emphasize experi- nonsmokers. 35.3 percent ex-smokers and 299 percent ences that provide opportunities forpupils to develop smokers. A comparisonofthesesmoking foundations essentialto self-understanding andself- current thoseinthe general population acceptance. in the intermediate grades, aclearly identified characteristics with showed at least a 10-percent difference in eachof the segment of the school day should bedevoted to a health 176 173 BEHAVIORAL AND EDUCATIONAL RESEARCH

three categories. Three times as many researchers quit their presentations to the 5th and 6th graders. In a period smoking as people in the general population. A close of 19 days, 70 teenagers visited 71 of the 75 elementary association was found between the smoking habits of the school in the county and reached approximately 10 000 researchers and physicians, the latter determined from 5th and 6th graders. The reaction from the community. prior national studies involving physicians only. Of 43 the schools, the teenagers and the preteens demonstrated researchers involved in treating clients to help them quit the effectiveness of youth-to-youth communication. An smoking, 18.7 percent were current smokers, 48.8 percent evaluation of the program showed that the 5th graders were nonsmokers and 32.5 percent were ex-smokers. Of were more receptive than the 6th graders and it was 120 ex-smokers and .current smokers, 39 percent attri- recommended that the program start on 4th graders. The buted their quitting or reduction in rate of smoking to teenagers stated they wanted straight facts but were being being involved in smoking research. A majority (63.4 given too much propaganda. The true effectiveness of the percent) of the respondents reported that doing smoking program will be determined when the 5th and 6th graders research influenced their attitudes and behavior toward are resurveyed sometime in high school. smokers. Most of these directed their efforts toward convincing and aiding smokers to quit. Aithough the respondents were less likely to be current smokers and 71-0937. Pan American Sanitary Bureau. Control of more likely to be ex-smokers than individuals in the Cigarette Smoking. Report on Measures Taken in the general population, dissonance created in the smokers Americas to Control the Advertising.In: XVIII Pan among theresearchers was not considered a major American Sanitary Conference. Pan American Sanitary determinant of this difference because of the coincident Bureau, Official Document No. 108, 1971, pp. 393-396. high educational and economic status of the sample. The extent of cigarette smoking as a serious public health problem in the Americas is reviewed. The Pan 71-0935. McFall, R. M., Hammen, C. L. Motivation, American Health Organization recently called for an Structure, and Self-Monitoring: Role of Nonspecific inquiry into the measures being taken in the Region for Factors in Smoking Reduction. Journal of Consulting the control of cigarette smoking. This survey showed that and Clinical Psychology 37(I):80-86, 1971. six countries exercise some control over tobacco growing and processing but set no standards governing tar and A comparison of the outcomes of major stop-smoking nicotine content of tobacco products. Information from studies reveals an intriguing similarity of data across a six countries on cigarette sales showed increases varying variety of different procedures, populations, and theoreti- from 8 to 113 percent for the last 10 years and between cal orientations. The elements of motivated volunteering, 59 and 188 percent for the last 20 years. Only one structure, and self-monitoring were regarded as non- country reported regulations governing cigarette sales but specific factors common to all these stop-smoking studies. these referred only to payment of taxes and the require- A stop-smoking clinic was designed which offered no ment of a cigarette sales license. Restrictions on smoking "treatment" but encouraged motivated volunteers to in public places exist in 14 countries but these are mainly employ self-control and required them to monitor their concerned with rue prevention and only cover public smoking and report progress at regular intervals. The transport vehicles and certain places of public entertain- outcome of the nontreatment clinic program was com- ment. Legal restrictions on the advertising of cigarettes parable to others reviewed and suggests that the non- have been adopted by Argentina, Panama, Peru and the specific factors studied may account for the temporary U.S. Canada has relied on voluntary restrictions self- behavior change found in most smoking treatments. imposed by the tobacco industry and advertisers in the (Au th. Abs.) face of community pressure. Both the U.S. and Canada have sponsored educational programs to help smokers give up the habit and prevent school children from starting to 71-0936. McRae, C. F., Nelson, D. M. Youth to Youth smoke, have made surveys of smoking habits, motivations Communication on Smoking and Health. Journal of and attitudes, and both have strong support from private School Health 41(8):445447, October 1971. organizations. Four other countries of the Region have indicated that they are undertaking educational programs A youth-centered smoking and health program devel- to combat cigarette smoking and 14 others are definitely oped by the Broome County' Interagency Council on planning educational programs and restrictive advertising Smoking, Binghamton, New York is described. At their controls on cigarette smoking. The Pan American Health organizational meeting, the youths decided that the group Organization is planning a survey of eight Latin American which could be most effectively reached was the Sth and cities which will provide information on the prevalence of 6th graders whom they felt were still in the process of smoking and the social, cultural and demographic char- making a decision about smoking. A questionnaire survey acteristics of smokers, will help health authorities in these of the habits and attitudes of the target group showed countries to formulate policies and programs on the use that of 8,129 who responded, 96.1 percent were non- of tobacco, and will indicate the' starting point for a smokers. Smoking was considered a health hazard by 83.3 correct evaluation of the effectiveness of control pro- percent of the smokers and 96.2 percent of the non- grams. smokers. Of the smokers, 10.2 percent were smoking a half-a-pack or more per day and 50 percent were smoking a half-a-pack a week. Reasons for smoking ranged from 71-0938. Piedroja Gil, G. Encuesta Realized& en los "tastes good" (5.7 percent) to "relaxation" (22.1 per- Alumnos del 6.Corso de Medicine de Is Facultad de cent). Most nonsmokers (68.5 percent) gave health as a Mackin* de Madrid. Habitos, Recreaciones, Vocaciones, reason for not smoking. The youth group contacted Enfermedades, Proyectos Futures y Aspectos de su voluntary and official health agencies and other com- Formacion. [Survey of Sixth-Year Medical Students at munity group for materials and visual aids to be used in the School of Medicine of Madrid. Habits, Recreation,

174 BEHAVIORAL AND EDUCATIONAL RESEARCH

Vocations, Illnesses, Future Plans, and Aspects of Their "conformity" and "to impress others," but personal Background.'Alleles de la Real Academia Nacional de gratification influenced the individual's decision whether Medicine 88(1):117-147,1971, Spanish. or not to continue. Personality profiles based onthe Gough Adjective Check List and the discrepancy between A questionnaire survey of 1,131 medical students (919 "real self" and "ideal self" both failed to differentiate men and 212 women) in Madrid, Spain, was undertaken between smoking categories. (Auth. Abs. Mod.) in order to determine how they thought, how they lived, likes and dislikes, etc., during their final year of medical school. A total of 90.8 percent of male stuck-tits and 87.7 71-0940. Rose, G. A Controlled Trial of the Effects of percent of female students were single. Ft.:.ults indicate Health Education in High-risk Subjects.Annales des that 75 percent of single male students and 70.9 percent Societes Beiges de Medicine Tropicale. de Parasitologie et of married male students were smokers; 41.4 percent of de Mycologie Humaine et Animale50(4):481487, 1970. singleand 38.4 percent of married female students smoked. The daily consumption of cigarettes ranged from The general principals that have been followed in 2 to 20 cigarettes for approximately 88 percent of the setting up a controlled trial investigation of the health mat- smokers and 80 percent of the female smokers. benefits derived from cessation of smoking are presented. Approximately 12 percent of the male smokers and 20 High-risk individuals are identified on the basis of results percent of the married female smokers smoked more than of a 15-minute screening examination which has been 20 cigarettes per day. Only 4.6 percent of the single applied to 14,000 male civil servants in Inner London, female smokers smoked more than one pack per day. aged 40 and over. The cigarette smokers with the highest That smoking was a dangerous habit was acknowledged risk-scores are selected for the trial. It is hoped that a by 90 percent of the respondents, and yet, 75 percent of total of 1,500 such men will enter the trial and be single male students and 41.4 percent of single female randomly allocated to either the treatment or the control students smoked habitually. Based on these findings, it is group. Treatment consists of 15-minute consultations recommended that: all incoming medical students should withaphysician who advises the patient of the positive be made aware of the health hazards due to smoking by gains from stopping, rather than the dangers of continuing means of a health education campaign; all professors his smoking habit. Each man knows that he is one of only should be advised not to smoke during classes, seminars, a relatively small number, selected because of the special or laboratory sessions; and smoking should be forbidden hazards of cigarette smoking to him in particular. Most of while attending to patients. those who respond to the advice given do so by an immediate and complete cessation of cigarette smoking. Contactismaintained overseveral months through 71-0939. Roberts. C. J., Fan', E., Lillick, L. C. Assoc's- personal consultations and mailed progress reports in an don of Psychosocial Factors to the Smoking Practices of effort to minimize relapses. High School Students.Chronic Disease Quarterly(Sup- plement No. 17):1-73, August 1970. 71-0941. Rowland, J. A. How About Smoking?Nursing Psychosocial factors and personality characteristics Outlook19(6):422423, June 1971. thought to influence smoking behavior of high school students were investigated. The Gough Adjective Check Antismoking efforts at the Veterans Administration List and specially developed general information and Hospital in Topeka, Kansas, centered around the use of smoking questionnaireswereadministered to 495 subjects group discussionto help both patients and medical who were then subdivided into regular smokers, ex- personnel in giving up the smoking habit. Film, literature smokers and nonsmokers. Psychosocial factors were classi- and posters were utilized and attempts made to dis- fied according totheir sphere of influence: "peer," courage personnel from smoking. For those who con- "family," "self," and "school," and chi-sq./1,Jc tests were tinued to smoke, special areas away from the patients applied to determine those factors for which significant were provided. Some of the typical questions asked about differences existed among smoking categories. The signifi- smoking at the meetings and their answers are given. The cant factors from all 37 areas were then pooled and meetings served the purpose of keeping the dangers of subjected to multivariate analysis. Altogether, 25 factors smoking constantly before both patientsandpersonnel were found to have significant discriminating ability in with emphasis on preventive aspects of health care. the comparisons of the three smoking categories. The mostimportantwere"peer"factors,followed by "family" and "school" factors. The one factor that 71-0942. Schechter, M. D., Rosecrans. J. A. C.NS. Effect discriminated most effectivelybetween smokers and of Nicotine as the Discriminative Stimulus for the Rat in a nonsmokers as well as smokers and ex-smokers irrespec- 'Maze.Life Sciences10(14, Pt. 0:821-832, 1971. tive of sex was "how many of four best school friends smoke." "Mother's attitude toward smoking" was the Rats were trainedto make a specific behavioral next best discriminator between smokers and nonsmokers response in a T-maze apparatus conditional upon whether of both sexes, and between smokers and ex-smokers they were injectedsubcutaneously with 400 micro - among girls. The latter was replaced by "father's attitude" grams/kg nicotine or saline. This differential response was among boys. For girls, "grade average" ranked third in dose- and time-related. Pretreatment with 750 micro - importance in the smoker-nonsmoker comparison, while grams/kg hexamethonium had no effect on the rats' another "peer" factor (who of friends most upset) took abilityto discriminate the cueing effect of nicotine, third place for boys. The analysis revealed also that the whereas,pretreatmentwith500micrograms/kg series of significant factors was able to discriminate mecamylaminesignificantlyinhibitedthiseffect.It between any pair of smoking categories with 100 percent appears that whatever the cues were to which the rats accuracy. Most-cited reasons for starting to smoke were differentiallyresponded,the effectis mediated by

175 BEHAVIORAL AND EDUCATIONAL RESEARCH

nicotine's action on the central nervous system. (Ruth. healthAdministration.NationalClearinghouse for Abs.) Smoking and Health. Rockville Maryland, DIIEW Publi cation No (IISM):72-7508. 1971.

71-0943. Silverman. A. P. Behavior of Rats Given a Two comprehensive studies have been made of the 'SmokingDose'ofNicotine.AnimalBehaviour patterns of smoking as well as the prevalence of smoking - 19:67-74, 1971. among teenagers in the United States. In 1968, the initial survey consisted of 4931 boys and girls aged 12 to 18 The social behavior of rats of two laboratory strains inclusive. Approximately 350 teenagers were interviewed was observed before and after the subcutaneous injection for each sex and age level. A second survey completed in of nicotine. The dose, 25 micrograms per kg, was about 1970, consisted of 2640 boys and girls of the same age equivalent to that inhaled by a man smoking a cigarette. lads as the first survey with approximately 185 inter- Paired male rats were separated daily, and observed once a views per age and sex. Results indicate an increase in weekfor 6 minutes afterre-introduction. Acts and teenage smoking for both sexes and at every age level in postures described by Grant & Mackintosh (1963) were the two-year interval between the surveys. The smoking recorded, and interpreted statistically by discriminant rates have increased in all sections of the country, in rural analysis and repession equations. There was a barely as well as metropolitan areas. The immediate environment significant difference in the baseline observations between of the teenager was found to have a profound effecton. the randomly selected experimentals and controls. How- his smoking habit. Whether he lives in a home where one ever, the difference was much greater after the administra- or both parents are absent, the education and occupation tionof nicotine, was greaterstillafterfour daily of the parents, the habits of older siblingsall havean injections, and fell to insignificance when nicotine was influence on the behavior of the youth. Those in a higher administered to the former controls, instead. The effects socioeconomic environment are less likely to smoke than of nicotine therefore appear to be additive to differences are those less advantaged. In families in which at least one between individual rats, and so were more clearly seen by of the parents attended college, teenagers have lower considering the rats as their own controls. The greatest smoking rates than those in whose families neither parent contribution to this effect of nicotine, in both albino and attended college. If both parents smoke, the teenager is hooded rats, was a consistent reduction of aggression. In twice likely to be a smoker himself than if neither parent one observation, other behavior involving approach to the smokes. If an older sibling smokes the chances ofa other rat, investigation, sexual, and submission, was also teenager srnol.ing are also greatly increased. Differences in slightly reduced; there was a little evidence that escape the teenagers themselves indicate that high school stu- was marginallyincreased, and in one observation, a dents who are in college preparatory courses are less likely possible indication of nausea. The total activity of the rats to be smokers thanthoseinother courses. Those was not consistently affected by nicotine. These other teenagers who work either part- or fad= have more effects seemed insufficient to account for the reduction than 2.5 times the smoking rates as those who do not of aggression, and it was argued that, at a behavior level, work. Two encouraging findings from the surveys were nicotine may have modulated this directly. (Audi. Abs.) that 9 out of 10 teenagers express the opinion that smoking is harmful to health, and almost that many predict that they will not be cigarette smokers 5 years 71-0944. Uragoda, C. G., Scnewiratne, B. Tobacco Smok- from now. ing in Ceylon.Journal of Tropical Medicine and Hygiene 74(7):145 -147, July 1971.

A survey was made of smoking habits in Kandy, 71-0946. Ward, S. Television Advertising and the Adoles- Ceylon. Of the 1127 subjects interviewed, 548 were males cent.Clinical Pediatrics 10(8):462-464. August 1971. and 579 were females. Only 9 of the females smoked compared to 264 males. The survey revealed that 90.1 A total of 1,094 adolescents, 12 to 17 years of age, percent of the smokers consumed cigarettes, 5.9 percent were surveyed to ascertain the attitudes of adolescents smoked (tobacco wrapped inthe dried leaf of toward television commercials, and to analyze the effects Diospyros melanoxylon),3.7 percent smoked cheroot, of televisions advertising on adolescents. In response to a and 0.3 percent smoked both becdi and cheroot; 36.6 questionnaire asking for examples of "Best" and "Worst" percent of the smokers were betel chewers as well. commercials and reasons for these judgments, no category Persons with a higher education smoked cigarettes in of advertiseme.as was overwhelmingly liked. However preference to beedi and cheroot. The per capita con- cigaretteadvertising was singled out as "worst TV sumptionoftobaccoinCeylon, the proportion of advertising". Anti-smoking advertisements were liked be- smokers in the sample and the daily average number of cause they were considered straightforward; and not cigarettes smoked are low in comparison to similar figures surprisingly, cigarette advertising was disliked because it for the United Kingdom. This probably explains the low was considered hypocritical and in bad taste. They were frequency of bronchial carcinoma in Ceylon. unequivocal in their negative response to cigarette adver- tising (17 percent of the total sample). The motivations or reasons for watching commercials are important in order 71-0945. U.S. Department of Health, Education, and to understand and predict attitudes. materialism, and the Welfare. Public Health Service. National Clearinghouse for effects on buying. This study suggests not that adoles- Smoking and Health. Teenage Smoking. National Patterns cents are helpless victims of television, but rather that of Cigarette Smoking, Ages 12 Through 18, in 1968 and they are a responsive audience with identifiable likes and 1970. US. Department of Health, Education, and Wel- dislikes. The more intelligent adolescent is less material- fare, Public Health Service, Health Services and Mental istic and less affected by television advertising.

179, 176 SMOKING CESSATION METHODS

714)947, Biernacki, T.. Sulcstrowski W.. Szafnagel, A. 71-0950. Evans, 1. W. Double-Blind Trial of Fenfluramine Leczenie Nikotynizmu lako Ogniwo Medycyny Profila- as an Aid to Stopping Smoking.In: Seminar on Fenflur ktycznej. (Treatment of Nicotinism as a Link in Preven- amine and Obesity. Nassau. Bahamas. February 22.26. tiveMedicine.) h'iadomosciLekarskie 1971.SouthAfricanMedicalJournal(Supple 24(16):1573-1575, August 15, 1971, Polish. ment):33.34. June 19. 1971.

The problem of treating nicotinism on a wider scale is I:orty patients (20 men and 20 women) took part in a discussedinterms of usingavailable outpatient and double-blind cross-overtrial designed to compare the inpatient health services and sanatoriums, and in popula- possible effects of fenfluramine with that of a placebo as tion groups under constant medical supervision. A flexible an aid to stopping smoking. The results showed that treatment plan is suggested which can be applied selec- fenfluramine is no more active than placebo in removing tively to each case on the basis of Schaer's classification the desire to smoke cigarettes. The patients were highly of smokers. Individual psychotherapy strengthened by motivated and had volunteered to take part in the study group psychotherapyispostulated together with the rather than being told by their physician that they must introduction of several drugs as psychotherapeutic vehi- stop smoking. In spite of this. less than a third of them clesvitamin dragees with antiseptic agents which would (12) could complete the trial. The group of patients who have a stronger psychic effect on the patient than the dropped out contained at least 12 who did initially reduce usual mint candies. their cigarette consumption, and these were more numer- ous (9 out of 12) among those taking fenfluramine than those taking placebo (2 out of 7). Furthermore. the group of the smokers who complained of 71-0948. Chapman, R. f., Smith, 1. W., Layden, T. A. includedallsix unpleasant side - effects. All sixof these were taking Elimination of Cigarette Smoking by Punishment and fenfluramine. Self- ManagementTraining. BehariorResearch and Therapy 913):255 -264, 1971. 71-0951. Gordon, W. W. The Treatment of Alcohol (and Faradic shock punishment and self-management train- Tobacco) Addiction by Differential Conditioning. New ing were usedinan attempt to eliminate cigarette Manual and Mechanical Methods. American Journal of smoking in two groups of subjects (23 total) who had Psychotherapy 25(3):394-417, July 1971. smoked from fourto 48 years and from 14 to 60 cigarettesper day. Group Ireceived two weeks of A research project is described in which an attempt post-trcatmcnt therapist monitoring while Group II re- was made to evolve biologic forms of aversion therapy ceived I I weeks. Only one subject in each group failed to which may be applicable to alcohol and tobacco addic- stop smoking during the course of aversion and self - tion, but which, when perfected. may also prove useful in management treatment, and reduction to zero cigarettes producing aversions to sweet foods, compulsive eating. per day occurred within four to five successive treat- and sexual perversions. Itis asserted that the natural ments. Post-treatment follow-ups at one, three, six and appetites and the natural aversions are determined by the twelve months revealed longer cessation of smoking in the formation of conditioned. differentially associated paired second group. Six of the eleven subjects in the second systems based upon the ingestion and rejection reflexes. group were not smoking at the twelve month follov.-up as By building up appropriate systems in training. control of compared to three of the twelve subjects in the first addiction may be achieved. Patients have been treated group. The results suggest that (1) faradic shock punish- using a manual technique. A mechanical technique is also ment combined with self-management training will for described. The results have been outlined and an im- most subjects eliminate cigarette smoking, and (2) post- proved form of technique is predicted in the light of treatment therapist monitoring seems to be an important experience gained and on the basis of theoretical consi- variable affecting long term cessation of smoking. (Auth. derations. The relationship betweenconditioningto Abs.) people (as physical entities which may act as conditioned signals) and alcoholic addiction is discussed. Considering aversion therapy and psychotherapy in terms of patterns 71-0949. Cousin. M. Comment Supprimer le Besoin de of nerve stimulation in time and space (and the basic Fumes? [How to Suppress the Need to Smoke?) Vie nature of the nerve impulse which underlies both forms of Medicale 52(25):3035.3039, July 1971, French. treatment makes this obligatory), a reconciliation of divergent views may be encouraged. (Auth. Abs. Mod.) The various reasons which can motivate a smoker to quit, and the different individual methods and aids which can be helpful in accomplishing this goal are outlined. To 714952. Lancet. Words of Warning. (Editorial) Lancet stop smoking is easy for a person with strong will power; l(7700):638, March 27, 1971. for others, it is more difficult and thus no method should be overlooked. Several possible measures to be taken at The British Government's plans for reducing cigarette the national level are also mentioned. smokinginclude anagreementwith tobacco

177 GENERAL

manufacturers for a health warning on cigarette packages. 71-0953. Rose, C., Udechuku, 1. C. Cigarette Smoking by However, tobacco advertising will not be banned and HospitalPatients.British Journal of Preventive and advertising will refer to the health warning but will not Social Medicine 25(3):160-161. August 1971. repeat it. This agreement with the tobacco industry will fall through unless Sir Gerald Nabarro withdraws his An inquiry is reported into the cigarette smoking habits of patients with chronic cardiovascular and respira- Tobacco and Snuff (Health Hazards) Bill. The government tory diseases recently discharged from hospital. Among is also studying alternative revenue sources if cigarette the 93 who smoked in the two weeks before admission, consumption falls, less dangerous forms of smoking, and anti-smoking advice by hospital staff was recalled by 69 methods for determining tar and nicotine contents of percent, of whom two-thirds had nevertheless continued different cigarette brands. Transportation concerns and to smoke after leaving hospital. There should be research entertainment managers are to be asked to set aside more to find more effective means of delivering anti-smoking nonsmoker accommodations. advice to hospital patients. (Auth. Abs.)

See also 71-0940

GENERAL

71-0954. Bastide, H., Houdaille, 1. Epidemiologie de 71-0955. Public Health. Special Report: Eight Years Tabac en France et Dans le Monde. [Epidemiology of After. Public Health 85(3):133 -136, March 1971. Tobacco in France and in the World.]Vie Medicate 52(25):2989-2995, July 1971, French. The recently published report of the Royal College of Physicians, 'Smoking and Health Now,' is firmly en- dorsed. The basicprincipal behindallthe report's A general review of the world-wide tobacco problem is recommendations, strong discouragement and restriction plesented. The increase in consumption of tobacco in rather than total prohibition of smoking, is upheld and States most European countries, Australia, and the United the various methods by which these recommendations since 1935 is discussed. Morality figures available related could be put into effect aro discussed. The effects on the to tobacco consumption are presented, and severalstudies public of thefirstreport by the Royal College of which have indicated a relationship between tobacco and Physicians published 8 years ano are analyzed, and its lung cancer, other cancers, and heart disease are mcn- successes as well as failures are considered for possible tioncd. guidelines for future measures.

181z 178 CHEMISTRY, PHARMACOLOGY ANDTOXICOLOGY

71-0956. Bhagat, B., Rana, M. W. Effect of Chronic DMBA, although of the same order as for BP, was Administration of Nicotine on the Concentrations of significantly less than the high value obtained previously Adrenal Enzymes involved in the Synthesis and Metab- with mouse embryo cells. In HeLa cells. both BP and olism of Adrenaline. British Journal of Pharmacology DMBA were metabolized, but the latter was considerably slower. While BP binding to DNA, RNA, and protein was 43(1):250.251, September 1971. significantly less in HeLa cells than in primary human Chronic administration of nicotine (1 mg/kg injected lung cells, DMBA binding was similar in both cell types. subcutaneously 5 times/day for 6 days/week for 12 The data indicate that primary human lung cells resemble BP becomes weeks) in male Holtzman rats resulted in an increase in mouse embryo cells in the degree to which tyrosine hydroxylase and catecholamine concentrations in bound to cellular macromolecules following metabolism. the adrenals, but failed to affect adrenal monoamine There have been reports of mouse and hamster cells being oxidase, catechol-0-methyl transferase or phenylethanol- transformed in culture by hydrocarbons and of these amine N-methyl transferase activities. (Auth. Abs. Mod.) transformed cells producing tumors when injected into adult animals. The present experiments suggest that the necessaryconditions exist for the transformationof 71-0957. Bhagat, B., Bayer, T., Lind, C. Effects of human lung cells by BP. Chronic Administration of Nicotine on Drug-Induced Hypnosis inMice. Psychopharmacologia21:287.293, 71-0959. Dalhamn, T., Rylander, R. Reduction of Ciga- 1971. rette Smoke Ciliotoxicity by Certain TobaccoAddi- Chronic administration of nicotine ,n mice for six tives. A mericanReview of RespiratoryDisease weeks did notaffectthe duration of hypnosis by 102(6):855-857, Junc 1971. , hexobarbital, barbital or zoxazolamine. The anticiliostatic effect of addition of oxolamine The onset of barbital hypnosis remained unaffected. that chronic administration of citrate to cigarette tobacco shown in earlier experiments Theseresultssuggest the original nicotine did not affect the drug metabolizing activity of was further elucidated using derivatives of hepatic microsomes. While psychotropic drugs signifi- compound. Citric acid, diethylamine citrate, phenylvinyl- oxadiazole (PVO), and phenylmethyloxadiazole (PMO) cantly potentiated the hypnosis due to pentobarbital and ciliostatic effect of hexobarbital, the degree of potentiation was the same in were added to cigarette tobacco. The both chronically nicotine pretreated mice and controls. the smoke was evaluated in short term exposure experi- Nicotine pretreatment significantly increased the duration ments incatsinvivo. The anticiliostatic effect was of sleeping time caused by ethanol alone. However,when demonstratedfor PVO and PMO. Experiments with treatment of nicotine continued for a longer period of varying concentrations of PMO indicated that a maximal time, the duration of hypnosis induced by ethanol effect was present at concentrations of approximately2 returned to control level. (Auth. Abs.) percent of tobacco weight. (Auth. Abs.)

71-0958. Brookes, P., Duncan, M. E. Carcinogenic Hydro- 71-0960. Dontenwill, W., Harkc, 11.-P., Baars, A., Goertz, E. Experimental Studies on the Intake and Depositionof carbonsand Human CellsinCulture. Mature 234(5323):4043, November 5, 1971. Smoke Particles in the Passive Smoking of Cigarette Smoke by Golden Hamsters. Complete English trans- Untersuchungenuber The effects of carcinogenic hydrocarbons on primary lationof"Experimentelle human embryo cells were examined and compared with Aufnahme und Ablagerung von Rauchbestandteilen bei their effect on human tumor cells (HeLa). Human embryo der passiven Berauchung von Goldhamstern mit Ziga- 21(1):142-143, fibroblast cultures were prepared from lung, skin/muscle, r e ttenrauch,"ArzneimittelForschung and guttissuesand tested for their ability to metabolize January 1971. and bind 'H-labelled benzo(a)pyrene (BP) and 7,12,-di- methylbenz(a)anthracene (DMBA) while similar studies See Abstract 71-0193. were carried out with HeLa cells. Bothhydrocarbons were metabolized by the embryo cells, DMBA rather more 71-0961. Forwerg, W., Crecelius, W. Bestimmung von slowly than BP. The lung cells metabolized most effi- Nikothrin Luft am Arbeitsplatz. (Determination of Zentralblatt fur ciently and retained this property during subculture.On Nicotine in the Air of a Working Area.] the other hand, the gut cells had a significantly poorer Arbeitsmedizin und Arbeitsschutz 21(7):214.218, July rate of metabolism after 40 days in culture. The binding 1971. of BP and DMBA to DNA, RNA, and protein in the primary lung cells was determined after isolation of these A modification of the Asmus photometric method cellular macromolecules. The rate of hydrocarbon metab- permits the quantitative determination of nicotine in olism in human embryo cells was found to be similar to working areas. Nicotineisselectively absorbed from 0.2 that in rodent embryo cells, and at least for BP, binding tobacco smoke by a mixture of 0.IN sulfuric acid and neutralized by to macromolecules was also similar. Thebinding index for percent n-butanol and the acid is then

179 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

sodium hydroxide. Phosphate buffer, potassium cyanide. of the first response and moderate inhibition of the and barbituricacidarethen added. resultingina secondary response. DMAE combined with hexamethon- coloration whose intensity at 510 nim is a measure of the ium elicited greater blockade of the biphasic response to concentration of nicotine in the solution. Six measure- nicotinethan either one alone.Histochemicallythe ments were made showing an average absorption of 98 acetylcholinesterase content in the vagally-denervated rat percent with a standard deviation of 6 percent. Disturbing ileum was markedly decreased. It was concluded that influences of other nicotine alkaloids, such as nornicotine, excitation of cholinergic and of noncholinergic intrinsic anabasine, and beta-nicotyrine, appear in trace amounts nerves by nicotine in the rat ileum is not prevented by only and can be disregarded. chronic vagal denervation. (A u th. Abs.)

71-0962. Gerhardt, T., Gothert, M., Malorny, G., Wilke, 71-0964. Goldfarb, J., Sharpless, S. K. Effects of Nicotine II. Zur Frage der Toxicitat von Kohlenoxid bei Atmung and Recurrent Inhibition on Monosynaptic Reflexes in von CO-Luftgemischen unter erhohtem Druck. [Toxicity Acute and Chronic Spinal Cats. Neuropharmacology of Carbon Monoxide in Man Breathing Mixtures of CO 10(4):413-423, July 1971. and Air at Elevated Pressure.]hitemationales Archie fur A rbeit smedizin 28(2):127.140,August31, 1971, The present experiments were undertaken to examine German. some of the changes which take place after spinal section in the cat. Recurrent inhibition was greater in cats 7.14 Investigations were carried out in healthy nonsmoker days after spinal section than in acute spinal preparations volunteers to learn whether carbon monoxide would be (P less than 0.05). The increased potency of the in- more toxic under increased pressure than under normal hibitory pathway subsided by 25-30 days following spinal pressure, if this gas is inspired at the same concentration section. The general trend of the size of the inhibitory under both conditions. It was shown by measurements of response to intravenous nicotine in spinal and hemisected CO concentration in alveolar air and of the COHb content animals, paralleledthe change in recurrent inhibition of blood that at 3 atmospheres the blood is saturated observed in spinal cats, although the data did not reach faster with carbon monoxide than under normal atmos- statistical significance (P <0.05). In hemisected cats, there pheric pressure, indicating that under increased pressure appeared to be an overall increase in recurrent inhibition diffusion equilibrium in the organism is achieved earlier. similar to that seen in spinal preparations (not significant in subjects breathing 100 ppm CO for 2 hours the CO P <0.05). In addition, there appeared to be increased concentration in alveolar air is 73 ppm under 3 atmos- recurrent inhibition on the hemisected side as compared pheres and not more than 36.7 ppm at I atmosphere. This to the acute side in cats 14-32 days following hc:ni resultis explained by the increased CO supply under section. There was clearly no increase in the response to increased pressure. It must be emphasized that the COHb nicotine on the hemisected as compared to the acute concentration is significantly lower under increased pres- sides. When the control animals were ranked using the sure than under atmospheric pressure (p <0.001), once strength of recurrent inhibition and the degree of depres diffusionequilibriumhas been attained. In subjects sion of the monosynaptic reflex by nicotine as criteria, breathing 50 ppm CO, the COHb concentration is only the rank orders for each measure were identical. No such 4.5 percent at 3 atmospheres but 7.25 percent atI relationship was obtained for any group of chronic atmosphere. This result is explained by application of the animals, suggesting a differential change in sensitivity to law of mass action on the competition of CO and 02 for nicotine and synaptic activation of the recurrent in- the receptor hemoglobin in the blood. It was concluded hibitory system. The resultsarediscussed from the from the experimental data that there is no reason to standpoint of disuse of spinal pathways following cord lower the threshold limit value of 50 ppm CO for work injury. (Auth. Abs.) carried out under increased pressure. (Auth. Abs. Mod.)

71-0965. Horvath, S. M., Dahms, T. E., O'Hanlon, .1. F. Carbon Monoxide and Human Vigilance. A Deleterious 71-0963. Goldenberg, M. M. Relationship Between Effect of Present Urban Concentrations. Archives of Chronic Vagal Denervation and the Response of the Environmental Health 23(5):343.347, November 1971. Isolated Rat Ileum to Nicotine. Archives Internadonales de Pharmacodynamk et de Thera* 192(2):353-36I, This study was conductedto determine whether 1971. carbon monoxide gas is a factor responsible for deteriora- tion of vigilance in men breathing pollutedair. Ten Chronic denervation of the abdominal vagi in rats for subjects were exposed for slightly longer than two hours, 36 weeks did not alter the biphasic contractile response on separate occasions, to CO levels approximating the of the ileum to nicotine or to acetylcholine (ACh), in average (24 ppm) and peak (111 ppm) levels found while vitro when compared to the responses of the normal driving in urban traffic. Smokers were not used as subjects ileum found in a previous study. Atropine blocked the because their blood COHb levels were already elevated. primary spike-like contraction to nicotine but did not During thelast hour of each exposure the subjects affect the slow, secondary contraction while the respopsis undertook a standard test of visual vigilance. They also toACh wereabolished. DMAE (42:0 - undertook the test while breathing air without CO. Blood bisi dimethy la m mon ium-acetaldehydediethylacetal)- carboxyhemoglobin levels were measured prior to ex- p,p -diacetylbiphenyl bromide), cocaine, and strychnine posure, before and after the tests. Heart rates and minute effectively inhibited the biphasic response to nicotine ventilatory volumes were also measured. The results r. without a similaraction on the response to ACh. showed that vigilance was impaired by breathing 11 l ppm Hexamethonium inhibited onlypartiallythe primary CO which raised the average COHb level to 6.6 percent. spike-like contraction to nicotine, but a combination of Heart rates and minute ventilatory volumes were not hexamethonium and atropine caused complete blockage affected. (Auth. Abs. Mod.)

18-3 180 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

71-0966. Langer, A. M., Mockler, A. D., Rubin,I., effect was produced by a mixture of high concentrations Hammond, E. C., Selikoff, I. J. Inorganic Particles in of CO and SO2. Cigars and Cigar Smoke. ScienceI 74(4009):585-587, November 5, 1971. 71-0969, Mesolella, C., Pendia, F., Testa, II., Morelli, G. A number of crystalline and optically isotopic inor- Rflievi Oto-Neurologici in un Gruppo di Operai Esposti ganic materials are used in the manufacture of reconsti- Cronicamente all'Azione dell'Ossido di Carbonic). [OM- tuted tobacco sheets. These sheets. used primarily in Neurological Observations in a Group of Workmen Chron- inexpensive cigars, often contain diatomaceous earth, ically Exposed to the Action of Carbon Monoxide.]Ar- which exists in part in the silica mineral form cristobalite, chiviiItalian(di Laringologia78(I):4760, January- a known fibrogen. Diatom fragments with this crystalline February 1970, Italian. form have been observed in the main smoke stream of cigars made with these tobacco sheets. (Auth. Abs.) After describing the difficulties which exist in defining chronic carbon monoxide intoxication and presenting previous research and observations of related acoustic and 71-0967. Maher, V. M., Lesko, S. A. (Jr.), Straat, P. A., vestibularchanges,this studyreports theresults of Ts'o, P.O.P. Mutagenic Action, Loss of Transforming oto-neurological investigations which were carried out on Activity, and Inhibition of Deoxyribonucleic Acid Tem- 44 workmen. Because of the various types of work plate Activity In Vitro Caused by Chemical Linkage of performed, these workmen had been exposed to carbon CarcinogenicPolycyclic Hydrocarbons to Deoxyribo- monoxide for a long period of time, ranging from I to 25 nucleic Acid. Journal of Bacteriology 108(1):202 -212, years. However, none had complained of acute intoxi- October 1971. cation. Among those studied, 10 had perceptive brady- acusia, 4 had a vestibular hyporeflexivity. and 24 showed In a solvent system of 0.01 M phosphate buffer (pH slight electroencephalographic alterations. The lack of a 6.8)-ethanol (2:1, v/v) and in an iodine-induced reaction, relationship between the degree and constancy of oto- the polycyclic hydrocarbons (3H)3,4benzopyrene and neurological damage and the duration of CO exposure, (3H)3,4-BP/(311)9,10-dimethy1-1,2-benzanthracene the levels of carboxyhemoglobinemia, and the levels of (DMBA) can be covalently linked to deoxyribonucleic blood iron did not allow the observed alterations to be acid (DNA) at room temperature. By stepwise addition of attributed to carbon monoxide intoxication. It is sug- the hydrocarbon and repeating the reaction two to three gested that these alterations can be attributed to other times after isolating the hydrocarbon DNA adduct, it was chronic intoxications due to acute poisonings from other possible to introduce as many as one covalently bound toxic industrial substances which are not observed by the hydrocarbon molecule per 100 nucleotide bases. When subject. 3,4-BP and DMBA were linked in this way to biologically active transforming DNA of Bacillus subtilis, they caused reductionofthe transforming activity of the DNA 71-0970. O'Donnell, R. D., Chikos, P., Theodore, J. accompanied by significant increases in the frequency of Effect of Carbon Monoxide Exposure on Human Sleep forward mutations. The majority of these hydrocarbon- and Psychomotor Performance. Journal of Applied induced mutations were not able to revert spontaneously. Physiology 31(4):513.518, October 1971. These samples of DNA covalently linked with hydro- carbons showed much lower levels of survival of biological Recent studies have indicated that human perfor- activity when assayed in recipient strains (hcr ) which are mance degrades after exposureto small amounts of known to be deficient in the enzymes required for repair carbon monoxide (CO) while other studies have found no of ultravioletlight-induced damage to DNA. 3,4-BP decrement. To further test the effect of such exposure, covalently linked to calf thymus DNA at a level of four subjects were exposed to 75 and 150 parts per approximately one hydrocarbon molecule per 330 bases million of CO during sleep for 9 hours, producing mean was shown to cause up to 80 percent inhibition of the in carboxyhemogiobin levels of 5.9 and 12.7 percent. Sleep vitro transcription of the DNA by highly purified ribo- was monitored continuously through electrophysiological nucleicacidpolymerase prepared from Micrococcus recording. Upon waking, subjects were given mental luteus under the experimental condition of template arithmetic, time estimation, tracking, monitoring, and saturation. The presence of 3,4-BP and DMBA molecules visual tests. No performance decrements or differences covalently bound to B. subtilis DNA samples was also from control conditions were found in any of the tests found to prevent complete denaturation of the bihelical used. With respect to sleep patterns, subjects under CO structure of certain DNA molecules and thus appears to had more deep sleep and less light sleep than in the effect a cross-link in these DNA molecules. (Auth. Abs.) control condition. Rapid-eye-movement sleep was not affected. It was concluded that, although certain CO effects occur in sleep, these are not great enough to affect 71-0968. Mamatsashvili, M. I. On the Detrimental Effect performance and that for healthy well-motivated human of Carbon Monoxide and Sulfur Dioxide on Fertility of subjects, these levels of CO do not produce performance Female Rats. Hygiene Sanitation 76:277 -279, 1970. decrements in the tasks used. (Auth. Abs.)

Albino rats were exposed for 72 days to inhalation of 1 and 2 mg/n CO and 0.5 and 4 mginSO2, al well as a 71-0971. Pestel, M. Peut-on Fumer Sans Danger? [Can mixture of these compounds, 2 and 4 mg /m , respec- One Smoke Without Danger ?J VieMedicate tively. Both CO and SO2 had detrimental effects on the 52(25):3040-304I, July 1971, French. estral cycle and fertility of the animals and a stimulating influence on the endocrine system, which could evidently Researchers have attempted to reduce the harmfulness be due to increased pituitary function. The strongest of smoking because it is clear that many smokers will find

181 1&4 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

reasons for justifying their habit. The present report through thestomach, would not be neutralized and briefly reviews the progress to modify the tobacco or the thereforeleadto duodenal ulcer formation. In these smoke. Filters can reduce the hazards to some degree. To experiments. 16 rats (Group I) were also infused subcu- this end, experiments are cited of dogs smoking seven taneously with saline at the rate of 0.54 ml/hour, 14 rats unfiltered cigarettes daily for two and one-half years anti (Group II) were infused subcutaneously with a solution of inwhich two dogs developed human-type bronchial 20 micrograms/kg/minute of nicotine sulfate in saline at carcinoma; no dogs smoking filtered cigarettes under the the rate of 0.54 ml/hour, and 12 rats (Group Ill) received same conditions developed such cancers. Possibilities of the same amount of nicotine sulfate subcutaneously as developing less harmful tobaccos include modifications of Group II, but water instead of acid was perfused through fertilizingpractices,different methods of processing the esophagus. When acid alone was perfused, duodenal tobacco, and hybridization of tobacco varieties to develop ulcers were found in 31 percent of the animals. When tobaccos with a lower tar and nicotine content. Smokers nicotine sulfate was also given, the incidence reached 93 who continue to smoke are currently advised to reduce percent and the ulcers were more numerous and severe their consumption of tobacco and not to inhale. than those in Group 1 rats. Nicotine alone produced no ulcers. Theseresultsstrengthenthe hypothesis that nicotine sensitizes the duodenum to the ulcerogenic 71-0972. Pirnay, F., Dujardin, J., Deroanne, R., Petit, J. property of acid flowing from the stomach. If man reacts M. Muscular Exercise During Intoxication by Carbon to nicotine as the rat does nicotine absorbed chronically Monoxide. Journal of Applied Physiology through smoking may contribute to ulcer formation and 31(4):573.575, October 1971. to ulcer recurrences by reducing secretion of alkaline pancreatic juice via inhibition of secretin. The metabolic, circulatory, and respiratory responses were analyzed during muscular exercises in which CO intoxication immobilized 15 percent of the hemoglobin. 71-0975. Shibata,S.,Hattori,K., Sanders, B. The During moderate exercise, 02 consumption was not Relationship Between External Calcium Concentration modified and induced a ventilation comparable to that we the Recovery Rate of Aortic Strips From Nicotine measured under normal conditions. On the other hand, Tachyphylaxis. EuropeanJournalof Pharmacology the heart rate greatly increased from 128.1 to 142.7 16(1):109-112, September 1971. beats/minute. This tachycardia appears to be the result of a much larger cardiac output brought about by the In rabbit aortic strips, a repeated exposure to the same decrease in the oxygen carrying capacity of the blood. concentration of nicotine produced tachyphylaxis. Com- During maximal exercise, the maximal 02 consumption plete recovery occurred 50.60 minutes following the was reduced 15.1 percent in spite of a much higher heart washout of the rust application of nicotine. Incubation in rate and a relative hyperventilation. This reduction of mediumcontaining norepinephrine (10-9 M) or dopamine maximal 02 consumption parallels the reduction of the (10' M) did not modify the time course of recovery. 02 transport possibilities of the blood. This thus provides halved the recovery time and low a confirmation of the hypothesis that there is a circula- Ca'Ca'-medium- medium inhibited this process. Thus nicotine ta- torylimitation upon the maximal 02 consumption. chyphylaxis does not appear to be due to catecholamine (Auth. Abs.) depletion but rather to be a blockade of the adrenergic nerve effectorsite by depolarization which prevents norepinephrine release. (Auth. Abs.) 71-0973.Portheine,F. "Paativrauchen"-Nkhtraucher- schutz.("Passive Smoking " - NonsmokerProtec- tion.]Medical Tnbune 18:(Unpaged), April 30, 1971, 71-0976. Turnbull, M. J., Kelvin, A. S. Cigarette Depen- German. dence. (Letter) British Medical Journal 3(5766):115, July 10, 1971. The present material consists of statements by Port- heine which had originally appeared in the Munchener The 24-hour urinary excretion of adrenaline, the Medisinische Wochenschrift and an exchange of corres- histamine metabolite 1-methylimidazole-4-acetic acid, and pondence concerning the substance of these statements. its isomer1-methylimidazole-5-acetic acid was signifi- Portheine had briefly summarized the injurious effect of cantly higher in 22 smokers than in 21 smokers. These passive smoking on nonsmokers. He also accused the differences may be partly responsible for the withdrawal ForschungsinstitutderZigarettenindustrie of burying symptoms sometimes seen on stopping smoking. Appar- their data concerning lung cancers induced in hamsters by ently, the urinary excretion of these compounds is not passive smoking in an obscure American journal and of immediately reversed upon cessation of smoking. using invalid techniques in obtaining values for carbon monoxide and nicotine in smoked-filled areas. W. Donten- will, who is the Director of the Forschungsinstitut, replies 71-0977. Varga, E., Kovacs, L., Gesztelyi, I. Analysis of to the "false" charges and is again attacked by Portheine. the Depolarizing Effect of Nicotine on Frog's Skeletal Muscle. ActaPhysiologicaAcademiaeScientiarum Hungaricae 38(4):325-342, 1970. 71-0974. Robert, A., Stowe, D. F., Nezamis, J. E. Possible Relationship Between Smoking and Peptic Ulcer. Nature The properties and mechanism of the slow depolariza- 233(5320):497 .498, October 15, 1971. tion induced by nicotine in the striated frog muscle may be outlined as follows. The depolarizing effect of nicotine Since nicotine inhibits secretion of alkaline pancreatic depends on the concentration (maximum between .05 juice,experiments - usingfemaleUpjohnratswere and .20 mM), on the site of measurement (maximum in conducted to determine if hydrochloric acid, perfused the end-plate area) and on seasonal conditions (the effect

185 182 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

is more marked from October to March than in spring or the Rat.Archives Internationales de Pharmacodynamie summer). The depolarizing effect is the most marked near et de Therapie 193( I ): 23-36. September 1971. the neuromuscular junction, may be inhibited by curariza- tion, and inthe aneural part of the muscle even a Chronic treatment of rats with 4.56 mg/kg/day of thousandfold of the otherwise effective nicotine concen- nicotine inthe drinking water produced a depressor tration causes no depolarization. Thus, the neuromuscular response, an augmented pressor action of norepinephrine, junction is apparently the site of the depolarizing effect. and a reduced pressor action of tyramine. In contrast, rats Slow depolarization spreads exclusively in Ringer con- made acutely tolerant to the pressor effect of nicotine taining nicotine. The cause of slow depolarization appears were subsensitive to both norepinephrine and tyramine. to be an increase in the Napermeabilityof the membrane Pressor responses to the muscatinic ganglionic stimulants, and about a 4.5-fold increase of `4Na influx, on the McN-A-343, AHR-602, or physostigmine, were erratically average. Tetrodotoxin (TTX) at a concentration of 10 7 affected by chronic treatment with nicotine. Pressor g/ml inhibits the spike propagation caused by nicotine in responses to DMPP, TMA, nicotine angiotensin, or vaso- muscle fiber, but leaves the increase of 24Na influx and pressin,however,wereunaffected.Treatmentwith slow depolarization unaffected. At a concentration of guanethidine, for 10 days, also sensitized rats to the 5X10 g/ml TTX diminishes both the depolarization and pressor effect of norepinephrine and reduced the response the increale of 24Na influx induced by nicotine. Nicotine to tyramine. It did not modify the response to any of the increases Na influx to the same extent at 0 C as at 20 otherpressorsubstances which had belt'testedin to 23 C. (Auth. Abs.) nicotine-treated rats. As with chronic nicotine treatment, guanethidine did not influence the development of renal hypertension in the ratbut lowered the pressure to normal levels whenitwas administered during the 71-0978. Wang, I. Y., Mower, H. S., Rasmussen, R. E., secondary phase of renal hypertension. Treatment of Crocker, T. T. Enzymatic Conversion of Benzo(a)pyrene. normotensiveorrenal hypertencive rats with DMPP Hydroxylation vs DNA-Binding. Archives of Internal elevated the systolic pressure but did not produce the Medicine 128(I):125-130, July 1971. secondary depressor effect characterisitc of nicotine. The depressor effect of chronically-administered nicotine may Hydroxylating and DNA-binding activity is increased not be the same asthat which results from acute in lung and liver microsomes after induction of enzyme nicotinization. It is not the result of a block at nicotinic activity by injecting benzo(a)pyrene (BaP) into intact ganglionic receptors. (Auth. Abs. Mod.) rats. Overall enzymatic activity increases more in liver than inlung, and DNA-binding increases more than hydroxy product formation in microsomes from liver as 71-0980. Zavadina, S. P., Khesina, A. Y. Toksicheskoe compared to lung. Three major metabolites, detected by Deystviye i Metabolism Kantserogennykh Uglevodordov v chromatography of a hexane-acetone extract after incuba- Kul' turakhNormal'nykhiOpukholevykhKletok tion of BaP labeled with tritium with preinduced liver Zolotistog Khomyaka. [Toxic Effect and Metabolism of microsomes, are reduced sharply by_hematin at 5 X 10's M. The greatest Carcinogenic Aromatic Hydrocarbons in Cultures of M, and eliminated by 2.5 X 10 4 Normal and Tumor Cells in Golden Hamsters.]Voprosy reduction was a peak identical with a standard sample of Onkologil 17(7):62-66, 1971, Russian. 3-hydroxy-BaP. Hematin reduced DNA-binding toa greater degree than metabolite production. This suggests Normal and transformed hamster cells were cultivated that hematin interferes with metabolic conversion of BaP inthemediumcontainingaromatichydrocarbons: to a DNA-binding product. The latter product may be a 3,4 -benzo(a)pyrene (BP)and7,12- precusor of 3-0H-BaP since both DNA-binding and dimethylbenzanthracene (DMBA). Both hydrocarbons 3-0H-BaP production are similarly suppressed. (Auth. were metabolized by normal cells more intensively than Abs.) by neoplastic ones. At the same time normal cells have proved to be more sensitive to the toxic effect of BP and DMBA. However,thereisnot always a correlation between cell sensitivity of transformed lines to BP and 71-0979. Wenzel, D. G., Azmeh, N., Clark, 1. J. Studies on DMBA toxiceffect andtheir metabolism of these the Acute and Chronic Depressor Actions of Nicotine in compounds. (Auth. Abs.)

See also7l-0989, 71-0990, 71-1002, 71 -1006, 71-1077

MORTALITY AND MORBIDITY

71-0981. Ferris, B. G. (Jr.), Speizer, F. E., Worcester, J., nor was there any significant difference in specific cause. Chen, H. Y. Adult Mortality in Bolin, NH, From 1961 to No single best predictor of mortality could be identified. 1967. Archives of Environmental Health 23(6):434439, In general, a previous history of respiratory disease was a December 1971. good predictor. It became much more so when associated with cigarette smoking, heart disease, gas exposure at work, and lowered pulmonary function. The relative role The mortality experience of the adult population of of these various factors could not be separated out with Berlin, New Hampshire, did not show any overall excess, confidence because of the small numbers. (Auth. Abs.)

183 186 MORTALITY AND MORBIDITY

71-0982. Hirayama, T. A Prospective Study on the addition, life expectancy in females in 1950 was only 2.9 Influence of Cigarette Smoking and Alcohol Drinking on years higher than in males, but by 1965 this difference the Death Rates for Total and Selected Causes of Death in had amounted to 7.1 years. Life insurance companies Japan. Smoke Signals 16(7): I -8, July 1970. attribute the slowing of the life expectancy curve and mortalitydifferencesinthe two sexes tocigarette In a cooperative study of the National Cancer Center, smoking, which is held responsible for an excess mortality the Institute of Public Health, and the prefectures of of 150 percent. The actual mechanics by which smoking Miyagi, A ichi, Osaka, Ilvogo, Okayama, and Kagoshima, a exerts its harmful influence is not discussed in the report. prospective study of 265.118 adults (maks 122,261, Smoking may onlybe a means of revealing latent females 142.857) has been in progress since late in 1965 hereditary differences but in the absence of specific data, in twenty-nine health Center Districts. In the study area the smoker would do well to discontinue smoking or to all persons aged over 40 in the 1965 census lists were reduce his consumption. interviewed. The response varied from 91.3 to 99.8 percent. Based on three full years' follow-up, a higher risk of cancer of the lung, esophagus, pancreas, liver, stomach, 71-0984. U.S. Department of Health, Education, and arterioscleroticheartdisease,peptic ulcer, and liver Welfare, Public Health Service. The Health Consequences cirrhosis was found among cigarette smokers; a higher risk of Smoking. A Reportof theSurgeonGeneral: of cancer of the csophagus and liver cirrhosis was noted 1971. U.S. Department of Health, Education, and Wel- among daily alcohol drinkers. An addictive effect of risk fare, Public Health Service, Health Services and Mental factors was also observed, including a strikingly high risk Health Administration, Washington, D.C., DHEW Publica- for the combined habits of daily alcohol drinking and tion No. (HSM) 71-7513, 1971, 458 pp. cigarette smoking in esophageal cancer. (Auth. Abs.) This report constitutes a comprehensive review of more than 20 years of research into the problem of 710983. Pestel, M. Tabac et Esperance de Vie. [Tobacco smoking and health with emphasis on the most recent andLifeExpectancy.' PresseMedicate additions to the literature. Evidence is presented con- 79(46):2081.2082, October 30, 1971, French. cerning the relationship between smoking and cardio- vasculardiseases, includingcoronaryheartdisease, Until recent times, life expectancy at birth had risen cerebrovascular disease, nonsyphilitic aortic aneurysm, very slowly, from 25 years in the seventeenth century, to and peripheral vascular disease; cancer of the lung, larynx, 35 years in the eighteenth and to 43 years by 1880. From oral cavity, esophagus, urinary bladder and kidney, and 1900 to 1956, the expectancy levels have risen more than pancreas; birthweight and outcome of pregnancy; peptic 20 years, but have barely increased a year since then. In ulcer; and tobacco amblyopia.

See also71.0985

NEOPLASTIC DISEASES

71-0985. American Cancer Society. 1972 Cancer Facts Hanna, M. G. (Jr.), Deatherage, L W. (Jr.) (Editors). and Figures American Cancer Society, Inc., 1971.31 pp. Morphology of Experimental Respiratory Carcinogenesis. Proceedings of a Biology Division, Oak Ridge National Some basic facts and figures on cancer in the United Laboratoryconference,Gatlinburg, Tennessee, May States, Inc:In:ling statistics on morbidity and mortality, 13-16, 1970. U.S. Atomic Energy Commission,ivbion site and sex incidence, and survivability, are presented. of Technical Information, Oak Ridge, Tennessee, AEC The importance of early detection, trends in individual Symposium Series 21, December 1970, pp. 93-104. sites of cancer, ACS education programs concerning ways for individuals to protect themselves against cancer, and The several types of lung cancer show different public attitudes toward cancer are discussed. Specific epidemiologic patterns of occurrence. In general series, informationisprovided on cancers of the breasts, thepattern of distributionischaracteristicallythat colon-rectum, lung, mouth area, skin, and uterus, as well produced by moderate cigarette smoking. Industrially as leukemia. Recent developments in the area of smoking exposed individuals may be most prone to develop and health, ACS antismoking efforts, and health costs of squamous all carcinoma, oat cell carcinoma, or adenocar- cigarette smoking are described. ACS activities in the area cinoma, depending upon the stimulus (e.g., chromate, of cancer research, cancer prevention, clinical fellowships, radon (plus cigarettes), and asbestos, respectively), while service and rehabilitation, and the International Associa- cancers arising from scars are mc4t often bronchiolar. tion of Laryngectomees are reviewed along with some of (Auth. Abs.) the economic aspects of cancer.

714987. Chaklin, A. Ontological Research.Journal of 57(2):80-81, July 16, C 71-0986. Berg, J. W. Epidemiology of the Different the Indian Medical Association Histclogic Types of Lung Cancer.In: Nettesheim, P., 1971. IR"? 184 NEOPL 4STIC DISEASES

Onco logical researchisreviewed interms of the (Editors). Progress in Experimental Tumor Research. virusogenetical theory and the role of carcinogens. The Volume 14: Inhibition of Carcinogenesis. Basel. S. Kugel, incidence of cancer in different regions as affected by 1971,pp. 105-137. living conditions, habits and customs of the population is discussed with emphasis on tobacco chewing and smoking Itis not possible at this time to make sweeping habits. The induction of tumors in. test animals by recommendations regarding the introduction of anticar- benzopyrene injections and the connection between cinogenic chemicals in the interest of human protection. smoking and lung cancer are mentioned. Advances in It should, however, become one of th. areas of intensified oncogenesis, diagnosis and therapy are described. research effortsdirectedtoward acquisition of adequate information: (a) on the specificity of antagonists for certain groups of carcinogens. (b) for determination of 71-0988. Churg, J., Kannerstem, M. Occupational Ex- the quantitiesof inhibitor required to abolish carcino- posure and Its Relation to Type of Lung Cancer.In: genic activty. (c) on the time relationship which must be Nettesheim, P., Hanna, M. G. (Jr.), Deatherage, J. W. (Jr.) met to obtain good results, particularly under circum- (Editors). Morphology of Experimental Respirator), Car. stances where accidental exposure to high doses of a cinogenesis.Proceedings of a Biology Division, Oak Ridge carcinogen had occurred, (d) on any ill-effects which may National Laboratory conference, Gatlinburg, Tennessee, result from the use of enzyme inducers. thereby lowering May 13.16, 1970. U.S. Atomic Energy Commission, desired drug or hormone levels. (e) on differential enzyme Division of Technical Info' mation, Oak Ridge, Tennessee, induction efficiency, and (I) on the inhibitory action of AEC Symposium Series 21, December 1970. pp. 105-120. certain drugs, abolishing the desired enzyme activity. Much remains to be learned before anticarcinogenesis can Morphologic studiesofoccupationallung cancer be considereda reality, but efforts should be made to demonstrate the .tence of two forms: mesothelioma, develop knowledge in this field and to plan a strategy for which israrer quite specificfor a particular a concerted effort to utilize anticarcinogenic information carcinogen, inthis instance asbestos, and pulmonary for human protection. (Auth. Abs. Mod.) carcinoma, which is frequent and which is produced by a variety of substances. The role of cocarcinogenesis in the etiology of pulmonary cancer is briefly discussed. Epide- 71-0991. Ferrell, R. L.. Carter W. S., Yarington. C. T. miological data and the similarity of histologic patterns to (Jr.) Epidemiological Aspects of Oral Cancer.Eye, Ear, thatof tobacco cancersuggestthepossibility that Nose and Throat Monthly50(10):386-390. October cigarette smokeisthe common cocarcinogen in the 1971. genesis of occupational lung cancer. (Auth. Abs.) The epidemiology of oral cancer is discussed with particular reference to the recognition of the relationship 71-0989. Dao, T. L. Inhibition of Tumor Induction in between certain commonly used carcinogens and an Chemical Carcinogenesis in the Mammary Gland. In: van increased incidence of oral cancer. Various studies citing Duuren, B. L., Rubin, B. A., Homburger, F. (Editors). the roles of alcohol, tobacco smoking and snuff dipping as Progress in Experimental Tumor Research, Volume 14: extrinsic factor in oral carcinoma are reviewed. Inhibition of Carcinogenesis. Basel, S. Karger, 1971, pp. 59-88. 71-0992.Fischer,G. Smoking Habits and Bladder Experiments are presented in which inhibition of Tumors. A Clinical Study. Complete English translation tumor induction in the mammary gland by chemical of"RauchgewohnheitenundBlasentumoren.Eine carcinogen has been achieved by the following methods: klinische Untersuchung,"Zeitschnft fur Urologie und (a) hormonal stimulation of target tissue; (b) hormonal Nephrologie64(4):271 -274, April 1971. deprivation of the host; and (c) administration of one of a variety of chemical compounds capable of stimulating To obtain precise anamnestic data on the smoking drug-metabolizing enzyme systems. Ovarian hormones habits of patients with bladder tumors, questionnaires availablein large amounts either by introduction of were given patients who were treated at the Urological pregnancy or injections of the hormones shortly before Section of the Emperor Franz Joseph Hospital in Vienna carcinogen administration can effectively inhibit tumor from April I, 1968 to December 31. 1969 and in the induction. The unique structural similarity between ster- Urological Polyclinic of the University of Berlin-Steiglitz oid hormone and polycyclic aromatic hydrocarbon led to from January 1 to June 30, 1970. A total of 160 the suggestion that steroid hormone and carcinogenic questionnatus were returned by patients with either a polycyclics may compete for tissue-binding sites. Results benign bladder papilloma or a bladder carcinoma. More indicated that to achieve effective inhibition of mammary than half of the patients suffering from bladder tumors tumor induction by DMBA, large amounts of steroid were pronounced heavy smokers and only a very small hormone must be either injected or made available by part were nonsmokers. or expressed in percentages, 3 pregnancy before DMBA administration. This fact seems percent were nonsmokers, 28 percent were ex-smokers, to support the postulate that one mechanism in the 14 percent were light smokers. and 55 percent were heavy inhibiton of tumor induction is saturation of tissue- smokers. By contrast, ofthepersons suffering benign binding sites by steroid hormone to prevent subsequent prostatic hypertrophy, 24 percent were nonsmokers, 42.5 binding with DMBA. Sufficient proof of this mechanism percent were ex-smokers, 17.5 percent were light smo- of inhibition however is not available. kers, and only 16 percent were heavy smokers.

71-0990. Falk, H. L. AnticarcinogenesisAn Alterna- 71-0993. Gubinelli, C. Considerszioni StatistIco-Cliniche e tive.In: van Duuren, B. L., Rubin, B. A., Homburger, F. Ftadloterapeutiche su 131 Cali di Neoplasie Maligne

185 1813 NEOPLASTIC DISEASES

Broncogene. (Statistical, Clinical, and Radiotherapeutic 71-0996. Lacassagne, A. Alcohol and Cancer, Complete Observations of 131 Cases of Malignant Bronchogenic English translation of "Alcool et Cancer," Lutte Contre Neoplasms.] La Radiologia Medico 56(12):1144-1154, Cancer 46(179):7-13, November-December 1969. December 1970, Italian. See Abstract 70-0857 A brief clinical and statistical account is given of 131 cases of malignant bronchogenic neoplasms observed over a period of 10 years. Simultaneous evaluation and 71-0997. Leuchtenberger, C., Leuchtenberger, R. Effects objective improvement after radiotherapy showed that of Chronic Inhalation of Whole Fresh Cigarette Smoke the best results were obtained with total tumor doses of and of Its Gas Phase on Pulmonary Tumorigenesis in 2500-3000 radians. A possible "aimed" treatment cycle Snell's Mice.In: Nettesheim, P., Hanna, M. G. (Jr.), pattern is discussed. In an effort to evaluate the relation- Deatherage, J. W. (Jr.) (Editors). Morphology of Experi ship between smoking and age at incidence of the disease, Inertial Respiratory Carcinogenesis. Proceedings of a Biol- and smoking and survival rates, each patient was classified ogy Division, Oak Ridge National Laboratory conference, according to the number of cigarettes smoked daily and Gatlinburg, Tennessee, May 13-16, 1970. U.S. Atomic the total duration of his smoking habit. There was a total Energy Commission, Division of Technical Information, of 49 nonsmokers (and occasional smokers), 34 moderate Oak Ridge, Tennessee, AEC Symposium Series21, smokers, and 48 heavy smokers (those consuming over 30 December 1970, pp. 329-346. cigarettes daily for a period of 30 to 40 years). Only the results from a comparison of the two extreme groups are Exposure of male and female SndU's mice to chronic reported. Heavy smokers had an incidence rate of three inhalation of puffs of whole fresh cigarette smoke or of years prior to that of nonsmokers. Heavy smokers had a its gas phase alone, for one year or longer, resulted in an longer survival rate than nonsmokers. However, because earlier occurrence and a higher frequency of glandular of the small number of cases compared, a single subject pulmonary tumors when compared with those of con- with a very long survival rate could significantly change trols. The enhancement of pulmonary tumorigenesis was the total average for the group. particularly striking after exposure to the gas phase alone, and was more pronounced in males than in females. Males exposed to the gas phase disclosed not only a significant 71-0994. Gulati, J., Bak, A. Clinico-Pathological Study of shift from pulmonary adenomas to adenocarcinomas, but Cancer of the Larynx. Antiseptic 68(7):481 .48S, July the frequency of adenocarcinomas was 23 percent, that is, 1971. five times greater than that of controls, which was 4.7 percent. No bronchogenic carcinoma was observed in con- The results of a clinical and histopathologic study of trols or in mice exposed to whole fresh cigarette smoke or 200 patients with laryngeal cancer are presented with its gas phase. (Au th. Abs.) special reference to the age of onset, duration, symptoma- tology, occupation, previous history of syphilis, tuber- culosis, and septic focus. One of the most common predisposing factors was smoking and the chewing of pan, 71-0998. Menakanit, W., Muir, C. S., Jain, D. K. Cancer in lime and tobacco, singly or in combination. The incidence Chiang Mai, North Thailind. A Relative Frequency of laryngeal cancer was 81 percent among smokers, 62 Study.British Journal of Cancer25(2):225.236, June percent in pan chewers, and 15 percent in those who were 1971. both smokers and pan chewers. The relative frequency of histologically diagnosed can- cer at the Chiang Mai Medical School in North Thailand 71-0995. Kemp, R. Patients and Cigazettes. Practitioner for 1964 .67 inclusive is examined. Most of the 1877 207(1238): 215-220, August 1971. cancers seen are in Thais (males, 927; females, 908), the remainder arising in Chinese (males, 21; females, 12), Hill Kingland's method of calculating lifetime totals of People (males, 6; females, 1) and others (females, 2). In cigarettes smoked to determine the relative danger of Thais, the outstanding finding is the extraordinarily high smoking is discussed. The lung cancer rate was estimated frequency of cancer of the hypopharyngeal-laryngeal to be 30 percent for smokers of over 500,000 cigarettes, region in both sexes (males, 18.4 percent; females, 3.4 20 percent for 200,000 to 500,000 cigarettes, and 14 percent). This may be associated with the smoking of a percent for under 200,000; nonsmokers have a 1.3 local variety of the cigar called "keeyo". This cigar, percent rate. Comparable patterns were found for the smoked in the usual manner, contains approximately usual group of coronary disease, atherosclerosis, emphy- equal quantities of home-grown, sun-dried, Thai tobacco sema, chronic bronchitis, ulcers and cancers of the larynx, and the chopped bark of the "koi" tree (Streblus aspen). mouth and bladder. Kingland took the figure of 200,000 In women, who also smoke "keeyo", the frequency of cigarettes in a lifetime as the threshold beyond which the hypopharyngeal-laryngeal canceris unusually high by danger increases significantly. But on the basis of lung occidental standards. There is no sex difference in the cancer figures, most people would be more inclined to put frequency of bronchial cancer (4 percent). In males, the safety threshold at 100,000 cigarettes. Most patients cancer of the penis ranks second and is much more feel they may be one of the fortunate ones who "gets frequent than cancer of the prostate and testis combined. away" with heavy smoking, but lung cancer is only one of Stomach and skin cancers are in third place. In females the hazards and is not even the most common. Respira- the most frequent cancers are cervix uteri, breast, and tory and coronary disease in relation to smoking is skin. Cancers of the lip and skin of the head and neck are discussed followed by a description of c basic approach more frequent in females than in males. Choriocarcinoma for physicians to persuade patients to stop smoking and is common and there is a large number of vulvar.cancers some comments on the role of the physician, the smoking in young women. The geography, economy and medical habit and the benefits of quitting. facilities of Chiang Mai Province are described. Although

186 NEOPLASTIC DISEASES

there is likely to be considerable under-reporting of in- compatible animals iroeulated with converted cells. Coo. ternal cancers, the high frequency of hypopharyngeal- trol cultures (untreated. DNA-treated only and chemical laryngeal cancer is not due to selective bias. (Auth. Abs. agent-treated only) failed to convert and degenerated. I he Mod.) incorporated, inactive DNA may have competed against cellular DNA for limited amounts of intracellular sub- stances required for repairing genetic damage caused by 71-0999. Park, J.F., Howard, E. B., Stuart, B. 0., the chemical agents. By analogy, massive invasion of Wehner, A. P., DiUey, J. V. Cocarcinogenic Studies in buccopharyngeal epithelium by DNA viruses concurrently Pulmonary Carcinogenesis.In: Nettesheim, P., Hanna, with exposure to environmental mutagens. such as in M. G. (Jr.), Deatherage, J. W. (Jr.) (Editors).Morphology heavy smoking, might act as cofactors to potentiate car- of Experimental Respiratory Carcinogencsis.Proceedings chlogenesis in the human buccal cavity and oropharynx. of a Biology Division, Oak Ridge National Laboratory (Auth. Abs. Mod.) conference, Gatlinburg, Tennessee, May 13-16, 1970. U.S. Atomic Energy Commission, Division of Technical Infor- mation, Oak Ridge, Tennessee, AEC Symposium Series 71.1002. Rubin, B. A. Alteration of the Homograft Re- 21, December 1970, pp. 417-436. sponse as a Determinant of Carcinogenicity.In: van Duuren, B. L., Rubin, B. A., Homburger. F. (Editors). Cocarcinogenic experiments are currently in progress Progress in Experimental Tumor Research, Volume 14: to determine the pathogenesis of several potentially car- Inhibition of Carcinogenesis Basel. S. Karger. 1971. pp. cinogenic materials on the induction of pulmonary neo- 138.195. plasia in experimental animals. The role of plutonium - induced lymphopenia and lymphatic pathology is being The purpose of these investigations was to determine evaluated in the pathogenesis of pulmonary neoplasia therelevanceofthecarcinogen-induced tolerance induced by inhalation of plutonium dioxide in beagle phenomenon to the process of actual careinogenesis. This dogs. Hamsters and dogs arc being exposed to combina- was sought by direct comparisons. qualitative and quanti- tions of uranium mine air contaminants including radon tative, between the ability of carcinogens to affect the daughters, uranium ore dust, diesel engine exhaust, and two types of responses in the same inbred animals. From cigarette smoke. The cocarcinogenicity of inhaled asbes- the studies of the interactions between substances that tos, nickel oxide, cobalt oxide, and cigarette smoke is enhance or inhibit carcinogens, it was possible to derive being investigated in hamsters. (Auth. Abs.) some evidence of the mechanism of carcinogen action and some insightinto possible methods of prophylaxis. Further, it was possibleto show that the homograft 71-1000. Richter, C. B. Application of Infectious Agents tolerance assay is a meaningful, sensitive (and rapid) tech to the Study of Lung Cancer: Studies on the Etiology and nique for detecting potential carcinogens as well as anti- Morphogeneds of Metaplastic Lung Lesions in Mice.In: carcinogens. The comparison with leukemogenesis not Net teshcim, P., Hanna, M. G. (Jr.), Deatherage, J. W. (Jr.) only showed the remarkable correlation between these (Editors). Morphology of Experimental Respiratory Car - two carcinogen activities, but also established the system cinogenesis.Proceedings of a Biology Division, Oak Ridge of induced leukemia in DBA/2 mice as a highly reliable National Laboratory conference, Gatlinburg, Tennessee, and sensitive technique for the assay of the polycyclic May 13-16, 1970. U.S. Atomic Energy Commission, Divi- hydrocarbon carcinoge ns. sion of Technical Information, Oak Ridge, Tennessee, AEC Symposium Series 21, December 1970, pp. 365-382. 71-1003. Rusk, H. S. How Smofr'ng Causes Lung Can. Squamous metaplasia of the bronchial epithelium and cer.Rocky Alountain Medical Journal68(10):37 -39, lung parenchyma was observed in spontaneously infected October 1971. DBA/2 mice. Transmission studies employing clinical material segregated two pathogenic agents: mycoplasma A new etiology of lung cancer is presented without and a paramyxovirus. Experimental superinfection em- absolute proof. However, circumstantial evidence points ploying these two agents resulted in reproduction of the to the possibility that tissue dryness and vasoconstriction clinically observed lesion characterized by high mitotic from nicotine produce cellular changes in areas of the indices in metaplastic tissue. Electron microscopy was respiratory tract most exposed to dryness. These same used to study the fine structure changes and localization areas are the most frequent sites of lung cancer (Auth. of the infectious agents.Thepotential role of the induced Abs.) lesion in experimental lung cancer is mentioned. (Auth. Abs.) 71-1004. Saxomanno, G., Saunders, R. P., Archer, V. E.. Auerbach, 0., Brennan, L. Metaplasia to Neoplasia.In: 71-1001. Roth, D., Oppenheim, A. Synergistic Effect of Nettcsheim, P., Hanna, M. G. (Jr.), Deatherage, J. W. (Jr.) Mutagens and Incorporated DNA In Vitro. Analogy for (Editors).Morphology of Experimental Respiratory rap BuccopharyngealCavity.Archives of Environmental dnogenesis.Proceedings of a Biology Division, Oak Ridge Health22(4):482-486, April 1971. National Laboratory conference, Gatlinburg, Tennessee, May 13-16, 1970. US. Atomic Energy Commission. Divi- Purified calf thymus DNA was incorporated, to satura- sion of Technical Information, Oak Ridge. Tennessee. tion limits, into cultured hamster embryo cells. The cells AEC Symposium Series 21, December 1970, pp. 63-80. were then exposed to carcinogenic and noncarcinogenic diepoxides and aromatic hydrocarbons. All tested cultures A histological study of the tracheobronchial tree and converted to permanent cell lines, exhibiting loss of sputum cells of six cascs of cancer of the lung is pre- contactinhibition.Tumors werenotinduced in sented. These six patients are divided into three groups

187 190 NEOPLASTIC DISEASES

according to toxic inhalant exposure. Two patients had incidence of papillomas in the larynx. trachea, and extra long exposure to radon in uranium mines, two had long- pulmonary bronchi. but did increase incidence of tumors term exposure to radon plus cigarette smoke, and two in the lungs. Some possible mechanisms are discussed. were long-time heavy cigarette smokers. All developed (Auth. Abs.) cancer of the lung. An attempt was made to match cells found in sputum prior to the time of surgery or death with sections showing similar cell patterns. An attempt 71-1006. Wattenherg, L. W. The Role of the Portal of was also made to correlate or show relationships of types Entry in Inhibition of Tumorigenesis.In: van Duuren, B. of metaplasia seen in each group and to correlate this with L., Rubin, 13. A., Ilomburger, F. (Editors). Progress in final tumor product. The metaplasia seen in the patients Experimental Tumor Research, Volume 14: Inhibition of exposed to cigarette smoke and radon are similar, and the Carcinogenesis. Bawl, S. Larger, 1971, pp. 89-104. tumorous final product is preceded by a histologically related metapbstic cell development. (Auth. Abs.) The induction of increased microsomalenzyme activ ityresults in the inhibition of carcinogenesis due to ex- posures to a variety of chemical carcinogens. Thus, these 71.1005, Smith, W. E., Miller, L., Churg, J. An Experi- enzyme systems have the capacity to exert a protective mental Model for Study of Cocarcinogenesi.s in the Res- effect against chemical carcinogens. Substantial studies of piratory Tract.In: Netteshcim, P., Hanna, M. G. (Jr.), the distribution of one group of the microsomal enzyme Deatherage, J. W. (Jr.)(Editors). Morphology of Experi- systems, the polycyclic hydrocarbon hydroxylascs, have mental RespiratoryCarcinogenesis.Proceedings of a been carried out. In addition to their occurrence in other Biology Division, Oak Ridge National Laboratory con tissues, polycyclic hydrocarbon hydroxylases occur in the ference, Gatlinburg, Tennessee, May 13-16, 1970. U.S. major portals of entry. Their activity in the lung and small Atomic Energy Commission, Division of Technical Infor- intestine is quite labile, being altered by diet as well as by mation, Oak Ridge, Tennessee, AEC Symposium Series defined chemical inducers. Studies which have been 21, December 1970, pp. 299-316. carried out in the rat suggest that most, and possibly all, of the polycyclic hydrocarbo: hydroxylase activity in Data are presented on yields, times of observation, and these two tissues is due to exposure to exogenous in- types of tumors in the respiratory tracts of hamsters after ducers. It is difficult at present to assess the implications intratracheal injections of different doscs of benzo(a)- of the above findings for man. If the activity of micro pyrene suspended in1 percent Tween 60. These data somal enzyme systems in the portals of entry of man afford base-line information for studies of promotion or show the same characteristics as those of the animals inhibition of carcinogenesis in the respiratory tract by studied thus far, then the response of individuals to chem- other substances. Addition of chrysotile to intratracheal ical carcinogens may be determined to a significant extent injections of benzo(a)pyrcne did not appreciably alter by exposures to exogenousinducers. (Auth. Abs.Mod.)

See also714958, 71-0973

NON-NEOPLASTIC RESPIRATORY DISEASES

71.1007. Camner, P., Philipson, K., Arvidsson, T. Ciga- 71 -1008. Camner, P.,Philipson, K. Humanstudier av rette Smoking in Man. Short-Term Effect on Mucocilbuy Tracheobronchiell Cleo/Ince sped Monodispersa Teflon- Transport.Archives of Environmental Health partildar Mukta med l'F och"m Tc.(Tracheobronchial 23(6):421426, December 1971. Clearance in man studied with Monothspened Teflon Particles tagged with "F and 99111Tc.] Nordisk Hy- gienisk Tldskrift52:1-9, 1971, Norwegian.

The short-term effect of cigarette smoke upon muco- Tracheobronchial clearance was studied with a tfst dliary transport has been studied with a test aerosol of 6- aerosol of monodisperse teflon particles tagged with 1°F to 7micron monodisperse particles and by external and99 mTe. Because of the reproducibility of the clear- measurement of the particles. The particles were pro- ance pattern in the same subject, it was possible to study duced from fluorinated ethylene propylene using a spin- the acute effect of different agents on mucociliary trans- ning disk technique and tagged with technetium 99m. The port. The acute effect of tobacco smoke in five subjects speed of mucociliary transport in a group of smokers was was an increase of mucociliary transport. One week after significantly higher during intensive cigarette smoking the subjects had quit smoking, they showed a slower than when they were not smoking (half-lives averaged clearance. The clearance pattern of one heavy smoker 22.8 and 43.9 minutesrespectively). On the average, with slight symptoms of bronchitis was affected by tracheobronchWclearancediminishedinthe same coughing. In two subjects, the clearance patterns were persons when they had abstained from smoking for one studied when different flow rates in the inhalations of the week; however, the decrease was not significant.(Auth. test aerosol were used. Clearance was largely dependent Abs.) upon the flow rates.

191 188 NON NEOPLASTIC RESPIRATORY DISEASES

71-1009. Chwat, M., Mordish, R. Hafra'ot Bedarkhe 286 women) aged from 30 to 65 years. The smoking habit Haneshima Uvisinusis'ezel `Ovdhn Bemispar Min& was established in one-third of the individuals. almost all Kutna Beyisra'el. [Respiratory Symptoms and Byssinosis of whom were men (only three smokers were women), Among Textile WorkersinIsrael.]Harefuah with 6.7 percent of these smoking more than 20 cigarettes 80(10):559-562, 586.587, May 16,1971, Hebrew. per day. Chronic nonspecific pulmonary disease was found in 15.2 percent of the population, simple chronic Respiratory symptoms and byssinosis were investi- bronchitis in 11.8 percent, chronic bronchitis with airway gated in 257 Israeli men who worked in cotton mills and obstruction in 2.6 percent, and obturation without char- in 64 controls who were members of the Israel Philhar- acteristics of chronic bronchitis in 0.8 percent. In persons monic Orchestra. Among the controls, 38 were smokers. over 40, the disorders were four times more frequent than Smoking was a significant factor which increased the in those between 30 and 39: The incidence in men was prevalence of respiratory complaints. The severity of res- 9.5 times higher than in women, and 11.5 times higher in piratory symptoms increased wit!: age. Of the cotton smokers than nonsmokers. A relationship was found workers, 174 complained of respiratory symptoms. Of between the number of cigarettes smoked per day and the these, 165 were smokers, but the nonsmokers had similar incidence of disease. Factors having a harmful effect on complaints. Pulmonary function values were significantly respiratory function encountered in the farmers (99.9 lower among the cotton workers thanthe controls. percent of the population) have less influence on the Among the cotton workers, exposure to dust was the incidence of disease than smoking. most important factor causing respiratory symptoms, whileCher factors such as aging and smoking were of minor significance. The prevalence of respiratory symp- 71-1013. Egle. J. L. (Jr.) Single-Breath Retention of toms and of byssinosis was related to work in depart- Acetaldehyde in Man. Archives of Environmental Health ments with a marked dust hazard. 23(6):427-433, December 1971.

The single-breath retention of acetaldehyde vapor by 71-1010. Coudray, P., Serise, M., Freour, P. Epidemio- the respiratory tract of human subjects was measured. logical Research on Chronic Bronchitis and Respiratory Experiments were performed in which the volume inhaled Insufficiency. Study of Prevalence in a Sample of Women and duration of inhalation and exhalation were varied. From 30 to 70 Years. Complete English translation of Some experiments involved breath holding of various time "Recherche Epidemiologique sur les Bronchites Citron- intervals. A direct relationship was found to exist between 'iques et les lnsuffisances Respiratoires. Etude de Preva- the volume inhaled and the percent taken up. There was lence Dans un Echantillon de Femmes de 30 a 79 Ans," an inverse relationship between rate of inhalation and Revue de Tuberculose et de Pneumologk 33(6):769-780, retention. At all inspiratory rates and tidal volumes, there September-October 1969. was an increase in retention as breath-holding time be- came longer. The humidity of the inhaled vapor had no See Abstract 71-0436. effect on acetaldehyde retention. Although several factors were found to affect uptake, the volume inhaled is the most important in determining single-breath retention. 71-1011. Douglas, F. G., Kafihnout, K. J., Patt, N. L. (Auth. Abs. Mod.) Foreign Particle Embolism in Drug Addicts: Respiratory Pathophysiology.A nnals of InternalMedicine 75(6):865-872, December 1971. 71-1014. Fournier, E., Zivy, P. Lung and Tobacco. Com- plete English translation of "Poumon et Tabac "Poumon Three of seven intravenous-drug addicts had radiologi-. et le Coeur 26(9):1109.1125,1970. cal, pathological, and functional manifestations of pulmo- nary foreign body emboli and granulomas; three others See Abstract 71-0441. had abnormal pulmonary function without clinical or radiological evidence of respiratory disease. In the seventh case there was necropsy evidence of foreign body gran- 71-1015. Gross,P. Some Aspects of Pneumoconio- ulomas in the lungs. The first six patients had reduced sis.Pathology Arnual 6:61-79, 1971. diffusing capacities, and the three with proved granulomas also had increased elastic recoil of lungs. Thus, the ul- Pulmonary clearance of dust proceeds along two path- timate effect of foreign body embolism on lung function ways. The physiologic mechanism consists of a muco- is reduction in diffusion and compliance, presumably ciliary "escalator" and alveolar clearance. Pathological caused by the extravascular, interstitial spread of granu- clearance consists of lymphatic transport of dust which lomas. Although embolic and granulomatous foreign body has penetrated the alveolar membrane to satellite lymph disease has not been proved in three cases, their dim- nodes. Macrophages help to aggregate otherwise diffusely inished diffusing capacities may be early evidence of its distributed dust particles. Failure of the pulmonary clear- presence. Early detection may prevent progression to ance mechanism is I) relative as whcn more dust is in- chronic respiratory disease. (Auth. Abs.) haled than can be removed by the clearance mechanism such as occurs in pneumoconiosis, or 2) absolute as when the clearance mechanism becomes defective because of a 71-1012. Durda, M., Szafranskl, W. Przewlekle Nieswobte congenital or acquired abnormality such as in alveolar Choroby Hue Wsrod Ludnoaci Wiejsklej Woj Lubelskiego. proteinosis. The respiratory bronchiole is the locus of [Chronic Non-specific Diseases of the Lung Among the clearance failure as evidenced by productive inflammatory Rural Population of the Lublin Province.]Gruzlica changes produced by various pulmonary irritants concen- Choroby Pluc 39(7):616620, July 1971, Polish. trated there. Alveolar septal destruction induced experi- mentally with papas: resembles centrilobular emphysema. The investigation based on a World Health Organiza- Centrilobular emphysema may be due to an inadequate tion questionnaire covered the rural population (237 men, inhibitionof endogenous enzymes such as occurs in

189 NONNEOPLASTIC RESPIRATORY DISEASES alpha-antitrypsin deficiency. Cigarette smoke may also Investigation 2F( I ):I-3, September 1971. vitiate antienzymatic activity locally, thereby resulting in alveolar destruction. An excessive amount of inhaled dust An alpha, -antitrypsin content below 60 percent/100 can lead to atelectasis in the alveolar ducts or respiratory ml scrumisa characteristic of the inherited type of bronchioles which sequester the dust. However, these alpha, -antitrypsin deficiency. Such individuals are homo- sequestered dust deposits can be slowly mobilized or zygous for the Piz gene, which results in the formation of demineralized by edema fluid. The inflammatory response alpha, -antitrypsin molecules in abnormally small amounts of the alveolar membrane to inhaled insoluble particulates and with lower than normal charge. An early manifesta is due to its mesodermal origin and to an avascularization tion of emphysema without preceding bronchial or pul- process. Two types of coal worker's pneumoconiosis monary disorders is common in PiZZ subjects. There is an (CWP) are recognized, the simple and the complicated early diminution of lung elasticity. This may be due to an (also known as progressive massive fibrosis). The con- elastolytic attack on nonpolar residues of the elastin version of simple to complicated CWP by infections with fibers which removes their outer shell and impairs etas- acid-fast bacteria is in many respects similar to the well- deity. Some evidence suggests that the mean collagen known synergistic effect of tuberculosis upon silicosis. elastin ratio in lung tissue is higher in PiZZ subjects. There is a somewhat higher prevalence of respiratory Inhalation of papain aerosols has induced emphysematous symptoms and less effective lung function suggestive of lesions in laboratory animals. Proteolytic enzymes have chronic bronchitis in miners and ex-miners as compared been recovered from the sputa of subjects with emphy- to non-miners, but this difference is probably caused by sema and/or bronchiectasis and may originate from al- environmental factors not related to mining. Although veolar macrophages or from polymorphonuclear leuco- smoking patterns of coal miners differ from other workers cytes. The two plasma proteins, alpharantitrypsin and because of the smoking prohibition in mines, cigarette alpha2-macroglobulin, probably protect us against these consumption is about the same as that of the general proteolytic enzymes. In alpharantitrypsin deficiency, population. A relationship between lung function dis- anything causing increased sequestration and destruction turbance and duration of coal dust exposure has been of polymorphonuclear leucocytes or increased macro- found in smoking miners as compared with nonsmoking phage activity in the lungs is potentially dangerous. This miners. Thus cigarette smoking seems more important in includes all types of air pollution, such as tobacco smoke. the production of chronic bronchitis and emphysema than the inhalation of coal dust. 71-1018. Leuchtenberger, C., Leuchtenberger, R. Einfluss von Mschem Zigarettenrauch auf die Entwicklung von Lungentumoren and auf Lungenkulturen bei der Snell- 71-1016. Langlands, 1.H.M., Wallace, W.F.M., Simpson, Maus. [Influence of Fresh Cigarette Smoke on the Devel- M.J.C. Insulation Workers in Belfast. 2. Morbidity in Men opment of Lung Tumors and on Lung Cultures in Snell Still at Work. British Journal of Industrial Medicine Mice.]SchweizerischeMedizinischeWochenschrift 28(3):217-225, July 1971. 101(38):13744380, September 25, 1971, German.

Two hundred and fifty-two (93 percent) of the insula- Chronic inhalation of whole fresh cigarette smoke, or tion workers in Belfast were examined by chest x-ray, of its gas phase alone resulted in earlier occurrence and questionnaire, clinical examination, and tests of respira- higher frequency of lung tumors in Snell's mice. This tory function. The frequency of chest x-ray abnormality, enhancement of pulmonary tumorigenesis was particu- lung field or pleural, increased from 13 percent in men larly striking after exposure to the gas phase alone, and who had worked for less than 10 years to 85 percent in more pronounced in males than in females. No broncho- men who had worked for 30 or more years in the in- genic carcinoma was observed, but the pulmonary tumors dustry. Pleural calcification was found in 15 x-rays. There were adenomas and adenocarcinomas a histological type was evidence suggesting that some men had pleural f i b - of pulmonary tumor which occurs at a lower frequency r o s i s or calcification due to exposure to asbestos i n child- and at a later age in Snell's controls. Lung explant cul- hood. Rales were present in 61 percent and clubbing in I I tures which weri. exposed to whole charcoal-filtered ciga- percent of men with lung field abnormality, but these rette smoke, from which cytotoxic factors were nearly all were not common when the x-rays showed only pleural eliminated, showed after exposure to this "non-toxic" abnormality. Where the lung fields were involved there cigarette smoke a selective damage to the alveolar macro- was a restrictive defect with impairment in lung function phages. After exposure of lung explant cultures to the gas most marked in the forced vital capacity and single breath phase from charcoal-filtered cigarette smoke, the alveolar carbon monoxide transfer factor, but where the pleura macrophages showed a selective stimulation of DNA was involved without lung field involvement there was a synthesis. These results indicate, on one hand, the impor- tendency to impairment of ventilatory function with a tance of particulate matter for the inhibition of call normal transfer factor. There was considerable impair- metabolism, and on the other hand, the importance of the ment of lung function in smokers compared with non- gas for the stimulation of cell metabolism of alveolar smokers; there was a lower mean FVC and TI in smokers macrophages. with normal chest x-ray than in nonsmokers with lung field abnormality in their chest x-ray. Smoking and ex- posure to asbestos have an additive effect in causing 71-1019. Leuchtenberger, C., Leuchtenberger, R. Morph- impairment of lung function in respect to vital capacity ological and Cytochemical Effects of Marijuana Cigarette and gas transfer, as well as in causing lung cancer. Smoke on Epithelioid Cells of Lung Explants From Mice. Nature 234(5326):227-229, November 26, 1971.

71-1017.Laurell,C.-B.Is Emphysema inAlpha, - Lung explants from Snell's and C57BL mice were AntitrypsinDeficiency aResultofAutodiges- prepared on coverslips and exposed to puffs of smoke don? Scandinavian Journal of C7inical and Laboratory from cigarettes prepared with tobacco alone and with the

.193 190 NONNEOPLASTIC RESPIRATORY DISEASES

same tobacco mixed with 'marijuana (0.5 g). Two types of 71-1022. Okajima, Y. Shigaretto-en Choki Hampaku marijuana were used, one containing 0.4 percent tetra- Bakuro no Kido Semmo Undo ni Oyobosu Eikyo. (Long- hydrocannabinol (THC) and one containing 4 percent Term Effect of Cigarette Smoking on Ciliary Activ- THC. Cigarette smoke withmarijuana evoked ity.]Journal of the Nagoya City University Medical morphological and cytochemical alterations in epithelloid Association21(4):1022-1046, February 1971, Japanese. cells of the lung explants, such as atypism, mitosis, and DNA synthesis, to a significantly higher degree than ciga- Repeated exposure of rabbits to cigarette smoke rette smoke without marijuana. The observation that the markedly decreased the cleansing activity of the cilia. higher concentration of THC in marijuana cigarette smoke There was an invere relation between this decrease and evoked earlier and more marked alterations, including the blood carboxyhemoglobin content and a direct re- higher DNA content, suggests that THC is at least partly lation with the blood cell count and hematocrit. responsible for the alterations.

71-1023. Powell, G. M., Green, G. M. Investigation on the Effects of Cigarette Smoke on Rabbit Alveolar Macro- 71-1020. Motley, H. L. Environmental Mr Pollution phages.Biochemical Journal124 (2): 26P-27P, September Effect on Pulmonary Function.Aerospace Medicine 1971. 42(10):1108-1110, October 1971. Experiments showed that the activity of crystalline Air pollution aggravates preexisting respiratory and rabbit muscle glyceraldehyde 3-phosphate dehydrogenase circulatory conditions in man. Oxidants, oxides of nitro- was inhibited after exposure to the filtered gas phase of gen and sulfur, carbon monoxide and particulates are the cigarette smoke and aqueous extracts thereof, that the more important pollutants increasing airways resistance degree of inhibition was dependent on the preincubation and bronchospasm and impairing oxygen transfer and period and on the relative concentration of the filtered transport in the lungs and blood with hypoxia. Significant gas phase, and that in the presence of cysteine (2.5 changes in pulmonary function measurements occur from micromoles/8 ml of filtered gas phase) there was no breathing smoggy air in Los Angeles and similar changes significant inhibition of activity. Further experiments occur from cigarette smoking. The allergic aspect is an showed that glyceraldehyde 3-phosphate dehydrogenase important factor in many patients. A significant increase activity in incubated rabbit alveolar macrophages was in arterial oxygen pressure occurs in some patients on 100 inhibited by the filtered gas phase and that the extent of percent oxygen breathing with intermittent positive pres- inhibition was dependent on the concentration of the sure breathing (IPPB) as compared to ambient 100 per- filtered gas phase. There was no decrease in enzyme cent oxygen breathing indicating small collapsed areas at activity in the presence of the filtered gas phase when the alveolar level perfused with blood but not ventilated, cysteine was added to the incubation mixtures. These but which can be opened up with the 1PPB (microatelec- findings are consistent with a thiol-blocking role for fil- tasis). Lack of surfactant appears a possible factor. Ciga- tered gas phase, with particular reference to the activity rette smokers have high arterial carbon monoxide hemo- of glyceraldehyde phosphate dehydrogenase, suggesting a globin saturation, three to four times that of nonsmokers relationship between macrophage phagocytic competence even in Los Angeles. Cigarette smoking presents a far and loss of enzyme activity. greater hazard from carbon monoxide for flying personnel and cardiorespiratory patients than breathing the Los Angeles smoggy air. (Auth. Abs.) 71-1024. Pudelski, J., Oldek, K., Deloff, L. Obraz Epi- demiologiczny Przewleklych Nieswoistych Chorob Pluc u Mieszkancow Miasta Zabrze. [Epidemiological Situation of Chronic Non-specific Diseases of the Lung in Inhab- 71-1ii21. Nikodemowiez, E., Sawicki, F., Janczy, S., itant of the Town of Zabrze.]Gruzlica i Choroby Pluc Czajkowska, L., Pawlikowska, L, Piotrowska, B. Cruz lice 39(7):604-609, July 1971, Polish. Pluc i Objawy Kau lu i Odkrztuszania Warod Mieszkancow Kra Icowa.[Pulmonary Tuberculosis and Cough and Epidemiological investigations were conducted on the Expectoration in Inhabitants of Krakow.]Gruz lica incidence of manifestations of chronic nonspecific bron- Choroby Pluc39(7):595-603, July 1971, Polish. chopulmonry disease in men ages 40 to 60 in Zabrze, an industrial town witb a high atmospheric pollution level The present analysis included persons examined at the (360 micrograms/m'). Of the 1190 men examined (over er4 lemio:ogical survey of inhabitants of Krakow in 1968. 90 percent of the population), 76 percent were smokers The incidence of chronic cough and expectoration was and 84 percent worked exposed to dust. The results investigated in persons in whom pulmonary tuberculosis, showed chronic cough in 29 percent, expectoration in either active or healed, was suspected (on the basis of data 21.7 percent, cough and expectoration in 20 percent, from past history, changes on miniature films or standard grade II dyspnea in 22 percent, and grade III dyspnea in roentgenograms), as well as in those in whom tuberculosis 11.6percent. Spirographic signs of obturation were was diagnosed. It was found that in tuberculous patients present in 18 percent and were more frequent and more as well as in persons in whom pulmonary tuberculosis was severe in older-age groups. suspected, the incidence of cough and expectoration was higher than in persons in whom tuberculosis was either not suspected or was excluded. The majority of the ob 71-1025. Rode, A., Shepherd, R. J. Smoking Withdrawal served chronic manifestations should be ascribed to the and Changes of Cardiorespiratory Fitness.American Re- effect of smoking. Smoking was more frequent and the view of Respiratory Disease104(6):933-935, December number of cigarettes higher in persons in whom tuber- 1971. culosis was suspected as well as in tuberculous patients. The manifestations were particularly frequent among The immediate changes of cardiorespiratory fitness those who have smoked for over 20 years. (Auth. Abs.) thataccompaniedasmokingwithdrawalprogram 191 1'44 NON -NEOPLASTIC RESPIRATORY DISEASES

included reduction of resting and exercise pulse rates and effects of smoking on the respiratory tract were excluded, the elimination of carbon monoxide from the blood with byselectinga homogeneous group of nonsmoking) a half-time of 3.7 hours in the men and 2.5 hours in the workers. A higher prevalence of chronic bronchitis (P less women. During a one-year interval there was little im- than 0.01) was found in workers with symptoms of provement of absolute aerobic power, and there was a byssinosis than in those without such symptoms. In hemp diminution of relative aerobic power. Factors having an workers, either with or without symptoms by byssinosis, adverse effect on fitness included a substantial increase of FEV Lo and FVC significantly decreased during work on body fat and a reversal of the carbon-monoxide induced the study days, Mondays and Thursdays; significantly polycythemla. Smoking withdrawal clinics should offer a lower reductions were registered on Thursdays. Inhalation total approach to health, including advice on diet and of metaproterenol sulfate (Alupent) before work signifi- increased physical activity. (Auth. Abs.) cantly diminished FEV1.0 reduction, although not com- pletelypreventing it.Metaproterenol inhalationafter worksignificantlyincreased FEV1.0, indicatingthe 71-1026. Rylander, R. Lung Clearance of Particles and reversibility of acute lung function changes during work. Bacteria. Effects of Cigarette Smoke Exposure.Archives Comparison of lung function values measured before of Environmental Health23(5):321.326, November 1971. work with values obtained in the control group indicates a chronic effect of hemp dust on ventilatory function. The ability of the lung to clear particles and viable (Auth. Abs. Mod.) bacteria was studied in guinea pigs exposed to cigarede smoke. The animals were given ten puffs of fresh cigarette smoke from one to four cigarettes daily during one to 71-1029. Wallace, W.F.M., Langlands, J.H.M. Insulation four weeks. They were then exposed to a mixed aerosol Workers in Belfast. I. Comparison of a Random Sample of killed radioactive and viableEscherichia con.The clear- With a Control Population.British Journal of Industrial ance of radioactive and viable bacteria was determined Medicine 28(3):211-216, July 1971. the former being an indicator of the mucus clearance and the latter, of the phagecytic activity of the lung. Smoke A sample of 50 men was chosen at random from the from cigarettes of high and medium tar content was population of asbestos insulators in Belfast and matched found to decrease both mechanical and bactericidal clear- with a control series of men of similar occupational group ance. After shorter exposure times, the results indicate with respect to age, height and smoking habit. With re- that the mechanical clearance flow is affected earlier than spect to smoking habit, 13 of the men were nonsmokers, the bactericidal clearance. When phenylmethyloxadiazole 9 were ex-smokers and 28 were smokers. Significantly was added to the tobacco by 2 percent by weight, an more of the insulators complained of cough and sputum effect on the mechanical or bactericidal clearance could and had basal rales on examination. Clubbing was assessed not be demonstrated. (Auth. Abs.) by means of measurements of the hyponychial angle of both index fingers. These angles were significantly greater in the group of insulators. Twenty-one insulators had 71-1027. Stebbings, J. H. (Jr.). Chronic Respiratory Dis- X-rays which showed pleural calcification with or without ease Among Nonsmokers in Hagentown, Maryland. 111. pulmonary fibrosis; one control X-ray showed pulmonary Social Class and Chronic Respiratory Disease.Environ- fibrosis. The insulators had no evidence of airways ob- mental Research4(3):213 -232, August 1971. struction but static lung volume was reduced and their arterial oxygen tension was lower than that of the con- The relationships of respiratory symptoms and pulmo- trols andtheiralveolar-arterial oxygen gradient was nary function to social class in a population of white male greater. nonsmokers are presented. Among the symptoms only dyspnea (grade 2+) was found to vary in prevalence with social class, being less common among respondents in 71-1030. Zivy, P. Pnewnothroax des Fumeurs et Poirmon white collar occupations whose fathers were white collar Tab &gigue.(Smokers'Pneumothoraxand Tobacco' workers. This isconsistent with the hypothesis that Lung.]Entretiens de Bichat. Medecine et Biologie1971. dyspnea grade 2 is primarily a cardiovascular symptom. pp. 267-272, French. The forced expiratory volume in one second (FEV1.0) and the peak expiratory flow rate (PEFR) were positively The important role which tobaccoism plays in the correlated with social class. This effect was of the order of development of spontaneous idiopathic pneumothorax is 10.21 liter for the FEV1.0 and ±22 liter/minute for the discussed based on a brief review of previously published PEFR. Upward social mobility had no effecton the results. The incidence of the disease before the age of 25 pulmonary function values. (Auth. Abs.) and the type of cases observed can be clearly distin- guished from the type of cases observed in subjects over 25 years of age. In the latter, incidence is greater among 71-1028. Vatic, F., Zuskin, E. Effects of Hemp Dust heavy smokers with a high daily consumption and a Exposure on Nonsmoking Female Textile Workers.Ar- prolonged smoking habit. Differences observed in the rate chives of Environmental Health23(5):359-364, Nov- of incidence of the disease may be due to existing differ- ember 1971. ences in inhalation and level of consumption in smokers. The increased incidence observed in the past 70 years may Symptoms of byssinosis were found in 39 percent of be attributed to a parallelincreasein tobacco con- 102 female hemp workers who were nonsmokers. The sumption.

See also710972, 71-0995

1q5, 192 t 4 CARDIOVASCULAR DISEASES

71-1031. Aronow, W. S., Rokaw, S. N. Carboxyhemo- 71-1034. Cassel, J., Heyden, S., Bartel, A. G., Kaplan, B. *bin Caused by Smoking Nonnicotine Cigarettes. H., Tyroler, II. A., Cornoni, J. C., Ilames, C. G. Occupa- Effects in Angina Pectoris.Circulation 44(5):782.788, tion and Physical Activity and Coronary Heart Dis- November 1971. ease. Archives of Internal MedicineI 28(6):920-928, December 1971. The effects of increased carboxyhemoglobin levels caused by smoking nonnicotine cigarettes upon exercise- In a seven-year followup study of a total county induced angina were investigated in 10 patients. The mean population, the incidence of coronary heart disease carboxyhemoglobin level after smoking eight nonnicotine (CHD) was found to be lower in black than in white men cigarettes, one every 30 minutes, rose from 1.58 to 7.79 inevery occupational category except sharecroppers percent. Smoking significantly decreased the mean exer- Among nonfarming occupations the occupational gradient cise time from the onset of exercise until the onset of in CHD observed in the 1960 prevalence study was no angina from 109.8 to 83.5 seconds. There was signifi- longer present when incident cases were the basis for cantly less of an increase in systolic blood pressure, heart comparison. The lower prevalence rate in white fairness rate. and product of systolic blood pressure times heart compared to nonfarmers however, was confirmed in the tate after exercise-induced angina after smoking compared incidence study. While smoking increased the risk of CUD to the nonsmoking state. Smoking nonnicotine cigarettes in both farmers and nonfarmers, farmers had lower rates increased the carboxyhemoglobin level, decreasing the than nonfarmers whether they smoked or not. Sustained rate of oxygen deliverability to the myocardium, with physical activity above a certain critical threshold value angina developing sooner, following less cardiac work. apparently protects against CHD. This explanation is (Auth. Abs.) supported by the relationship discovered between leisure time and on-the-job physical activity aad the prevalence of CHD. Hypotheses concerning the possible pathogenic 71-1032. Diener, K. Zuckerverbrauch, Zigarettennuchen processes through which physical activity might operate and HeninfarkL [Sugar Consumption, Cigarette Smok- arc reviewed. ing, and Myocardial Infarct]Schweizerische Meditin- ischeWochenschrift101(39):1420-1421, October2, 1971, German. 71-1035. Cassel, J. C. Review of 1960 Through 1962 The results of several studies on the relationships Cardiovascular Disease Prevalence Study. Archives of between sugar consumption, cigarette smoking, and myo- Internal Medicine I 28(6):890-895, December 1971. cardial infarct are briefly summarized. Three studies are cited:(1) Central Middlesex Hospital, London (299 The Evans County Cardiovascular Epidemiological patients without diabetes or ischemic heart disease); (2) Study was initiated to confirm the clinical observation U.K. Atomic Energy Authority (2483 whitecollar that coronary heart disease (CHID) occurs less frequently workers born between 1912 and 1926); and (3) a North among blacks than whites. An attempt was made to Lambeth study (2996 men born between 1903 and 1942 explain this difference on the basis of variations in blood with duodenal ulcer). These three studies showed that pressure, serum cholesterollevels,cigarette smoking sugar consumption was lowest in nonsmokers, highest in patterns diet, and occupation and physical activity. The heavy smkers, and intermediate in ex-smokers. Studies findings showed that differences in CHD rates between by Pall et al. and by Burns-Cox, Doll, and Ball showed a the different ethnic and social class groups could not be relationship of myocardial infarct, not with sugar con- accounted for by differences in blood pressure, choles- sumption, but with cigarette smoking. A Cardiff-South terol, cigarette smoking patterns, and diet. Differences in Wales study (2697 adult females) and another on 334 old habitual physical activity was the most likely explanation men are then cited. In the male study, no relationship was for the differences in CHD prevalence. found between ischemic heart disease and high sugar consumption. In the female studna slight but not statisti- cally-significant relationship was observed between angina attacks and sugar consumption. In both studies, however, 71-1036. Cloarec, M. Stress, Tabac et Maladie Arterielle. there was a positive statistically-significant relationship [Stress, Tobacco, and Arterial Disease.]Entretiens de between sugar consumption and tobacco consumption. Bichat. Medecine et Biologie 1971, pp. 635-638, French.

A propective study of 870 heavy smokers is briefly 71-1033. Casciu, G., Marraccini, L., Zedda, S., Carta, G., described in a discussion of the relative role played by Fulghesu, G. On the Incidence of Cardiovascular Disease tobaccoism among other risk factors in arterial disease Among the Workers of the Mining Industry of Sardinia. etiology.Arterialhypertension,obesity, hyperchoks- 2nd Communication: Incidence in Relation to Habitual terolemia, hypertriglyceridemia, lack of physical activity. Smoking and Consumption ofAlcohol. Complete and social and family stress were among the various English translation of "Sulk: Frequenza Delle Cardio- factors studied. The excessive use of cigarettes was found vascubpatie to gli Operal Dell'Industria Estrattiva Della to be a definite risk factor, primarily in peripheral arterial r, Sardegna, Note II: Incidenza in Rapporto all'Abitudme al diseases, and in coronary heart disease in general, heavy Fumo e all'Alcool," Rassegna Medka Sarda 71(Supp1.1): smokers having a four-fold greater incidence than non- 191-199, 1968. smokers. It was also noted that it was not the intensity of stress which characterises the heavy smoker but rather, his See Abstract 700144. personal reaction to the 'aggressions' of daily living.

193

196 CARDIOVASCULAR DISEASES

71-1037. Colt, J. D. A Reproducible Treadmill Test for appraisal of some risk factors associated with IHD, the IntermittentClaudication.Angiology22(7):375-379, importance of cigarette smoking as an aggravating factor July-August 1971. as proved by a number of studies is discussed. After discontinuation of cigarette smoking the risk of develop- A treadmill walking test is described which can be ment of IHD diminishes. In smoking there is an increased used to make gross quantitative measurements of inter- secretion of catecholamines with release of fatty acids, mittent claudication. The test is reproducible with a mini- increased blood coagulability, carbon monoxide effects. mum of variables in the individual patient. Safety during increased peripheral vascular resistance, and other, still thetestingappears adequatesinceseveral hundred unknown mechanisms. The noxious effects of cigarette patients have been tested without mishap, more than half smoking could be reduced by manufacturing detoxicated of whom had documented past coronary occlusions. Pre- "harmless"cigarettes and by appropriate education, testing internal medicine evaluations must be obtained, which would gradually alter the social attitude towards however. Smoking reduces the ability of the walker if he smoking in general and the craving for cigarette smoking, isa moderately severe claudicator, as does increased particularly in adolescents. The former way would seem weight. Although the test is not designed to replace pal- to be easier and faster, although the results of a sys- pation of the pulses, plethysmography, or arteriography, tematic drive against smoking in the USA are encouraging. it is a reproducible means of documenting the ability of Administrative measures, such as higher insurance pre- the claudicator to walk. miums to be paid by smokers in contrast to nonsmokers, still have only a limited importance. 71-1038. Dalderup, L. M. Risk Factors for Coronary Heart Disease (CHD).l'oeding 32(8):406408, August 71-1041. Gokina, M. S. 0 Sokratitel'noy Sposobnosti 15,1971. Miokarda uRabochikh, Podvergayushchikhsya Dlitel'nomu Vozdeystiyu Malykh Kontsentntsiy Okisi Metabolic changes playing a rolc in the incidence of Ugleroda. [Myocardial Contractile Function in Workers cardiovascular disease are listed and the important effects Exposed to Prolonged Action of Small Concentrations of of physical activity, smoking and diet are indicated. The Carbon Monoxide.]VrachebnoeDelo8:130-139, problem remains extremely complicated, but examining August 1971, Russian. people for metabolic abnormalities and treating them (more physical activity, less smoking, suitable dietary Observationsof 76 workers (48 machinists, 28 prescriptions, drugs) could at least make a start for a real mechanics, 2045 years old) of a plant for the manu- prevention of cardiovascular disease. facture of alcohol and ammonia compresses, are reported. Polycardiographic analysis of the left ventricle systolic phases using the nitroglycerine test helped to reveal latent 71-1039. Dc Soldati,L., Barbicro, 0., Chutlian, A., changes of the contractile myocardial function in the Rosental, R., Mattiauda, 1. Segundo Infarto. [Second workers exposed to prolonged (14 years) action of small Infarct.)Revista Argentina de Cardlologla amounts of carbon monoxide concentrations (15-78 39(3):137,138,140,142,145,146,May-June1971, mg/n ). Spanish.

A study of 41 cases of second myocardial infaict .71-1042. Goldberg, A. N., Krone, R. J., Resnekov, L. showed that most infarcts occurred in males (81.8per- Effects of Cigarette Smoking on Hemodynamics at Rest cent) and in the age range of 50 to 60 years. Of these and DuringExercise.I.NormalSubjects.Chest patients, 72.9 percent were smokers, SO percent were 60(6):531-536, December 1971. diabetics, 36.5 percent were hypertensive, 45.9 percent were overweight and 48.6 percent had hypercholes- Cardiovascular responses to submaximal graded up- teremia. An examination of combinations of predisposing right exercise were investigated by pulmonary and sub- factors showed that of 20 diabetic patients, 10 had hyper- clavian arterial catheterization in nine healthy young men tension, 13 were smokers and 9 were overweight; of 15 before and after smoking a single cigarette. At rest, after hypertensive patients, 10 were diabetic and 9were smoking, the mean cardiac index and mean heart rate smokers. There was no statistically significant correlation increased, while arteriovenous oxygen difference, stroke between time of appearance of the second infarct and index, and mean pulmonary arterial pressure remained either diabetes or hypertension. There was an increase in unchanged. During successively increasing levels of exer- the incidence of heart failure as a cause of death in the cise, the mean heart rate was greater and the stroke index second infarct. Of the 12 patients who died, 5were lower than values for comparable work before smoking. diabetic and 6 were hypertensive. The arteriovenous carbon dioxide, oxygen consumption, pulmonary arterial pressure, systemic vascular resistance, lactate production, pulmonary ventilation, and arterial 71-1040. Fejfar, Z., Pisa, Z. Ischaernic Heart Disease. oxygen pressure did not change significantly. By de- creasing the stroke volume response to exercise, smoking Prognosis, Treatment,Rehabilitation,andPreven- tion.CorerVasa 113(1):1-17, 1971. a single cigarette significantly alters the hemodynamic response to exercise in adirection,opposite to physical Present knowledge about the prognosis, treatment, training. and prevention of iqchemic heart disease (1HD) is sum- marized and some methods which would lead to an effec- 71-1043. Gordon, T., Sorlie, P., Kennel W. B. Section 27. tive mass control of the disease are outlined. In an CoronaryHeartDisease,AtherothrombodcBrain

197.. 194 CARDIOVASCULAR DISEASES

Infarction,IntermittentClaudicationAMultivariate 71-1045. Hinkle, L. E. (Jr.) The Antecedents of Myo- Analysis of Some Factors Related to Their Incidence: cardial Infarction and Sudden Death in a Cohort of Framingham Study, I6-Year Foilowup.In: Kannel, W. Actively Employed Men. Journal of Occupational Medi B., Gordon, T. (Editors). The Framingham Study. An cine 13(9):433.440, September 1971. Epidemiological Investigation of Cardiovascular Disease. U.S. Department of Health, Education, and Welfare, The incidence of coronary heart disease and sudden Public Health Service, National Institutes of Health, Wash- death in actively employed middle-aged American men ington, D.C., May 1971, 42 pp. and some of the characteristics of these men who die suddenly and unexpectedly were investigated. The study This report has considered, both by univariate and was based on a prospective and retrospective investigation multivariate analysis, the relation of certain key character- of a random sample of 301 men of median age 55 who istics to the major atherosclerotic eventscoronary heart were on the active payroll of the New Jersey Bell Tele- disease (CHD), atherothrombotic brain infarction (ABI), phone Company in1962. The findings showed that and intermittent claudication (IC). These key character- middle-aged men whose deaths are due to coronary heart isticsblood pressure, serum cholesterol, cigarette smok- disease are not drawn from the population of apparently ing, LVH-ECG and glucose intolerancehave been shown healthy men. Coronary deaths occur among a mixed pop- to be related to all three major atherosclerotic events. In ulation of men with what appears, on clinical examina- general, relationships appear to be as strong far women as tion, to be coronary heart disease, hypertensive cardio- men. When the whole set of variables is considered jointly vascular disease and chronic lung disease, or some combi- they have a closer association with ABI and IC than with nation of these conditions. Most men who die coronary CHD. In men two of these variablesscrum cholesterol deaths also have one or more significant metabolic ab- and cigarette smoking stem to bear their strongest rela- normalities such as hyperlipidemia, impaired glucose tion to CHD at young ages, the relationship seeming to tolerance, elevated scrum uricacid, obesity andal- essentially disappear by the age group 65-74 years. Other coholism. Of 24 men who died from coronary heart age differentials are less clear, and taken as a whole, this disease, 19 had smoked for more than 30 years, and 7 set of variables is associated with each atherosclerotic were still smoking two packs of cigarettes per day when event equally strongly in all age groups between 45 and they were examined. Many of the physiological abnormal- 74 years. These three atherosclerotic events are related ities and pathological conditions of men who die coronary not only in terms of common precursive factors but also deaths could have been detected within two to three years in that both CHD and IC seem to independently pre- prior to death. Men dying from coronary heart disease, dispose to other atherosclerotic events. CHD, ABI and IC including those who die suddenly and unexpectedly, have are distinguished by different levels of incidence by age abnormalities of cardiac rate, rhythm and conduction and sex and also in terms of the relative importance of the prior to the onset of their fatal episode. key factors. The dominant factor predisposing to ABI is high blood pressure. None of the key factors is clearly dominant for CHD but glucose intolerance is only weakly 71-1046. Hloucal, L., Dusek, J. Aetiopathogenese and related to this atherosclerotic disease and cigarette smok- Prophylaxe der koronaren Atherosklerose (11). [Epps& ing has little relationship to CHD in the form of uncom- °genesis and Prophylaxis of Coronary Atherosclerosis plicated angina pectoris. All five factors play an important (11).]Zeitschriftfur Therapie9(5):257.267,1971. role in intermittent claudication, with glucose intolerance German. more important for this event than for either CHD or Md. (Auth. Abs. Mod.) The etiopathogenesis of atherosclerosis and its clinical manifestations, especially coronary heart disease, is com- plicated and has not been solved thus far. In addition to endogenous factors (genetic influencesinherited meta- 71-1044. Heyden, S., Cassel, J. C., Bartel, A., Tyro ler, H. bolic disturbances, enzymatic defects of the vascular wall, A., Hames, C. G., Comoni, J. C. Body Weight and Ciga- and improper hormonal regulation), a series of so-called rette Smoking as Risk Factors. Archives of Internal risk factors contribute to the origin, development, and Medicine 128(6):9 I 5-919, December I971. manifestation of atherosclerosis which has been demon- strated in many epidemiological studies. Included in these are the living habits of the civilized world: influences of In males, the incidence rate of coronary heart disease nutrition, sedentary occupation, and lack of physical (CHD) in white noncigarette smokers was 52.7/1,000 and activity connected with the development of automation among blacks, 9.8/1,000; among white cigarette smokers and automobile travel, in addition to overweight hyper- the rate was 101/1,000 but in blacks wily 32.5/1,000. tension, disturbances of glucose metabolism, excessive The incidence rate of CHD in the leanest whites was smoking, and especially influence of stress. Hyperlipemia, 95.5/1,000, among the leanest blacks, 24.1/1,000; how- particularlyhypercholesteremia,hyperuiglyceridemia, ever, in the most obese whites the rate WAS 137/1,000 and and elevated values of beta- lipoproteins are important among the blacks, 53.6/1,000. When comparing white indications for the origin and development of athero- smokers with nonsmokers in the leanest and most obese sclerosis. Smoking is not a primary atherogenic factor but tertiles, smokers run a substantial risk of developing CHD, appears to promote thrombogenesis. is increasing with increase in overweight (80, 90, and considered to be a result of greater nervous stress. The 150/1,000, respectively). The risk of nonsmokers develop- incidence of coronary atherosclerosis is lowest in non- ing CHD does' not increase from the leanest to the mod- smokers engaged in physical labor. Primary prophylaxis erately overweight and the most obsess group, (51, 30, by diet and exercise regimens should be instituted in and 64/1,000, respectively). Therefore, obesity in white potential and latent atherosclerotics even at a young age. 'pales seems to enhance the risk of CHD among cigarette A secondary prophylaxis in manifest atherosclerosis with ,knokers but not among nonsmokers. (Auth. Abs.) hyperlipcmia is accomplished by drugs with hypolipemic

195 198 CARDIOVASCULAR DISEASES

effect. Both physical and psychic rehabilitationshould be by infusion of nicotine, a significant reduction in capillary carried out after acute myocardial infarct. flow in the inner portion of the myocardium compared to the outer part was observed. (Auth. Abs.) 71-1047. !sager, H., Hagerup, L. Relationship Between Cigarette Smoking and High Packed Cell Volume and 71-1050. Modan, B. 'Epidemiyologya shel Mahalot Lev Haemoglobin Levels. Scandinavian Journal of Haema- Tarashtiyot.[Epidemiologyof ScleroticHeartDis- tology 8(4):241-244, 1971. eases.]Harefuals 59(10):431-440, November 15, 1970. Hebrew. In a study including 394 men and 339women, all aged fifty,apositivecorrelation betweencigarettecon- A number of factors which have been clearly estab- sumption and packed cell volume (PCV)was found in lished as causes of heart disease, such as hypercholes- both sexes. In women, a statistically significant correla- teremia, hypertension, stress, and cigarette smoking,are tion was also found between cigarette consumptionand reviewed. The report also deals with other factors having hemoglobin concentration. In male cigarette smokers,the some influence on the disease such as race, age, marital incidences of PCV-values over normal range and of sub- status, occupation, physical activity, socioeconomic level. normal mean corpuscular hemoglobin concentration- climate, and drinking. Smokers are three timesas likely to values were significantly higher than in males whodid not develop ischemic heart disease as nonsmokers. Cholesterol smoke cigarettes (smokers and nonsmokers). Astatis- levels among young smokers are higher thanamong non- tically significant negative correlationwas found between smokers. Chronic carbon monoxide poisoning caused by cigarette consumption and lung function (forcedexpira- smoking can also have a damaging effecton the heart. tory volume in one second) but therewas no evidence of Theories as to the manner in which smoking effects the any relationship between lung function and hematological body vary. Smoking may accelerate the atherosclerotic variables. From these results itis concluded that the process, it may act directly on blood vessels, or it may association between cigarette smoking and hematological accelerate blood clotting and the destructive disturbances variables is probably not secondary to the relationship in rhythm. The prevention of heart disease is also dis- between cigarette consumption and lung function. (Auth. cussed. Abs. Mod.)

71-1051. Naeye, R. L., Dellinger, W. S. Pulmonary 71-1048.Jahnecke,J.Prophylaxe von Haz- and Arterial Changes With Age and Smoking. Archives of Gefassscbaden dutch Ausschaltung von Rigkotaktorenin Pathology 92(4):284-288, October 1971. der arztlichen Praxis. [Prophylaxis of CardiovascularDis- eases by Elimination of Risk Factors in MedicalPrac- A quantitative, histologic analysis was undertakenon tice.]Zeitschrift fur Allgemeinmedizin der Landarzt small pulmonary arteries of 126 long-term male cigarette 47( 24):1189-1199, August 31, 1971, German. smokers and 67 nonsmokers. The percent of small pulmo- nary artery walls comprised of normal circular smooth The present work undertakes the study of cardio- muscle decreased with age more rapidly in smokers than vascular diseases in the light of current considerationsof in nonsmokers. The younger nonsmokers had less arterial diagnosis and therapy. Hypertensionappears to be the longitudinal muscle than did similar aged smokers. Be- most important single risk factor, not only for arterio- tween ages 30 and 70, collagen content of arterial walls sclerotic diseases of the heart, but also for peripheraland increased from 8 percent to 25 percent in nonsmokers cerebrovascular arterialdiseases.Diabetes mellitus is and from IS percent to 39 percent in smokers. The deserving of equal rank with hypertension.The other risk vascular abnormalities may have little functional im- factorsdiscussed aretsigarette smoking, overweight, portance because there was no significant increase incor hyperlipidemia, and heredity. Elimination ofrisk factors pulmonale as the abnormal constituents increased in the results in an impressive and statistically-significantim- arterial walls. Smokers had thicker right cardiac ventricles provement in prognosis. Mortality figures indicate the than did nonsmokers, presumably due to increasedvas need to institute prophylactic measures before theage of cuter resistance at some site other than the small pulmo- 40 years. Prophylaxis initiated after 50years of age nary arteries. (Auth. Abs.) appears to be less successful. Most risk factorscan be completely eliminated by a purposeful "concentrated" treatment. 71-1052. Pasquazzi, M. I Fattori di Mali° Coronarico. [Coronary Risk Factors.]Policlinico; Sezione Pratica 78(14):575-587, July 15, 1971, Italian. 71-1049. Mathes, P., Rival, I. The Effectof Nicotine on The present status of risk factors for coronary heart Regional Blood Flow in the Canine Heart.Proceedings disease is reviewed. Although there is of the Society for Experimental Biology no doubt con- and Medicine cerning the statistical association of many factors withan 138(1):361- 364,October 1971. increased risk of coronary heart disease no causal rela- tionships have been established. The major risk factors The effect of nicotine administration on regional myo- (hypercholesteremia,hypertension,obesitydiabetes, cardial blood flow was examined in normalhearts and sedentary living, and cigarette smoking) after partial coronary artery occlusion. Under are examined. As normal the different studies show, the risk ofcoronary disease circumstances as well as after infusion of nicotinein increases with the number of cigarettes smoked, with the normal hearts, the subendocardial protion of themyo- duration of the smoking habit and with the depthof cardium had a higher capillary flow than the subepicardial inhalation. Pipe and cigar smoking does not fraction. Partial coronary artery constriction appear to alone did increase coronary risk and a lower incidence ofcoronary net alter this relationship; however, when it was followed disease has been observed in ex-smokers. 1014 196 CARDIOVASCULAR DISEASES

71-1053. Paul, 0. Myocardial Infarction and Sudden behavior pattern Type A individual who comprises rather Death.Hospital Practice6(11):91 -103, November 1971. specific personality traits including ambition, competitive drive, aggressiveness, impatience. and a strong sense of Studies have shown that most sudden cardiovascular time urgency. After 8Y: years of follow-up studies, the deaths, particularly those caused by coronary disease, incidence of new coronary disease events in the study occur in the first hours of the 24-hour period following population was found to run at least twice as high among onset of acute signs and symptoms, and that the bulk of Type A as among Type B subjects (described as extremely victims die at home or en route to the hospital. However, passive and lacking drive). Moreover, in the presence of death rates have been reduced by as much as 50 percent Type A behavior, the risk of recurrence of myocardial in patients receiving optimal care in coronary care units. infarction is markedly increased; in addition, there is a Thrombosis appears to be involved in only a minority of definite trend to Type A behavior in cases of myocardial cases, but other pathophysiologic factors such as ab- infarction that terminated in death. With statistical con- normal freefattyacid metabolism, arrhythmias, and trol of a broad series of other coronary risk factors by microcirculatory compromise may be implicated. There is means of a multiple regression procedure, the predictive little evidence that physical or emotional stress is likely to power of Type A behavior persistedespecially among trigger most sudden deaths. Risk factors associated with younger men inthe study group Among men in the arteriosclerotic heart disease, notably hypercholestero- 39-49-year age group at entry, the coronary disease risk lemia, hypertension, hyperglycemia, and excessive ciga- was at least twice that among Type B men of the same rette smoking, also heighten the risk of both fatal and age. Older men manifesting Type A behavior were also at nonfatal infarction. However, factors related to sudden increased risk although the difference here was less signifi- death may not carry the same weight in reference to cant. The 12 risk factors held constant in this analysis nonfatal infarction. Cigarette smoking may be one such (made after 41/2 years of follow-up) included (among factor. The possibility that excessive smoking is a critical others)hypercholesterolemia, hypertension, excessive factor in precipitating sudden death is supported by the cigarette smoking, obesity, and parental history of coro- fact that survival time after onset of acute myocardial nary disease. The hypothalamus may be the CNS region infarction decreases sharply in heavy smokers. Research involved in hypercholesterolemia seen in Type A indi- emphasis is now being placed on identifying both epi- viduals. Experiments in rats suggest that the specific areas demiologic and prodromal clues. involved arefornix, medial portion of lateral hypo- thalamic areas, and the ventromedial nucleus.

71-1054. Pincher le, G. Factors Affecting the Mean Serum Cholesterol.Journal of Chronic Diseases24(5):289-297, 71-1057. Schmauss, A. K., Arlt, E. Morphological Find- August 1971. ings, Postoperative Complications, Mortality and Duration of Bed Rest Following Amputations Occasioned by Dis- Cholesterol examinations were conducted on over orders of the Peripheral Circulation. Complete English 7000 businessmen between 1964 and 1969. Mean choles- translation of "Morphologische Befunde, postoperative terol levels were related to age, sex, height, obesity, blood Komplikationen, Letalitat und Liegedauer nach Amputa- pressure, calcification in the iliac arteries, exercise, mental tion wegen Durchblutungsstorungen,"Zeitschrift fur stress, uric acid levels and season of the year. There was Arztliche Fortbildung64(2):84-87, January 15,1970. an increase in mean cholesterol with increasing numbers of cigarettes smoked. However, ex-smokers showed no SeeAbstract 70-0470. decrease in cholesterol levels. No correlation was found with enlargement of the heart and the presence of cardio- graphic abnormalities. The significance of these findings 71-1058. Siedek, H. Die Prophylaxe der arteriosklero- to the individual patient and the epidemiology of is- tischen Herz- und Gefasserkrankungen. (The Prophylaxis chemic heart disease is discussed. ofArterioscleroticCardiovascularDiseases.] Wiener Medizinische Wochenschrift121(30/31/32):575 -581, July 31, 1971, German. 71-1055. Preuss, E.-G., Eder, H., Weller, P. Risk Factors in Occlusive Diseases of the Peripheral Arteries of Varying The major experimental and clinical studies that have Severity. CompleteEnglishtranslationof"Risiko- revealed the significance of various risk factors for arterio- faktoren bei peripheren arteriellen Verschlusskrankheiten sclerotic diseases are reviewed. The present report deals unterschiedlichen Schweregrades,"Zeitschrift fur die with the roles of generally-acknowledged risk factors such Gesamte lnnere Medizin und IhreGrenzgebiete as hyperlipidemia, hypertension, the diabetic metabolic 25(10):464-468, May 15,1970. state, obesity, physical inactivity, body constitution and familial influence, and smoking. Heavy cigarette smoking SeeAbstract 70.0906. has been implicated in almost aU epidemiological studies in the development of myocardial infarct, peripheral vas- cular occlusive diseases and cerebral infarct. There is no 71-1056. Rosenman, R. H., Friedman, M. The Central connection between smoking and hypercholesteremia and Nervous System and Coronary Heart Disease.Hospital hyperuiglyceridemia but nicotine has a mobilizing in- Practice6(10):87 -97, October 1971. fluence on catecholamines and Increases the percentage of nonesterified fatty acids which in turn influence thrombo- A prospective study among more than 3000 men has cyte adhesiveness. The value of several drugs in current demonstrated that aggressive behavior plays a major path- use in the prophylaxis of arteriosclerotic cardiovascular ogenetic role in coronary disease. The study describes a diseases are also discussed.

197 2O CARDIOVASCULAR DISEASES

71.1059. Startler,J.,Stanger,R., Shekel le,R.B. plaints are detectable as a main complaint only in about Regional Differences in Prevalence, Incidence and Mor- 50 percent of the cases. Silent infarct is not detectable in tality From Atherosclerotic Coronary Heart Disease.In: these cases. As with older infarct patients, strong psychic deHass, J. H., Hemker, H. C., Snellen, H. A. (Editors). or physical stress are of great importance as releasing lschaemlc .Heart Disease.Leiden, The Netherlands, Leiden factors. Anterior wall and combined infarcts prevail. In University Press, 1970, pp. 84-127. the acute syndrome, transaminases, acceleration of blood precipitation, leukocylosis, and a fever reaction at high The major methods of comparing impact ofcoronary percentages are detectable. Almost invariably a coronary heart disease on different populations yield similar find- sclerosis, with or without thrombosis,is found on ings. Regional differences are marked, whether the data autopsy. The prognosis is more favorable than in infarct examined are from international pathological studies, patients in more advanced age. (Auth. Abs. Mod.) comparison of mortality rates or studies of living popula- dons. In the more economically developed countries,pre- mature coronary heart disease (CHD) is already a major epidemic. Time trend studies indicate bothan increase in 71-1061. Summers, D. N., Richmond, S., Wechsler, B. M. CHD in these countries and beginning of change in less Cigarette Smoke: Effects on Lactate Extraction in the developed countries that are on the road to greaterecon- Presence of Severe Coronary Atherosclerosis.American omic development. Racial, ethnic, geographicor climatic Heart Journal82(4):458467, October 1971. factors as possible causes can be eliminated by data coming from time trend studies, migration statisticson Fifteen patients with angiographically demonstrated prevalence and mortality, as well as study of class differ- severe obstructive coronary artery disease were the study ences in CHD rates within single countries. The high order subjects. Hemodynamic measurements were made before correlation between CHD mortality and national income and during cigarette smoking, and metabolic evaluation provides an important etiologic clue. While higher income was performed in these states and during isoproterenol itself cannot explain the higher mortality, it is,at least stress. Heart rate, aortic pressuresystolic ejection and until now, accompanied by a mode of life whose charac- diastolic filling periods were measured. Myocardial lactate teristics can be etiologically connected ioexcess CHD extraction was evaluated at three coronary sinus drainage mortality. Thesecharacteristicsincludea nutrition sites. Despite increases in heart rate, aortic pressure the pattern high in total calories, total fat, saturated fat and systolic ejection period per minute and the tension-time dietary cholesterol; heavy cigarette smoking and seden- index per minute lactate production was not induced by tary living habits. The international comparative data pin- smoking in any patient without lactate production in the point intake of saturated fat as the major dietary factor control state. In three patients with lactate abnormalites accounting for differences in CHD mortality among the prior to smoking, inhalation of cigarette smoke sustained 22 countries surveyed. Although other nutrientsare often and slightly aggravated this circumstance. Isoproterenol associated with highsaturatedfatintake (protein, induced lactate production in all but one patient. Ciga- sucrose) the data do not justify attributing an independ- rette smoking in a group of patients with severe ob- ent causal role to them. When such factors as atherogenic structive coronary artery disease did not produce evidence dietary patterns, cigarette smoking and sedentary living of ischemia as determined by abnormalities in lactate habits are present together, CHD mortality ratesare extraction. (Auth. Abs.) increased even further. Knowledge shed by such inter- national comparisons dealing with the etiology ofcoro- nary heart disease could help lower the coronary and 71-1062.Wilbert,L. Nikotinkonsum andarterielle overall mortality to the lower level still prevalent in the Verschlusalcrankheit. (Nicotine Consumption and Arterial less developed countries. Occlusive Disease.]Medizinische Klinik 66(36):1190-1192, September 3, 1971, German. 71.1060. Storch, H., Engelmann, L., Kohler, H. Der A group of 190 nondiabetic patients with peripheral Herzinfarkt im Jungeren Lebensalter. (Myocardial Infarct vascular disease consisted of 181 smokers (95.3 percent; in Young People)DeutscheGesundheitswesen 171 men, 10 women) and 9 nonsmokers (4.7 percent; 3 26(34):15934600, August 1971, German. men, 6 women). Most smokers consumed more than 10 cigarettes daily with consumption in the 40 to 70-year- Thirty patients, only three of whomwere women, olds of 18 to 20 cigarettes daily. Four nonsmokerswere who had suffered myocardial infarct prior to theage of hypertensive. Vascular disease was found in six women 40 years, are studied. These cases comprise only2.07 and two men (4.2 percent). Arterial occlusions were percent of tto 1147 persons investigated. The absolute found in 64.7 percent in the femoropopliteal region, in increase in the total rate of infarct in theyounger and 22.8 percent in the aortoiliac region and in 12.5 percent medium ages ot demonstrated. Risk factors couldbe below knee joints. There was no relation between the detected in 2501'27 evaluative cases. Smoking is foundto number of cigarettes smoked and the location of the play a dominant role in myocardial infarct inyounger occlusive process. The fmdings show a considerable in patients. Of 22 patients with valid smoking data, 16 crease of obliterative arterial disease after the age of 50 smoked from lto 30 cigarettes daily. Chest pain com- years. (Auth. Abs. Mod.)

See also 71-0972, 71-0975, 714995, 71-1025,71-1071

201 198 re.

OTHER DISEASES AND CONDITIONS

71 -1063. Ainamo, .1. The Seeming Effect of Tobacco 71-1065. Daniell, H. W. Smoker's Wrinkles. A Study in Consumption on the Occurrence of Periodontal Disease the Epidemiology of "Crow's Feet."Annals of Internal andDentalCaries.SuonsenHammaslaakariseuran Medicine75(6):873-880, December 1971. Toimituksia67:87-94, 1971. A simple method of grading the severity of facial skin In young adult males there seems to be an inverse wrinkling is described. It can be rapidly learned and easily correlation between the frequencies of tobacco consump- used by untrained students. In a study of 1,104 subjects tion and toothbrushing. The corresponding higher Plaque the severity of wrinkling correlated with a history of Index scores in smokers than in nonsmokers were sug- habitual cigarette smoking, after adjustment for age and gested to have resulted in the higher amounts of dental outdoorexposure. The association between cigarette calculus and open caries lesions, respectively. The trend smoking and wrinkling was striking in both sexes soon towards more advanced marginal bone loss with increased after age 30, was related to the duration and intensity of smoking was a result of the abundance of plaque retentive cigarette smoking, and was more pronounced than was calculus and caries. The higher Plaque Index scores were the association between wrinkling and admitted outdoor not accompanied by higher Gingival Index scores in exposure. Smokers in the 40- to 49-year age group were as smokers than in nonsmokers. This finding was suggested likely to be prominently wrinkled as nonsmokers who to derive either from an increase of gingival resistance or were 20 years older. (Auth. Abs.) from a decrease of the virulence of the plaque as a result from the heat and toxic irritants involved in the tobacco fumes. The study failed to confirm the earlier presump- 71-1066. Dickens, G., Trethowan, W. H. Cravings and tion that tobacco consumption per se would advance the Aversions During Pregnancy.Journal of Psychosomatic development of periodontal disease and dental carics. It Research15:259-268, September 1971. seems more probable that smoking and poor oral hygiene are concomitant characteristics of the same individual and The pievalence and nature of cravings and aversions that those who smoke are negligent not only of their for certain foods not normally compulsively longed for or health in general but also of their oral hygiene and dental disliked were studied in 100 primiparae. Either or both conditions. (Auth. Abs. Mod.) were found to occur frequently, and more often together than separately. The most common craving was for fruit and sweet, sour, or sharp-tasting foodstuffs. The most 71-1064. Bernhard, P. Certain Injurious Effects of Ciga- common aversion was for tea or coffee. The cravings are rette Smoking on Women. Complete English translation more probably the result of an impaired sense of taste in of "Sichere Schaden des Zigarettenrauchens bei der pregnancy whereas aversions may have more to do with Frau,"MedizinischeMonatsschrift3:58-50, 1949. an alteration in the sense of smell. Cravings and aversions occurredsignificantly more ofteninwomen with a On the basis of investigations extending over the past history of pica in childhood, in women with a history of 20 years involving 458 female smokers and 5000 female appetite change in response to emotional stress, and in nonsmokers, the following injuriouseffectsof cigarette women who smoked or drank alcohol before pregnancy. smoking on women were found. The thyroid undergoes During pregnancy, there was a sharp drop in the number changes leading to hypothyreosis or hyperthyreosis. By of women who smoked, and this amounted to 15 percent the way of the thyroid glands, other endocrine glands are in those with aversions and cravings. The presence of affected, particularly the ovaries. Smoking may cause cravings and aversions may indicate, a predisposition due disturbances of growth and of puberty in young girls. In a to a degree of oral fixation. number of ,female smoke:3; menstrual cycle disorders occur by way of neurohormonal actions. In a great number of women, cigarette smoking causes contractions 71-1067. Doyle, M. J., Lopez-Amor, E., Dingman, J. F. of the smooth-muscled organs of the genitalia referred to HypersecretionofAzginineVasopremininAcre- as "genital sensations" and "tuba! cramps". Smoking may megaly.Journal of Clinical Endocrinology and Metab- be the cause of sterility in women. Having effects going olism33(3):418123, September 1971. beyond a dysfunction of the endocrine glands, smoking may cause a hormonal, especially thyreogenic, sterility by Four of five patients with untreated active acromegaly stimulating and paralyzing the smooth muscles of the demonstrated prolonged antidiuresis and sustained release genitalia. Also, a decrease of the libido due to the con- of arginine vasopressin (AVP) with 0-Lotine stimulation of sumption of nicotine reduces the possibilities of concep- the neurohypophysis.Thishyperresponsiveness was tion. In some female smokers, the climactenum occurs acutely suppressed by adrenal steroids in two subjects. prematurely. Women smokers also age prematurely.he Long-term estrogen treatment restored a normal nicotine decrease of the libido and the appearance of certain virile response in one patient; another showed improved nico- traits are found more frequently in smokers than in non- tineresponse after pituitary X-ray irradiation and a smokers. In predisposed cases, cigarette smoking may normal response with added estrogen therapy. Three induce the complex of eclamptic symptoms. Cigarette additional active patients in clinical remission with estro- smoking has been statistically confirmed to cause, in a gen medication showed normal responses to nicotine. number of pregnant women, miscarriages as well as pre- These studies suggest that, in active acromegaly there is a mature birth. neurohypophyseal hyperresponsiveness to nicotine which

199 202 OTHER DISEASES AND CONDITIONS

improves with clinical remission of the disease. Sincethe 71.1071, Medical Letter on Drugs and Therapeutics. osmoregulatory responses of thneurohypophysis to de- CigaretteSmoking and Carbon hydration, hemodilu Hon and induced hyperosmolality Monoxide,Medical fell Letter on Drugs and Therapeutics13(221:91.92, October within the expected normal range, it appears to bea 29, 1971. selective neurohypophyseal derangement. (Auth. Abs.) Evidenceisreviewed which suggests that carbon monoxide in cigarette smoke may be injurous topersons 71-1068, Fedrick, J., Butler, N. R. Certain Causes of with coronary, cerebral or peripheral vascular insuffi- NeonatalDeath,IV,MassivePulmonary Haemorr- ciency, and that it may have adverse effects hage.Biology of the Neonate on the 18(3/4 ) : 243-262, 1971. sensory and motor faculties required for the safe handling of a car or airplane. A total of 122 singleton deaths with massive pulmo- nary hemorrhage collected in the 1958 British Perinatal Mortality Survey was compared with a control population 71.1072, of 16,625 live births. A high incidence among multiple Shea, J.J., Kitabchi, A. E. Management of births was noted, as well as a high proportion of infants Fluctuant Hearing Loss.Journal of the Tennessee Afedi. cal Association64(101:862.869, October 1971. with congenital heart disease. Excluding these, itwas noted that the majority of infants died on the third and Fluctuant hearing loss is an inner car disorder charac- fourth days. Forty percent had been asphyxiatedat birth and in most cases the symptoms, which were frequently terized by fullness, tinnitus, fluctuation in hearing, and cerebral, did not appear until after the first day. There vertigo. Obstruction of the endolymphatic duct andsac was a high incidence among immature infants, but the arc known to be associated with Menicre's disease but variousmetabolic disordersare majority of cases were delivered at term. Therewas also associated with marked growth retardation in many of these. Altogether fluctuant hearing loss. Most important of these isan abnormal glucose tolerance, which was found in 57 there were almost three times as many males as females. percent of cases, in 50 percent of which the glucose Although long membrane rupture, a history ofante- partum hemorrhage and low social class were of some intolerance had not been previously observed. Also importance in the etiology of the lesion, the main factors detected were hyperlipemia in 7 percent, excessive smok- were primiparity, maternal smoking in pregnancy, poor ing in 10 percent, fluid retention in 10 percent, allergy in pastobstetric history, transferralof the infant after 7 percent, and anxiety in 7 percent. The diagnosis and delivery, and severe maternal pre-eclampsia, especially if treatment of this disorder are discussed. the delivery was abdominal. (Auth. Abs. Mod.) 71.1073, Talamo, R. C. The AlpharAntitrypsin in Man, 71-1069, Guerre, J., Ayachc, R., Matuchanski, J., Jannon, Journal of Allergy andClinical Immunology P.,Pequignot,H.Les Sequelles Tardives des Gas- 48(4):240-250, October 1971. tzectomics. (Delayed After-Effects of Gastrectomy,jEn. Recent studies related to alpharantitrypsin are tretiens de Bichat. Medecine et Biologie1971, pp. 71.76, re- French. viewed emphasizing its important role in human physio- logy. Various methods forthe evaluation of serum alphavantitrypsin andthe related genetic typing of A study of 193 patients who had undergonegas- trectomy is briefly described. Functional complicatons individualsaredescribed.Itsrelationshipto familial were reported by 60 percent of the subjects. The time emphysema, other pulmonary diseases, and familial cir- rhosisarediscussed particularly lapsed since gastrectomy was performedwas not related as related totissue to whether or not complications appeared, since the damage. Although the exact normal role of the alpha'. period ranged from 3 to 45 years in the cases studied. Of antitrypsin is not known, research findings suggest that it plays a central role in the maintenance of normal tissue several exogenous factors discussed whichmay aggravate the complications, smoking is noted to be of primary integrity. The severe inherited deficiency ofa normal importance. It appears that smoking is less tolerated by enzyme inhibitor thus can lead to pulmonary damage and other diseases. these who have undergone gastrectomy because itpro- duces severe after-effects locally from smoke irritation. Of the patients who complained of after-effects, 55percent were smokers. 71.1074, Tyldesley, W. R. Tobacco Chewing in English Coal Miners. A Preliminary Report.British Journal of Oral Surgery9(1):21-28, July 1971. 7 1-1 070,McKendrick,A.J.W.,Barbenel,L.M.H., McHugh, W.D. The Influence of Time of Examination, The tobacco chewing habits of 1490 coal miners from Eating Smoking and Frequency of Brushingon the Oral S closely associated mines in South Lancashire, England Debris Index.Journal of Peridontal Research5:205-207, 1970. were studied. Among the miners, 7 of 399 surface workers and 374 of 1091 underground workerswere chewers; 178 of the chewers were also smokers. Of the The effects of time of day, eating since the teeth were 633 nonchewers, 243 were smokers. Therewere 22 last brushed, and the number of stained teeth in smokers, chewers with leukoplakia and pre-leukoplakia, 10 of on the oral debris index of 103 subjects were examined. whom had lesions in multiple sites. Pre- leukoplakia was None of these effects was found to be significant. foundin only one nonchewcr. The incidence of leu- Increased frequency of toothbrushing produced a statisti- koedema was 10 percent in chewers and 4.9 percent in cally significant reduction in oral debris. (Auth. Abs. Mod.) nonchewers. An analysis of site distribution of the lesions showed 31.5 percent were in the alveolar ridgemucosa.

200 OTHER DISEASES AND CONDITIONS

There was no evidence of incipient malignant change in a mixed chewing-smoking habit and its possible influence any of the lesions studied. The fact that many miners had on the findings are discussed.

BEHAVIORAL AND EDUCATIONAL RESEARCH

71-1075. Beal, G. M., Warren, R. D., Fleischman, W. A. 71-1078. Frankenhaeuser, M. Behavior and Circulating Smoking Behavior. Department of Sociology and An- Catecholamines. Brain Research 31:241-262, August 20, thropology, Iowa State University, Ames, Iowa, Sociology 1971. Report No. 88A, June 1971,146 pp. A review is presented of the relationships between two This reportisa descriptive analysis of individual catecholamines in blood, adrenaline and noradrenaline, attitudes,beliefs, situations, and behaviorrelatedto and behavioral functions of healthy human subjects. smoking and health, based on a nonmetropolitan area Experiments with catecholamine infusions are described sample of adults. Data on which the report is based are and laboratory studies of the effects induced on cate- presented in tabular form in Smoking Behavior. Data cholamine secretion by various activities and environ- Book,SociologyReportNo.88B.(SeeAbstract mental influences arereported. The effects of some 71. 1076.) A second set of data are contained in a report centrally acting drugs, such as nicotine, on catecholamine presenting a description of actual and potential resources output are considered. The importance of circulating available in health and health related organizations for the adrenaline for a variety of psychological functions has implementation of programs designed toreducethe been clearly demonstrated by experimental results, while incidence of cigarette smoking (Sociology Report No. the possible significance of circulating noradrenaline in 90).Implications fromthese twosets of dataare relation to behavior remains obscure. The data available presented in a third report which deals with the develop- today suggestthattheconcept of adrenaline as an ment ofalternativetypes of interventionprocesses 'emergency hormone', which facilitates fight and flight directedatdecreasingcigarettesmokinginnon- reactions under conditions inducing rage and fear, should metropolitanareas (Sociology Report No. 91). (See be extended to include also the coping behavior of Abstracts 71-1082 and 71-1083.) healthy individuals exposed to everyday stress situations. The mechanism by whichadrenaline influences the central nervous system is not yet understood. but data 71-1076. Beal, G. M., Warren, R. D., Fleischman, W. A. from behavioral studiesclearly show that adrenaline Smoking Behavior. Data Book. Department of Sociology secretionisrelatedto both cognitive and emotional and Anthropology, Iowa State University, Ames, Iowa, functions. Sociology Report No. 8811, June 1971. Unpaged.

This report presents data based on a nonmetropolitan 71-1079. Gossett, J. T., Lewis, J. M., Phillips, V. A. area sample of individuals and includes attitudes, beliefs, Extent and Prevalence of Illicit Drug Use as Reported by situations, and behavior related to smoking and health. A 56,745 Students. Journal of the American Medical Asso- description and analysis of these findings are presented in ciation 216(9):1464-1470, May 31, 1971. Smoking Behavior, Sociology Report No. 88A. (See Abstract 71-1075.) The 54-page interview questionnaire A survey of all junior and senior high students in the used in this survey is appended to the present report. nation's tenth largest public school system (Dallas In- dependent School District) revealedthat 28 percent reported experimentation with an illicit drug. 8 percent 71.1077. Eisinger, R. A. Nicotine and Addiction to reported use more than ten times and 4 percent reported Cigarettes.British Journal of Addiction 66(2):150-156, frequent current use. The rank order of "popularity" for 1971. 61 drugs was different for the junior- and senior-high populations. Although both groups acknowledged using Psychological addiction as a function of nicotine alcohol most frequently, followed by tobacco, the next content of clarettes smoked was examined. There most frequently used drug for the senior-high student was appears to be some relationship, although it is not the marihuana, followed in order by nonprescription stimu- most prominent dosage factor, between nicotine and lants, glue, solvents, and amphetamines. Junior-high stu- psychological addiction to cigarettes. Investigations of dents reported glue, solvents. nonprescription stimulants, physiological or pharmacological addiction to cigarettes marihuana, and lighterfluidinthat order following have concentrated upon the primary importance of alcohol and tobacco. Boys reported more illicit drug use nicotine in "le addictive process. Results of the analyses than girls, upper class students more than lower. Peers Performeds., ,est the independence of psychological were most often the source. The survey appears to reflect addiction to cigarettes from the unvalidated concept of high levels of reliability and validity for an approach of physiological or pharmacological addiction. (Auth. Abs. this kind. Two repetitions of the survey are planned in the Mod.) 1970 to 1971 school year. BEHAVIORAL AND EDUCATIONAL RESEARCH

71.1080. Graham, S., Gibson, R. W. Cessation of Pat- exposure to tobacco. The carcinogenic properties of terned Behavior: Withdrawal From Smoking.Social cannabis compared with those of tobacco have not yet Science and Medicine5(4):319-337, August, 1971. been determined, but even if the use of cannabis alone provesto be less dangerous than smoking ordinary The hypothesis that an innovation will be acceptable if cigarettes,the effects of combined cannabis/tobacco 1) there is improvement with computability, and 2) there smoking will also need to be examined. is increased contact with the innovation, is testedas it applies to cessation of smoking. It was hypothesized that individuals successful in stopping smoking would be those 71-1082. Klonglan, G. E., Paulson, S. K. Coordinating with pre-existing needs, values, knowledge, attitudes, and Health Organizations: The Problem of Cigarette Smok- behavior which would be compatible with and could find ing. Department of Sociology and Anthropology, Iowa improvement inwithdrawal. Their milieu would also State University. Ames, Iowa, Sociology Report 90, June provide contact with the idea of not smoking or aban- 1971, 283 pp. doning the habit. A group of 996 males were interviewed and classified according to their smoking behavioras: Many public and private health organizations have Never Smoked; Never Stopped; Recidivists (those who addressed themselves to the health-damaging problem due had tried stopping for at least a week but had resumed); to smoking with the intent of redo :ing the incidence of and Successes (those who had stopped at leastone year cigarette smoking. One major obstacle to success has been prior to the survey and had never resumed). Successes and overlap and duplication of effort resulting from indepen- Never Smoked appeared to be more aware of the dent activities of the organizations which further results scientific evidence on the hazards of smoking than those in an inefficient use of resources. A more efficient who continued to smoke. There was evidence that they approach might be through coordination where each were less habituated to smoking, that they had more organization carries out parts of programs which are symptoms of respiratory pathology, and that they had compatible with those carried out by other organizations had more serious illness in the past. Successes seemed to and are best suited to the organization's resource capabil- have a more highly developed rationale as to why smoking ities. The research reported in this study is concerned should be discontinued than Recidivists. In addition, with both issues, that is, the coordination of organizations individuals associated rather intimately with Successes, and the health problem of cigarette smoking. The general such as fathers and wives, had similar behavior, suggesting objective of the research was to determine what intta- that they provided greater contact with the idea ofnot organizational characteristics and preconditions are neces- smoking and implying that cessation of smokingmay be sary for the establishment and maintenance of coordi- more easily achieved when others in the milieu also have nated efforts among health-related organizations in the not smoked or have given it up. The importance of the area of cigarette smoking and health. social factors in such changes may be suggested by the fact that Recividists frequently noted that the urgings of their friends had played an important roleintheir 71-1083. Klonglan, G. E., Beal, G. M., Paulson, S. K., dlehion. Warren, R. D., Fleischman, W. A. The Potential of Organizational Coordination as an Intervention Process: Applied to the Problem of Cigarette Smoking and 71-1081. Hasleton, S. The Incidence and Correlates of Health. Department of Sociology and Anthropology Marihuana Use in an Australian Undergraduate Popula- Iowa State University, Ames, Iowa, Sociology Report 91, tion.Medical Journal of Australia2(6):302-308, August June 1971, 78 pp. 7,1971. This report brings together findings and implications A random sample of 168 rust- and second-year of two separately reported but related research studies. students in the Faculties of Arts and Science at the These studies were conducted for the National Clearing- University of Sydney were questioned about marihuana house for Smoking and Health in an attempt to better use, and the social and academic correlates of their drug understand (I) the cigarette smoking behavior, attitudes use were established. The sample was also tested on the and beliefs of nonmetropolitan residents, (2) the knowl- Eysenck Personality Inventory and the Anderson and edge, opinions and use of nonmetropolitan health-related Western Student Attitude Inventory. Results indicate that organizations by such residents, and (3) the interaction about 18 percent of students have used marihuana at this among such organizations particularly with respect to stage of their career. The modal user is male, living away their commitment to involvement in the health problem foam home in shared accommodation. He is unlikely to of cigarette smoking. Specifically, the major concern of have any formal religious affiliation, and he has been this report is to explore alternatives for intervention in exposed to a variety of other drugs. Users tendto be the health problem of cigarette smoking focusing on somewhat extrovert, radical, and open-minded. From coordination of organizations in rural (nonmetropolitan) responses to questions concerning the use of tobacco, it areas. The ultimate objective of alternative intervention was evident that users are not si;bstituting marihuana for program is, of course, to bring about change in indi- tobacco. Only 50 percent of the total usersare non- vidual's smoking behavior. smokers, while 77.5 percent of the non-usersare non- smokers. While only 2.2 percent of thenon users are heavy smokers (smoke more than 100 cigarettesper week), 13.3 percent of the combined users 71-1084. Mausner, B., Piatt, E. S. Smoking: A Behavioral are heavy Analysis. New York, N.Y., Pergamon Press, 1971, 238 smokers of tobacco. Smoking marihuana involves drawing pp. a lungful of smoke into the chest and holding it there for as long as ; Assible. This is reportedly very difficult unless The first the norm.,', rejection response has been attenuated by part of this book describes a series of investigationsintothenaturalhistoryof cigarette

'2O5 202 BEHAVIORAL AND EDUCATIONAL RESEARCH smoking; the second describes an experimental attempt to cigarettes/week for those 17 years old and over. In girls, induce change in smoking habits. The initial studies in the the corresponding figures were 13.5 and 33.2. A com- rust part consist of analyses of descriptive material drawn parison with regular smokers surveyed in 1967 showed an from interviews, questionnaires, and diaries furnished by a increase in the present group in smoking in all age groups variety of groups of smokers. In two of these studies the in both boys and girls, excluding the 18+ age group in the interrelationships of different kinds of reports from boys. Parental knowledge of their child's smoking was individual smokers are examined. Questionnaire data on positively correlated with the child's age. Parental ap- the role played by smoking in the lives of a group of proval increased with the child's age, but even in the young men and their beliefs about the consequences to 17-year old or over group. two-thirds of the parents themselves of continuing to smoke or stopping are then disapproved. Even parents who smoke disapproved of analyzed. These data on beliefs and patterns of support their children's smoking habits. There was a positive for smoking were related to measures of personality traits. correlation between parental smoking habit and their Implications are presented for psychological research into daughter's habit but no positive association in the boys. the design of control programs in other areas in which The vast majority of the children recognized that smoking people must sacrifice immediate gratification for long- was harmful to their health, even 82 percent of the range benefits. regular. smokers. Over 9 percent of the boys and 6 percent of the girls stated they had been offered drugs. Two percent of the children had taken drugs. The type of drug 71-1085. Newman, I. M. Ninth Grade SmokersTwo offered and taken most often was marihuana, followed by Years Later. Journal of School Health 41(9):497-501, LSD, pep pills, heroin, morphine/opium, barbiturate and November 1971. cocaine, in that order. Regular smokers were more prone to come in contact with drugs than nonsmokers. Nearly Forty smokers and forty nonsmokers were studied for three-fourth of the children had taken an alcoholic drink a three-year period in order to examine changes in social with 13 percent of the boys and 10 percent of the girls status, peer group membership, and the achievement of stating they were regular drinkers. theirparents' and schools' expectations which were initially related to cigarette smoking. Smoking was found to be significantly related to social status for females, but 71-1087. Phillips, A. J. The Smoking Habits of Profes- not for males at the beginning and end of the three-year sional Groups in Canada. In: U1CC Technical Report period. In the eyes of her peers, smoking "typed" a Series, Volume 6:Public Education About Cancer. female and associated her with a lower social status Recent Research and Current Programmes, 1969. Geneva, position than was granted most nonsmokers. Males, Union Internationale Contre le Cancer, 1970, pp. 34-37. however, appeared to be free of any social demotion resulting from cigarette smoking. Smoking was closely A sample survey of the smoking habits of Canada's relatedto peer group membership, and peer group doctors, nurses, and teachers showed that the proportion memberships related closely to each individual's position of smokers among there groups is below that for the in the social status system. Among those who either quit population of Canada as a whole. Approximately one- smoking or took up the habit, there appeared to be a third of the nurses and teachers, and 45 percent of the related change in status and peer group membership. In doctors have stopped smoking cigarettes. Ex-smokers ninth graders, smoking behavior was significantly related reported "belief in scientific evidence" and "relief of to the extent to which they felt they were actually respiratory symptoms" as the most common reasons for meeting their parents' and schools' expectations. No such having quit smoking. The incidence of smoking among relationship existed by the end of the eleventh grade doctors was found to be highest in those living in towns which indicated that the earlier smokers, who felt they whereas among nurses and teachers, it was higher in cities. were not achieving others' expectations, had dropped out of school, quit smoking, or learned to achieve and meet others' expectations. 71.1088. Read, C. R. The Teenager Looks at Cigarette Smoking. In: UICC Technical Report Series, Volume 6: Public Education About Cancer. Recent Research and 71-1086. O'Rourke, A., Wilson-Davis, K., Gough, C. Current Programmes, 1969. Geneva, Union Internationale Smoking, Drugs and Alcohol in Dublin Secondary Contre le Cancer, 1970, pp. 97-104. Schools.IrishJournalof MedicalScience 140(5):230-241, 1971. The results ofan.American Cancer Society survey of smoking beliefs and behavior in young people ages 13 to A questionnaire survey was made of smoking, drug 18 years are presented. Only 21 percent of current and alcohol habits of secondary school children in Dublin. teenage smokers and 2 percent of nonsmokers predict Results showed a higher incidence of smoking among that they will be smoking in 5 years. Three out of five Dublin boys under 14 years of age as compared with the youngsters ages 13 to 18 have tried cigarettes but only 27 incidence in British surveys. Over age 14 there was little percent are current smokers (defined as having smoked at difference between the samples. Over two-thirds of the least one cigarette in the last 30 days). Smoking is light in boys aged 12 or under had tried smoking. The proportion comparison with adults: 95 percent of all youngsters who smoke regularly increased with age but this increase report smoking less than a pack a day. One quarter of in regular smokers came only from boys who experi- those who ever smoked had their rust cigarette by the mented with smokingthere was no age trend among the time they were 10, another quarter when they were 11 or nonsmokers. Among the girls, a significantly lower pro- 12, one-third when they were 13 or 15, and the rest from portion smoked at each age than the boys. Boys smoked 15 on up. Both smokers (65 percent) and nonsmokers (86 significantly more cigarettes than girls. In boys, the mean percent) believe smoking is a cause of cancer. Cigarette number of cigarettes smoked steadily increased from 18.4 smoking among teenagers is inversely related to academic cigarettes/week for those 12 years old and under to 59.9 achievement and aspiration. Reasons for smoking are

203 206 BEHAVIORAL AND EDUCATIONAL RESEARCH

largely social. Among smokers, reasons for disliking the the men included lack of discipline and tension, andin habit were mostly related to economics, health, and the 'womena difficulty tender-minded, dependentaspect of in quitting. Smokers, as compared to non- personality, emotional instability, expedience, smokers, are more socially precocious, more adventurous, shyness. and manifest a greater inclination to move into the adult apprehension, lack of self-discipline, and tension. Inmen, the ability to resist the pressure to smokeand to quit world, Where friends, siblings, parents, and other fre- smoking was linked with an experimenting, critical quently seen adults smoke, youngsters are more likely to mind, take up the habit. When teenagers feel their parents whereas an assertive, independent spirit andlack of tension were characteristic of the nonsmoker.In women. understand them, the youngsters are less likelyto smoke. an apprehensive, worrying personality was the Influential adults who had told youngsters notto smoke most included parents, teachers, adult youth club leaders, significant characteristic of the continuing smoker.Pre- doctors, and friends. The considerable percentage of vious reports that smokers are independent.resistant to teenagers who have tried cigarette smoking and quit, and suggestion, and extroverted were not confirmed in this the fact that the number of cigarettes consumed study. The data indicate that it is the nonsmoker whois by independent and resistant to suggestion and that smokers is relatively small suggests that the habit isnot shyness and lack of confidence in a crowdmay contribute to the yet deeply rooted in most of the current smokers. smoking habit. Teenagers are aware of anti-cigarette commercials,report having anti-cigarette programs in school, andare familiar with thewarning label on cigarettepackages. How teenagers resolve the conflict between the 'youth and 71-1091. Schmidt, F. Sind Raucher "andere" Menschen? adult worlds is closely linked with how they resolve (Are Smokers "Different" People?)Selects 3:240, 242, the January 19,1970, German. problem of the cigarette habit. When, where,and with whom teenagers have their first cigarette is not considered Prof. Arthur Jores of Hamburg is criticized for making critical in determining whether or not theirsmoking habit is continued. misleading statements in minimizing the harmfulnessof cigarette smoking. In an interview reported in thedaily press, he had shrugged off the findings of the Terry 71-1089. Robbins, P. R., Tanck, R. H., Meyersburg, H. Report showing the relation of smoking to lungcancer as A. being based merely on statistics, ignoring the effects of Psychological Factors in Smoking, Drinking, andDrug smoking on other organs, and ignoring the Experimentation. Journalof ClinicalPsychology numerous 27(4):450.452, October 1971, large-scale studies on humans and themass of evidence based on animal experimentation. Accordingto Jores, 10 An attempt was made to relate measures of smoking, cigarettes per day does not cause damageto the human organism. To counter Jores statements, Schmidt drinking and drug experimentation in college studentsto referred scores from personalitytests. The study yielded a to the findings of Hammond's study on twins, Eyesenck's linking of personality, smoking and lungcancer, Doll and replication of earlier findings that the MinnesotaMulti- Hill's study on over 40,000 British physicians, phasic Personality Inventory (MMPI) PD scale and the tended to observations of a practicing physician, Dr. Lothar relate to both smoking and experimentation withdrugs. Krekel. Other than the Pp scale, however, no test linking smoking with angina pectoris and lungcancer. The score correlated appearance of Jores' statements in a newspaper rather significantly with any two of the social healthhabits than in a reputable journal was consideredas evidence of considered, Smoking was positively correlated with the an attempt to mislead the casual reader. neurotic scales of the MMP1, with the DreamIncident Technique (DIT) scale for aggression, and withreports of psychological problems. Smoking was negatively corre- 71-1092. Simmons, H. E. Your Psyche, the lated with measures of achievement. While thefindings Cigarette and for drinking were limited in that the sample the Pill. The Psychogenic Theory of Disease.Sacra- included few mento, California, General Welfare Publications, 1969, heavy drinkers, almost all results obtainedwere nonsigni- 260 pp. ficant. Positive relationships were found betweendrug experimentation and the DIT measures of tension relating to autonomy and affection. A theory of psychogenic disease is presented which suggests that some diseases originate in the psyche and develop as glandular reactions to emotions. Asthma, arthritis, congestive heart ailments. diabetes, 71-1090. Rode, A., Shepherd, R. J., Ross,R. Smoking epilepsy, andPersonality. AmericanReview of Respiratory ulcers, colitis, skin disease, multiple sclerosis, thyroid Disease 104(6):929-932, December 1971. disease, and cancer are among the diseases postulatedas psychogenic because in them tissue responds to glandular The psychologic characteristics of 336 malfunctioning caused by emotional stress. The disease- men and 265 producing emotional stress, the glandular products women attending a smoking withdrawal clinicwere cata- assessed by the Cattell 16 factor test. Findings lyzed by the stress, and the disease caused by theresulting showed hormonal imbalance are discussed. Psychogenic theory that the population had different sexualattributes of personality suggests that many lung ailments have their genesis inthe than the usual mixture of smokers and psyche, that lung cancer may be one of the conditions nonsmokers, and in many instances, thesex role was reversed. The men were affected by caused by emotional stress, and that cigarettesmokers their feelings, may have significantly different emotions than the expedient, shy, and imaginative, whereas thewomen were non- assertive, self-opiniated, forthright, and smoking population. Psychogenic theory alsosuggests self-sufficient.. that emotional stress in combination with the ingestionof Other characteristics contributing to the smokinghabit in contraceptive pills may cause serious disease.

See also 71-1099

204 BILLS AND LEGISLATION

BILLS AND LEGISLATION

71-1093.Schmidt,F.UberdenZigarettentod. Petitions to the U.S. Court of Appeals for the District Ergauzungen and Kommentare. (On Cigarette Deaths. of Columbia Circuit for review of orders of the Federal Supplement and Commentary.] Deutsches Arzteblatt Communications Commission by petitioners John F. 67(29):2288-2291, July 1 8, 1970, German. Banzhaf, Ill, Station WTRF-TV, the National Association of Bradcasters, the Tobacco Institute and eight cigarette After some background on the harmfulness of ciga- manufacturers are reviewed. These appeals challenge the rette smoking, several German health statutes are cited as FCC's ruling requiring radio and television stations which the legal basis for proceeding against the manufacture and carry cigarette advertising to devote a significant amount sale of cigarettes as hazardous substances. A prohibition of broadcast time to presenting the case against cigarette on radio andtelevisioncigaretteadvertising and a smoking. heightened educational program are urged to protect the health of juveniles. The German legislature is also asked to authorize compulsory labeling of tar and nicotine content 71-1095, U.S. Federal Communications Commission. on cigarette packs. The moderate nature of this last Petition for Review of a Report and Order of the Fedetal requestis emphasized by the fact that in the United Communications Commission. United States Court of States, manufacturers must print health warnings on Appeals for the Fourth Circuit, No. 15,382, argued May cigarette packs. The protection of nonsmokers in public 5, 1971, decided August 20, 1971. places and work areas is also viewed as a must. Doctors are urged to support these measures. In a petition for review of a report and order of the Federal Communications Commission by the Tobacco Institute and a number of cigarette manufacturers, the U.S. Court of Appeals for the Fourth Circuit affirmed the 11-1094. U.S. Federal Communications Commission. On FCC's ruling thatradio and television licensees who Petitions for Review of Orders of the Federal Communi- broadcast announcements discouraging cigarette smoking cations Commission. United States Court of Appeals for as a health hazard are not required by the fairness the District of Columbia, Nos. 21,285, 21,525, 21,526, doctrine to grant time for the presentation of opposing and 21,577, decided November 21, 1968. views.

SMOKING CESSATION METHODS

71-1096. Anand, C. L. Effect of Avena sativa on Cigarette 71-1097. Augendre,P.,Cousin, M., Lagarde,J.-P., Smoking, (Letter). Nature 233(5320):496, October 15, Matton, A. "Le Plan de Cinq Jours" ou "Une Desintoxica- 1971. tion.Tabagique Controlee." ('The Five-day Plan" or "A Controlled Tobacco Detoxification.1Concours Medical The effect of Avena sativa, a drug derived from 93(19):3480-3486, ?try 8, 1971, French. common oats, was studied in a group of 26 cigarette smokers. The drug was chosen because it has been used The proceedings of an antismoking forum in February successfully in India to cure the opium habit. Healthy 1971 concerning the operation of the Five-Day Plan in volunteers and chronic patients in the chest wards of the village of Salers are reported. The four participants in Ruchill Hospital, Glasgow, including tuberculous patients the forum discussed the origins of the Plan from its participatedin the trial. The total duration of their beginnings in 1954, the basis for its application, the smoking, habit and the average number of cigarettes manner in which smoker volunteers are recruited, and the smoked per day in the six preceding months were conduct of the sessions. The villagers of Salers were not recorded. They were told that a drug was being tested recruited in the usual manner and the treatment had been which might affect their smoking, and that they were to irregular because of the lack of preparation. The immedi- make no conscious effort to alter their smoking during ate results of the Five-Day Plan are considered very the trial. Thirteen patients were selected randomly to satisfactory-85 to 95 percent success in those who receive the drug and the others received a placebo for 28 completed the entire coursebut the long-term results days. In the drug group, the total daily consumption by were expected to be much lower. J, L. Schwartz's 13 patients dropped from 254 cigarettes to 74 by the end criticisms of the methods, results, and criteria for evalu- of the trial. Five had stopped smoking, seven had reduced ating the efficacy of the Five-Day Plans are noted. consumption to less than 50 percent, and in one no change had occurred. In the placebo group, total daily consumption actually increased from 215 cigarettes to 71.1098. Conrad, F. G. Smoking-Withdrawal Clinics. 217. Smoking had been stopped by none, reduced to (Letter) New England Journal of Medicine 285(1):60, above 50 percent by six, and increased by three; four July 1, 1971. reported no change. The drug seems to reduce the number of cigarettes smoked per day, along with diminished Of 52personsattendingafive-daysmoking- craving for smoking. withdrawal clinic at Wilford Hall USAF Medical Center,

205 2s SMOKING CESSATION METHODS

Lack land AFB, Texas, 40 stopped smoking, but only 7 zero.Ile high incidence of relapse or "backsliding" maintained abstinence until the end of the year. Most of during the first three months would indicate thateven the group relapsed during the rust month and 73 percent disregarding those failures who never do manage to stop were smoking again by the end of two months. This low smoking despite treatment, treatment methodsas pre- success rate is similar to those of other clinics conducted sently practiced make only a moderate impressionon over the past seven years. those who do manage to stop. Either the usual treatment period is too brief or the methods too inefficient to produce a lasting effect. The majority of "patients" need 71-1099. Hunt, W. A., Barnett, L. W., Branch, L. G. some further supportive or booster treatment during the Relapse Rates in Addiction Programs. Journal of Clinical first six months after successful completion of therapy. Psychology 27(4):455 -456, October 1971. The observationis made thatthere may be some personalityand/orphysiologicalcharacteristicsattri- Based of 84 studies containing smoking cessation data, butableto those persons treated (approximately 20 a typical "extinction" curve of the relapse rate over time percent) who never return to smoking. Relapse curves for is described and discussed. The curve is marked by a steep heroin and alcoholaddictionare compared to the decline during the rust three months, by a subsequent smoking curve, and a remarkable similarity is observed in gradual leveling off, and by an asymptotic level well above the curves from these three areas of drug behavior.

See also 71-1025

GENERAL

71-1100. Horn, D. The Smoking Problem in 1971. the number of cigarettes smokedper day in 1966: the (UnpOlished) PresentedattheAmericanCancer more cigarettes smoked, the harder it was to give up Society' 13th Annual Science Writers' Seminar, Phoenix, smoking. Future anti-smoking programs should include Arizona, April 6, 1971, 12 pp. more activities that stress decision-making, offer more help on the long-term staying off of cigarettes for those The percentage of adult male smokers has dropped who have managed to quit, and promote lesi hazardous from 52 percent in 1966 to 42 percent in 1970, and smoking and less hazardous cigarettes for smokers who among women from 34 to 31 percent for the same period. feel incapable of quitting. In 1964 and in 1966, 76 percent of the adult population felt that cigarette smoking was enough ofa problem for something to be done about it. By 1970, 86.5percent felt this way. The anti-smoking commercials 71-1101. Read, C. R. Why Do We Advertise the Chief on television in Cause of Lung Cancer? Occupational Health Nursing 1969-1970 are probably the reason for this widespread 19:9-11,July 1971. change. In 1964' and again in 1966, 13 percent of the adult population rejected the idea that smoking is harmful The decline in cigarette smoking among adultsover to health, while in 1970 the percentage droppedto 7 percent. In both 1964 and 1966, 45 percent of the the past five years and the effects on this decline ofrecent population agreed that cigarette advertising should anti-cigarette television messages and of recent scientific be and medical findings incriminating smokingas a major stopped completely. By 1970, itwas up to 60 percent. Negative reactions to being in the presence of smokers cause of disease are discussed. Smoking behavior and risks among women and the fact that women are now a major rose from 46 percent in 1964 to 48 percent in 1966 and to 58 percent in 1970. In the period from 1964 to 1966, advertising target are emphasized. Efforts by the Federal 36 percent of the smoking population tried Trade Commission and the American Cancer 'Society to to give up require the tobacco industry to carry tar and nicotine smoking and 20 percent were successful fora net success contents and a warning to smokers in their advertisements rate of 7 percent. From 1966 to 1970, 61 percent tried to and to generally curb cigarette advertisingare described. quit smoking and 36 Ilercent were successful fora net success rate of 22 percent. Being very concerned about the possible effects of smokingon your own health increases the likelihood of thinking about the problem 71-1102. Russell, M.A.H. Smoking in Britain: Strategy for and deciding to do something about it. Future Emancipation. BritishJournal of Addiction However, it 66(2):157-166, September 1971. reduces the likelihood of both short and longterm success for those who try. Responses of smokers, askedin 1%6 if The health cost of smoking in Britain, the national they would be smoking five years later,were found to be highly predictive of the entire response to the problem, and the reasons for failure to process of givk up controlitmore effectivelyarediscussed. A future smoking during the next four years. The feelingthat it antismoking strategy should hinge on the two Interacting would be very hard to give up smokingwas another important factor in predicting whether key factors that maintain smoking, the dependence factor or not people gave and the favorable social climate. Any tacticor measure up smoking over that four-year period. One of the most that diminishes the effect of either of these factors should important predictors of success in givingup smoking was also diminish smoking. In the absence of an effective

2C9 206 GENERAL

in the treatment applicableto large numbers of dependent days from work and more bed care for smokers smokers and with lack of fundamental knowledge ofthe United States as compared with nonsmokers, are arranged nature of dependence,the abilityto overcome the by age and sex in a table. dependence factor is at present rather limited. But much could be done to intensify research in this area.On the other hand, the engineering of a change of social climate 7 1-1 104.Schmidt,F.BeschlussedesArztlichen 1. to one less favorably disposed towards smoking isquite Arbeitskreises Rauchen and Gesundheit auf der feasible and potentiallyhighly effective. This would, Jahreshauptversammlung am 27. 2. 1971 in Mannheim. however, require a coordinated sustained intervention on [Resolutions of the Medical Work Group for Smoking and a national scale, with amulti-disciplinary organizing Health at the First Annual Meeting on February 2,1971 committee closely backed by the Government with in Mannheim.]Zeitschrift fur AllgemeMmedizin der adequate financial and legislative support. It would not be Landarzt47(18):959.960, June 30,1971, German. sufficient merely tocurb commercial promotion of cigarettes; but it would be necessary to accompanythis A 10-point program described includes legal pro- with antismoking propaganda of a commercial advertising tection for nonsmokers, prohibition on tobacco adver- type and scale. Continuous evaluation and publicreaction tising, acceptance of the American "Fairness Doctrine" monitoring would be required to ensure maximal efficacy forradio and TV advertising, printedwarnings on of such tactics as selective tax increases, tighter controlof cigarette packs, a 50-percent increase in cigarette taxes, sales outlets, and restriction of smoking in publicplaces. continuing control of tar and nicotine content of cigarette (Auth. Abs.) brands, a ban on cigarette vending :nachines in public places, prohibition on sale to minors, protection of health of the fetus, and promotion of detoxification centers. 71-1103. Schmidt, F. Warum U.S.-Lebensversicherungen General recommendations include nonsmoker direction dieBeitragssatzefurNichtrauchereamassigen. Bin for detoxification centers, worker sick-funds to pay for nachahmenswertes Beispiel. [Why US. Life Insurance detoxification centers, encouragement of detoxification Companies Reduce Premium Rates for Nonsmokers. An by offering lower sick-fund ratesor premiums for Example Worth Mentioning.]Deutsche Versicherunk nonsmokers, discontinuance of indirect cigarette adver- szeitschnft 4:96-97, 1971, German. tising on TV or in films, and an appeal to smoking physicians to set an example for the public and not to Dr. Schmidt's 3-week study trip which he made with hinder antismoking measures. Dr. Portheine in December 1970 for the purpose of investigating antismoking measures in the United States, is briefly reported. A fuller account of the trip is in press. 71-1105. Terry, L. L. Rauchen Selbstmord in Raten. Schmidt feels that a real breakthrough has taken place in Gibt es noch Hate? [SmokingSlow Suicide. isThere the United States in changing public opinion with regard Sozialmedizin, to smoking and in reducing cigaretteconsumption in AnyHope?'Rehabilitation, Physikalische Medizin, Praventivmedizin; Internationale 1969 and 1970. Reductions in life insurance premiums 24(3):33-37,September for nonsmokers in the United States has been attributed Zeitschriftmit Zentralblatt to the..findkrgs of numerous investigations,starting with 1971, German. the 1964 Terry Report. There are also some statistics presented by Hammond to the World Conference on Cigarette smoking is the leading cause of self-induced disability, disease, and death in the U.S. and in many Smoking and Health in New York in 1967, demonstrating lung the increased mortality rates of male and female smokers, other countries. The relation of cigarette smoking to cardiovascular disease, and statistics based on a study of about 300,000 U.S. cancer, non-neoplastic lung disease, and emphy- and general disability is discussed in detail. On thisbasis, army veterans showing increased lung cancer to cigarette smoking are urged to sema mortality and an increase inthe incidence of those habituated myocardial infarct due to smoking. The results of a questiontheir dependency which compromises their National Health Survey Report showing a greater loss of future good health. CHEMISTRY, PHARMACOLOGY ANDTOXICOLOGY

71-1106. Agurell, S., Leander, K. Stability, Transfer and Man. Journal of Pharmacy and Pharmacology23(Supple- Absorption of Cannabinoid Constituents ofCannabis ment):62S-67S, December 1971. (Hashish) During Smoking. Acta PharmaceuticaSuecica 8(4 ): 39 1-4 02, September 1971. Nicotine and a basic metabolite, cotinine,were deter- mined in the urine by gas-liquid chromatography The cannabinoids of a hashish preparation after were intraveousadministrationof()-nicotinehydrogen determined qualitatively and quantitatively. Agroup of (+)-tartrate to groups of male and female smokers and Cannabis smokers using this preparation obtaineda 14-20 nonsmokers in whom the urine was maintained percent at an acid transfer of the cannabinoids present inthe pH. The urinary recoveries of nicotine and cotinine hashish cigarette to the respiratory system. These from results male smokers fell in two groups. One showeda lower agree with experiments using tobacco cigarettes h.spreg- recovery of both alkaloids than was seen with male nated with pure cannabinoids, showing a 14-20 percent nonsmokers. The other showed a similarrecovery of transfer with the main stream of smoke. Whilecigarette nicotine but more cotinine than the male smoking made only 14.20 percent of the nonsmokers. cannabinoid Female smokers excreted less nicotine butmore cotinine constituents of hashish available to the smoker, this figure than female nonsmokers. More nicotine butless cotinine was increased to about 45 for pipe smoking.The was excreted by female nonsmokers than by male experienced Cannabis smokers using deep inhalations nonsmokers. The results show that sex-dependentmetab- absorbed over 80 percent of the cannabinoids in themain olism of nicotine occurs in nonsmoking humans stream smoke. There is no difference in the transfer of and that smoking causes alterations in nicotine metabolism.(Audi. cannabinoids using the deep inhalation technique,when Abs.) compared to normal superficial smoking.Except for decarboxylation of cannabinoid acids, there isno substan- tial difference between the major cannabinoids of the 71-1109. Shown, A. S., Maitria, B. B.,Shown, M. smoke as compared to the drug itself. That thesmoking Ammonia Retentionby Smokers: A Comparative process causes only limited changes in the cannabinoid Study.IndianJournal of MedicalResearch fraction was also shown by smokingpure delta' -tetra- 59(8):1296 -1299, August 1971. hydrocannabinol, cannabidiol, cannabinol, andcannabidi- olic acid. The present results indicated thatto achieve a Inhalation and retention of ammonia by cigarette "normal biological high" by smoking, the absorbed dose smokers, smoking cigarettes with and without filtertip, of deltas -tetrahydrocannabinolwas in the range of 3-5 mg and bidi smokers have been quantitatively estimatedand for the tested persons. The results furtherindicate a the results compared. It has been concluded rather rapid fall in the content of delta' that bidi -tetrahydro- smokers retain twice as much the amount ofammonia as cannabinol in stored hashish, partly dueto the transfor- is retained by cigarette smokers. No difference mation to cannabinol. A gas chromatographic however, method for could be detected between the two types ofcigarette the determination of cannabinoids, usingtriphenyl car- smokers. (Auth. Abs. Mod.) binol as internal standard, is presented.

71-1110. Bilimoria, M. H., Nisbet, M. A. The 71-1107. Beckett, A..11., Gorrod, J. W., Jenner, P. Differentia- The tion of Tobacco Smoke Condensateson the Basis of Analysis of Nicotine-1.-N-Oxide In Urine, in the Presence ReducingProperties. BeitragezurTabakforschung of Nicotine and Cotinine, and ItsApplication to the 6(1):27-31, July 1971. Study of In Vivo Nicotine Metabolism inMan. Journal of Pharmacy and Pharmacology 23(Supple- Condensates obtained by smoking cigarettes, ment):55S -6)S, December 1971. cigars, and pipe tobacco have been comparedon the basis of theirabilities to reduce cytochrome C and dichloro- A rapid quantitative assay for nicotine-e-N-oxidein phenolindophenol. Most market brands of urine,inthe presence of nicotine and cotinine, flue-cured is cigarettes, while differing on the basis of totalreducing reported.,The urinary excretion of nicotine,cotinine, and nicotine4 -N-oxide was determined after activities, give similar values when reducingactivity is nicotine had expressed as specific activity (reducing activity been administered in cigarette smoke, per mg orally, or intra- particulate matter). Condensates from blended cigarette venously to subjects with either fluctuating,controlled acidic, or controlled alkaline urinary brands containing other types of tobacco in additionto pH. The urinary flue-cured, have lower specific activities. excretion of the N-oxide in 24 hours from Special types, smokers under such as cigarettes made from 100percent reconstituted normal conditions was about half thatof the cotinine tobacco and a also give excretion; more trans- than cis-diastereoisomer lower values. of nico- Both cigars and pipe tobaccos give condensates tine-1 -N-oxide was excreted. (Auth. Abs.) with distinctly lower specific activities than those obtained from flue-cured cigarettes. In the case of pipe tobacco,a large amount of water accumulates on the Cambridge 71-1108. Beckett, A. H., Gorrod, J. W., Jenner,P. The Effect of Smoking on Nicotine Metaboliim pads and has to be taken into account when calculating In Vivo in specific activities. (Auth. Abs.)

208

211 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

71-1111. Bilimoria, M. H., Nisbet, M. A. Effect of 71-1114.Driscoll,P.,Deuber, A. Die Wirkung von Tobacco Smoke Condensates on Ascorbate. Beitrage zur filtriertemZigarettenrauchauf den Kohlenmonoxid- Tabakforschung 6(1):32-35, July 1971. liamoglobin-Spiegel and die Atmungsferquenz der Ratte. [The Effect of Filtered Cigarette Smoke on theCarbon Ethanolic extracts of tobacco and tobacco smoke Monoxide-Hemoglobin Level and the Respiration Fre- contain compounds capable of accelerating theoxidation quencyinRats.]ZeitschriftfurPraventivmcdizin of ascorbate. Using a polarographic technique, smoke 16:413-414, 1971, German. from cigarettes, cigars, and pipe were examined for The frequency of respiration in rats exposed to gas oxidizingproperties. Smoke from Virginia cigarettes showed greater activity than that from blended cigarettes. phase (Cambridge and wood charcoal filtered) and gas- while smoke from cigars and pipes had evenlower vapor phase (Cambridge filtered only)smoke was mea- activity. The reaction of ascorbate and smoke has been sured and the results then compared with the percentages shown by electron paramagnetic resonance to involve a carboxyhemoglobin (COHb) in each animal directly radical intermediate. (Auth. Abs.) after a 30-second exposure. Two types of 85-mm non - filter cigarettes were used in the tests, a commercially available cigarette (A) and a specially preparedtest cigarette (B). The animals were tested in a latin-square 71-1112. Birnstingl, M. A., Brinson, K., Chakrabarti, B. K. of COHb, The Effect of Short-Term Exposure to Carbon Monoxide sequence. The results showed all percentages with the exception of Cigarette A gas phase and Cigarette onPlateletStickiness. BritishJournalof Surgery 58(11):837 -839, November 1971. B gas-vapor phase, differed significantly. The frequency of respirationforthe gas-vapor phase was only about Prolonged exposure to carbon monoxide accelerates one-third that of gas phase respiration but the differences the development of atheroma in rabbits owing tointimal in COHb percentages were much narrower. No explana- accretion of platelets and fibrin and intramural lipid tion for the differences in the COHb percentages could be accumulation. A group of 7 rabbits was exposed in a found in a study of the test parameters of the two CO cigarettes. It was concluded that differences other than in closed chamber to an atmosphere containing 400 ppm the degree of alveolar for 6-14 hours on several occasions. Platelet stickiness was respirationrate couldaffect estimated by a modified Hellem's glass-bead method ventilation and thus the absorption of carbon monoxide. immediately after exposure and on the following day, for Animals later given a 15-second exposure to whole or comparison with values in the resting period prior to charcoal-filtered smoke showed great variability in the exposure. There was a highly significant increasein respiration rate of the individual animals. platelet stickiness immediately after exposure to CO, followed the next day by a significant fall below the pre-exposure value. The increase in plateletstickiness 71-1115. Elmenhorst, H. Nachweis von Maltol in Cigarett- after CO exposure may provide a link between tobacco enrauch.[DetectionofMaltolinCigarette smoking and peripheral vascular disease. (Auth. Abs. Smoke.]BeitragezurTabakforschung6(2):70-73, Mod.) September 1971, German. Maltol (2- hydroxy -3- methyl -4- pyrone) as a new to- .71-1113. Cohen, S. D., Nicholas, B. A., Jenkins, H. J. bacco smoke constituent was identified by thin layer Classification of Nicotine Block at Neuromuscular Junc- chromatography and UV-spectrometry. After conversion tion.Journal of Pharmaceutical Sciences into the methylether, by reaction with diazomethane, 60(11):1740 -1742, November 1971. maltol was identified by gas chromatography and mass spectrometry. The amount of maltol in the smoke of a The effect of nicotine on the electrical thresholdof cigarette, made from tobacco without any additives, was the neuromuscular junction in a rat sciatic - gastrocnemius 5 to 10 micrograms/cigarette. The occurrence of gamma- preparation was studied and compared with the effects of pyrone derivativesintobacco smoke has not been a true curarizing agent and those of apseudocurarizing reported until now. It might be possible that the newly agent on the threshold of the like structure ofthe same found gamma-pyrone derivative is only the first repre- preparation. Low doses of both nicotine and succinyl- sentative of a new class of chemical smoke constituents choline chloride caused a decrease in the predrug electri- (Auth. Abs.) cal threshold level of the neuromuscular junction, while high doses of these drugs caused an elevation of the predsug threshold level. Both low and high dosesof 71-1116, Enzell, C. R., Bergstedt. E., DalhamnT., dhr..:thyltubocurarine chloride, on the other hand, Johnson, W. H. Tobacco Chemistry. 4: Chemical and ce Jed anelevationinthisthreshold level.Eserine CiliotoxicStudiesof Smoke FromFreeze-Dried salcylate enhanced the early blockades caused by nico- Tobacco. Beitrage zur Tabakforschung 6(1):41-50, July Lae and succinylcholine chloride but opposed the late 1971. blockades caused by these same drugs. Eserine salicylate opposed both the early and the late stages of a neuro- Freeze-dried and corresponding conventionally cured muscular blockade brought about by dimethyl tubo- tobacco have been subjected to comparative studies. The curarine chloride. Nicotine and succinylcholine chloride cigarettes manufactured from the freeze-dried tobacco induced a spastic paralysis in chicks, whereas dimethyl have a noticeably lower average weight due to the higher induced a flaccid paralysis in other filling capacity of this tobacco. This has little or no chicks of the same age and weight. On the basis of these influence on the taste, but affects the burning rate studies, nicotine is classified as a neuromuscular blocking considerably. Determinations of the amounts of total agent of the pseudocurare type which does not exertits particulate matter, dry condensate, and nicotine in the effect through acetylcholine release. (Auth. Abs.) smoke shows that these are about half in the case of the 212 209 CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

freeze-dried material when an equal number of cigarettes a severe anoxia. In a smoker consuming 30 cigarettes are smoked; they differ much less when an equal amount per day, the anoxia at ground level is equivalentto that found of tobacco or an equal number of puffsare used as the at an altitude of 2,000 meters, and at 3.000 bases for comparison. However, the phenol content of the meters the anoxia is equivalent to that found atan altitude of 4,500 smoke is noticeably lower for the freeze-dried 'cigarettes. meters. The stenocardia phenomena induced by Examination of the ciliotoxic effect of the smoke smoking from areeggrevated by anoxia. The spastic phenomenaof the two types of tobacco on rabbit trachea in vitroshows blood vessels induced by nicotine that there is no significant difference between the number are further aggrevated by the anoxia and especially by the lowtemperatures at of puffs required to achieve completeciliostasis. A the high altitudes encountered in flight.Immoderate use detailed gas chromatographicmass spectrometricstudy of alcohol has a harmful influence using a high resolution glass capillary column on the pilot, princi and compu- pally by reducing' the utilization ofoxygen. Combustion terized data-acquisition demonstrates that thereare no products of fhels, components of hydraulicfluids, and significant differences between the gas phases ofthe carbon tetrachloride from fire extinguishersalso adversely smoke derived from the two differently treatedtobaccos. (Auth. Abs. Mod.) affect the reactions of pilots in flight.

71-1120. Luderitz, P. Experimentelle 71.1117. Hengy, H., Thirion, J. The Untersuchungen Determination of uber die Wirkungen von Kohienmonoxidens Kraft- Thiodan and Thiodan Sulphate on Tobacco and inSmoke fahrzeupbgasenauf Condensate. Beitrage zur Tabakforschung 6(2):57.61, denGesundheitszustandvon September 1971. Verkehtspolizisten. [Experimental Studieson the Effect of Carbon Monoxide From MotorVehicle Exhaust Gases on the State of Health of Traffic Police.] A gas chromatographic method was developed for the Zeitschtift fur dieGesamte Hygiene and IhreGrenzgebiete quantitative determination of alpha and beta-Thiodanand 17(9):645-646, September 1971, German. Thiodan sulfate on tobacco and in smoke condensatein concentrations as low as 0.01 parts per million. Asurvey Tests were carried out on 120 police (80manual was made of the Thiodan and Thiodan sulfate content of traffic controllers and 40 indoor leaf tobacco and cigarettes. Thiodan and Thiodan controls) of a metro- sulfate politan area in the winter of 1968/69. Ahexobarbital residues in leaf tobacco were found to amountto between tolerance test demonstrated appreciable 0.02 and 0.3 ppm and to between less than 0.02 damage to the and 0.05 function of the central nervous system ofthe exposed ppm, respectively. Cigarettes manufactured from Virginia personnel. Complaints of headache, fatigue, tobacco were found to contain between 0.1 and0.2 ppm nausea, and of Thiodan and less than 0.05 vomiting were significantly more frequent in theoutdoor ppm of Thiodan sulfate. personnel than in the indoor controls. The The transfer rate of Thiodan and Thiodansulfate from carboxyhemo- globin (COHb) values of the trafficcontrollers however cigarette tobacco into the mainstream smoke rangedfrom 14.5 percent to 16.3 percent. (Auth. Abs.) did not exceed the values found in non-exposedsmokers. Before the tests, the COHb valueswere significantly higher in the smokers than innonsmokers but the absolute values at the end of the working dayranged from 71.1118. Ivanov, N. G., Paskaleva, K.,Ivanov, N. Y., 4 to 7 percent which caused Atanasov, Y. Vliyanie na Por'oznosttana Tsigarenata no acute injury to health. Khartiya Vurkhu Kondenzata Because of the low COHb values, carbonmonoxide does na Dima I Negoviya Sustay. not appear to be the sole causative agent. [Influence of Porosity of Cigarette Paperon the Smoke Condensate and Its Composition.]Bulgarski Tiutiun 15(9):11 - 15,1970, Bulgarian. 71-1121. Mokhnachev, I. G., Kanevcheva,I. S. K Voprosu obIssledovaniiSostava Tabachnogo The effect of porosity on the components ofcigarette Dyma. L smoke such as smoke condensate, nicotine, volatile ICachestvennyy Sostav Aminov TabachnogoDyma. [In- vestigation of the Composition of Tobacco phenols, carbonyl compounds, and aldehydesand ketones Smoke. 1. has been investigated. It was found that Qualitative Composition of TobaccoSmoke an increase in the Amines.] lzvesdyaVogl:nthUchebnykh porosity can influence the qualitativeand quantitative Zavedenii, Pishchevaya Tekhnologlya 1(56):62-63, 1967,Russian. properties of the smoke. An increase in porositycreates conditions for an average reduction of 25percent of these Paper chromatography was utilized for thequalitative substances, even without the use ofa filter. The reduc- analysis of the smoke of five brands of tions are more pronounced whena filter is used. The cigarettes: Lyubek, Amerikan 572, and Trapezand 2578,1272, and acidity of the condensate and gas phase isnot appreciably 93. The analyses revealed the altered with the increased porosity of thepaper. presence of the following amines: methyl, ethyl, propyl, butyl, amyl,dimethyl and trhnethyl amines. Several unidentifiedbases were also detected in the smoke. Brand differences 71-1119. Lomonaco, T. Breve Compendia had no influence de Medicine on the qualitative composition of the tobacco smoke. Aeronautics e Spaziale (Continuazione). [BriefCompen- dium of Aeronautic and Space Medicine(Continua- tion).]Minerva Medico 62(70:3399-3402, September 22, 1971, Italian. 71.1122. Montgomery, M. R., Rubin R. J.The Effect of Carbon Monoxide Inhalationon In Vivo Drug Metabolism The harmful consequences of pilot in the Rat. Journal of Pharmacology andExperimental exposure to various Therapeutics 179(3):465.473, December 1971. substances, particularly tobacco smoke and itsprincipal constituents, are hiiefly summarized. Carbon monoxide Previous studies have shown that the by combining with hemoglobin of theblood can result in cytochrome P450-containing hepatic mixed function oxidasesystem 21:,3 210 71. CHEMISTRY, PHARMACOLOGY AND TOXICOLOGY

is inhibited in vitro by carbon monoxide (CO). This study activity) reduced the significance of these findings pro- reports that acute exposure to CO resulted in inhibition viding further support for using such preselection techni- of in vivo drug metabolism inrats as measured by ques when attempting to study the pharmacology of a prolonged responseto two drugs,hexobarbital and subtle psychoactive drug such as nicotine. Female rats zoxazolamine. Exposure to CO for 90 minutes followed appeared to be, chemically and behaviorally, more sensi- by drug testing in room, air resulted in a significant tive to nicotine which appeared to be somewhat related to prolongation of response to hexobarbital at a CO concen- the fact that female 5-HT accumulation was faster than tration of 1000 ppm and a significant prolongation of that in similarly treated male rats. (Auth. Abs. Mod.) response to zoxazolamine at a CO concentration of 250 ppm. Exposure to the same CO levels for 90 minutes followed by drug testing in the CO environment resulted 71-1125. Schuller, D., Drews, C. J., Harke, Analyt- in significant enhancement of the CO-induced effect. The ische Untersuchungen an Gasphasenkondensat. (Ana. prolongation of the pharmacologic responses could be lytical Investigation of Gas Phase Condensate.]Beitrage explained by a CO-induced inhibition of the hepatic Tabakforschung6(2):84-88,September1971, mixed function oxidase enzyme system responsible for zur the metabolism of these compounds. Inhalation of atmos- German. pheres containing lowered oxygen concentrations also By the use of gas chromatographic and mass spectrom- inhibited zoxazolamine metabolism. The data do not, as etric methods gas phase condensate from cigarette smoke, yet, allow a final conclusion to be made concerning the isolated on a prepatative scale has been compared with mechanism of the CO-induced effect, i.e., whether it is native gas phase from the smoke of the same due to the direct effect of CO on P-450 or, alternatively, the to an indirect effect of the induced tissue hypoxia. cigarettes and investigated for qualitative composition. With regardtocomposition, thereisa satisfactory However, an initial approach to this problem has been conformity between both mixtures of substances. It has made by establishing the concentrations of CO and been possible to identify or to characterize more than 60 lowered inspired oxygen required to produce equivalent constituents. (Auth. Abs.) alterations in drug metabolism. (Auth. Abs.)

71-1123. Neurath, G., Dunger, M., Kustermann, I. tinter- 71-1126. Seehofer, F., Wennberg, D. Einfluss verschie- suchung der "Semi-Volatiles" des Cigarettenrauches. [In- dener Zugvolumenprofile auf Ausbeute and Zusammen- vestigationofthe"Semi- Volatiles"ofCigarette setzung des Rauches beim maschinellen Abrauchen von Smoke.]Beitrage zur Tabakforschung 6(1):12-20, July Cigaretten. [Influence of Different Puff Volume Profiles 1971, German. on the Yield and Composition of the Smoke of Machine- SmokedCigarettes.]BeitragezurTabakforschung Six fractions of the steam volatiles of tobacco smoke 6(1):7-11, July 1971, German. condensate (semi-volatiles) were formed by column chro- matography on silica gel. The constituents were identified A study was made of the effect of the puff profile on by means of a combination of gas chromatography and yield and composition of the mainstream smoke of mass spectrometry. About 320 compounds were indi- cigarettes smoked on a RM 20/68 smoking machine cated. Out of the 215 substances identified 69 have not producing three different puff profiles (square-shaped been previously reported in cigarette smoke. (Auth. Abs. profile, early peak, and late peak profiles). The smoke was Mod.) precipitated in an electrostatic .trap. Crude condensate, dry condensate, smoke nicotine, phenols puff number, and draw resistance were determined. Significant differ- 71-1124. Rosecrans, J. A. Effects of Nicotine on Brain ences were found between the dry condensate yields of Area 541ydroxybyptandne Function in Male and Female two puff profiles and between the nicotine and phenol Rats Separated for Differences of Activity. European yields of all the three puff profiles. (Auth. Abs.) Journal of Pharmacology16(1):123-127, September 1971. Male and female rats separated according to differ- 71-1127. Segal, A., Katz, C., Van Dun/en, B. L. Structure ences in activity were administered five nicotine micro and Tumor-Promoting Activity of Anthrafin (1,8-Dfity- doses, and 5- hydroxytryptamine (5-HT) function esti- droxy-9-anthrone) and Related Compounds. Journal of mated in diencephalon (Dien.) and brainstem areas of Medicinal Chemistry 14(12):1152-1154, December 1971. each experimental group. Chemical parameters were studied by comparing 5-HT accumulation in pargyline The compound anthralin, whichis used for the treated rats and it was observed that this factor was treatment of skin diseases is shown to exist normally in significantly lower in nicotine treated high activity rats of the semiquinone form, that is 1,8-dihydroxy-9-anthrone. both sexes. These effects were most evident in the Dien. In Me3CO or MeOR the compound spontaneously di- of the female, while brainstem areas were similarly medics andoxidizes to1,8-dihydroxyanthraquinone. affected in the male mt. 5-HT function appeared to be Anthralin dimes has the structure 1,6,7,12,18,21-hexa- unaffected by nicotine in low activity rats, but there was hydroxy-5,12:6,11-di-o-benzo(a,e)cyclooctene. The fact some evidence that this system was stimulated, especially that anthralinisa potent tumor-promoting agent in in the Dien. of the female rat (+ 31 percent). Correlations two-stage carcinogenesis should encourage an examination between the stimulatory effects of nicotine on activity of tobacco tars, which have marked promoting activity and 5-HT accumulation in the high activity rat supported for similar phenolic materials. Its transformation products previous research which indicated that nicotine can and other related compounds were inactive in this assay. inhibit this chemical system. Pooled data (high and low (Auth. Abs. Mod.)

211 214 CHEMISTRY,PHARMACOLOGY AND TOXICOLOGY

71-1128. Spincer, D., Chard, B. C. TheDetermination of administration of nicotine to the mother while theless Formaldehyde in Cigarette Smoke. Beitragezur Tabak- forschung 6(2):74-78, September 1971. mature fetus showed no significant changes in its acid- base status. The adverse effects of nicotineon the fetus, following its administration to the motherseem to be doe A specific, sensitive method for the determinationof to the combined effects of impaired placental perfusion formaldehyde in cigarette smoke is described employing and a direct action of the transmitted nicotineupon the the spectrophotometric detection ofthe product formed cardiovascular system of the fetus. (Auth. Abs.) by reaction of formaldehyde with p-rosanilineand sulfur dioxide. The procedure is applicableto the analysis of smoke from cigarettes manufactured fromflue-cured, burley, and fermented tobaccos. Smoking 71-1131. Westfall, T. C., Brasc, D. A. Studieson the parameters and Mechanism of Tolerance to Nicotine-Induced the use of Cambridge filters have been found Elevations to affect of Urinary Catecholamines. BiochemicalPharmacology delivery markedly. The effect of severalcommercial filters 20(7):1627-1635, July 1971. on formaldehyde delivery has been examined. (Auth. Abs.) The mechanism of the return to normal ofthe elevatedurinarycatecholaminesobservedafterthe 71-1129. Stauffer, H. P., Br -rquin, J. Einespektralphoto- chronic administration of nicotine has beeninvestigated. metrische Methode zur Bestimmungvon Formaldehyd im Three possible mechanisms leading to thisphenomena Vollrauch von Cigazetten. (A SpectrophotometricMethod were explored: (1) that continual nicotine exposure leads for the Determination of Formaldehydein Whole Smoke to an induction of enzyme activityresulting in an of Cigarettes.]Beitrage zur Tabakforschung 6(1):21-26, increased metabolism of the alkaloid, (2)that nicotine July 1971, German. exposure results in some alterations in the storageor release of catecholamines, and (3) thatsome alteration in A simple method is presented for the estimationof the inactivation of the amines occurred. Thedata indicate formaldehyde in whole cigarette smoke. Theprocedure is that after chronic nicotine (1 mg/kg, subcutaneous,twice based on the Hantzsch reaction betweenformaldehyde, daily up through 14 days), (1) therewas no increase in acetylacetone, and ammonium ion inan aqueous buffer the metabolism of nicotine itself determinedfrom mea- solution.Thereactionproduct,3,5-diace41-1 ,4 - surements of nicotine oxidase activity, (2)there was no dihydrolutidine, has an absorption maximum at 412 nm alterationinthe endogenoustissuelevels of cate- and is measured spectrophotometrically.The operations cholamines determined by fluorometric analysis,(3) there are simple and there are no separation steps required. viasnoalterationinthetissueuptakeof Reproducibilityis excellent and interference by other H)norepinephrine, and, as previously reported,(4) no carbonyl compounds can be neglected.Acetaldehyde in alteration in the turnover of norepinephrine determined concentrations 10 times higher than formaldehydeinter- by measuring the decline of (3H)norepinephrinein the feres to less than 1 percent. Different types ofcigarettes heart following intravenous administration.On the other have been analysed with respectto their delivery of hand, there was a significant increase in themonoamine formaldehyde. Values found range from 40to 90 micro- oxidase activity of the heart and liver andan increase in grams per cigarette. The concentrations found inwhole the catechol-o-methyl transferase activity ofthe liver. It is smoke are significantly higher than the valuescited in the concluded that tolerance to nicotine inducedelevations of literature for gas phase formaldehyde.(Auth. Abs. Mod.) urinary catecholamines is due to increasedmetabolic enzyme activity resulting in faster metabolism of the catecholamines released from the adrenalmedulla and 71-1130. Suzuki, K., Horiguchi, T.,Comas-Urrutia, A. C., adrenergic nerve terminals. (Auth. Abs.) Mueller-Heubach, E., Morishil,:a, H.0., Adamsons, K. Pharmacologic Effects of Nicotine Uponthe Fetus and Mother in the Rhesus Monkey. American Journal of 71-1132. Zielhuis, R. L. Luchtvesontreiniging,Roken en Obstetrics and Gynecology 111(8):1092-1101, December Geneesmiddelen. 15, 1971. [Air Pollution, Smoking and Medi- cine.]T1 /dschrift voor Sociale Geneeskunde 49(20):704, October 8, 1971, Dutch. The short-term pharmacologic effects ofnicotine upon the cardiovascular performance, acid-basestatus, and One result of smoking (voluntary pollution) oxygenation of the mother and fetus and were investigated in exposure to air pollution (compulsory pollution)may be 43 rhesus monkeys inthe second half of gestation. an enzymatic induction which can accelerate the velocity Nicotine giver. intravenously to the mother in either a of degradation of administered medicaments,thus re- single dose of 1 mg/kg ora constant infusion at a rate of quiring greaterquantities of the medicaments. This 100 micrograms/kg/min elicited bmdycardia and hyper- hypotheses has been tested by the administrationof tension which was followed by persistenthypotension. pentazocine during narcosis with The fetus responded with hypotension a fixed and bradycardia amount of nitrous oxide until complete relaxationis (singleinjection)or tachycardia(constant infusion). achieved. The quantity of pentazocine Direct intravenous injection of nicotine into was then deter- the fetus in a mined in relation to residential locationand smoking single dose of 0.9 to 2.5 mg/kg producedchanges similar habits of the anesthetized subjects: to those seen in the mother but quite different 11 of 15 smokers from those required an above-average quantity ofpentazocine as which occurred in the fetus when nicotinewas given to compared with only 7 of 26 nonsmokers; 13 the mother. The cardiovascular of 20 urban responses were more dwellers required above-average amountsas compared pronounced in the mature fetuses than in theless mature with only 5 of 21 rural inhabitants; 9of 10 urban ones, indicating that sensitivity to nicotine is relatedto smokers required above-average amountsas compared the development of the autonomicnervous system. with 6 of 16 urban nonsmokers Hypoxia and acidosis of the metabolic and anonly 3 of 15 rural respiratory nonsmokers. These differenceswere statistically signi- 'type developed in the more mature fetus following ficant. See also, 71. 1142, 71-1145,71-1146,71-1149,71-1151,71. 1153, 71-1169, 71-1189,71-1269, 71-1270 212 MORTALITY AND MORBIDITY

71-1133. Fingerland, A., Husak, T., Bend lova, J. Contri- times higher in smokers than in nonsmokers. The fre- bution to the Investigation of the Effect of Cigarette. quency of arteriosclerosis and myocardial infarction is Smoking. nom& Vedeckych Praci Lekarske Fakulty about 50-60 percent higher in smokers than in non- KarlovyUniversity v Hradci Kralove 14(2):221-234, smokers. The frequency ri:* peptic ulcerationis 3 to 6 1971. times higher in smokers than in nonsmokers. During the years 1965 and 1966, 1,338 adults (765 males and 573 females) were autopsied. Of 662 autopsied adult males for whom smoking data were established, 517 71-1134. Royal College of Physicians of London. Smok- (63 percent) were smokers and 145 (37 percent) were ing and Health Now. A New Report and Summary on nonsmokers. Of the 431 women studied for whom a Smoking and Its Effects on Health From the Royal smoking history was established 26 (6 percent) were College of Physicians of London. London, Pitman Medi- smokers and 405 (94 percent) were nonsmokers. The cal and Scientific Publishing Company, 1971, 148 pp. study focused on the relationship between smoking and the following seven diseases as diagnosed at autopsy: lung This second report on smoking by the Royal College cancer, chronic bronchitis, pulmonary emphysema, sili- of Physicians reviews the evidence of the effects of cosis of the lung, generalized arteriosclerosis, myocardial smoking on health and makes proposals for the pre- infarction, and peptic ulceration of the stomach and vention of diseases due to smoking. Topics covered duodenum. Results indicated for all seven conditions include smoking anditsrelationshiptoIllness and approximately the same frequency in male and female shortening of life, lung cancer, chronic bronchitis, emphy- nonsmokers, a fact which infersthat differences in sema, cardiovascular diseases, and other conditions. Sug- morbidity and mortality rates are related less to sex than gestions for the prevention of smoking-related diseases to external influences, especially cigarette smoking. The include the identification of risk groups, the need for frequency of lung cancer is 8 to 15 times higher in altering smokers' attitudes, ea importance of the doctor's smokers than in nonsmokers and the frequency of lung role, control of cigarette advertising, health education in cancerproportionallyincreaseswith the amount of schools, banning of smoking in public places, health cigarettes smoked. It is 25 times higher in males that have warnings on cigarette packages, more smoking control smoked over 500,000 cigarettes than in nonsmokers. The clinics, statutory limits on nicotine and tar contents of frequency of chronic bronchitis and emphysema is 2 to 3 cigarettes, and differential taxation on tobacco products.

See also, 71-1188, 71-1193, 71-1237

NEOPLASTIC DISEASES

71-1135. British Medical Journal. Occupational Cancer of that are present in such occupations, perhaps by delaying theLung and Smoking. BritishMedicalJournal their elimination through paralysis of ciliary action. 2(5705):313, May 9, 1970.

There appears to be an association between cigarette 71-1136. Cherry, C. P., Glucksmann, A. The Influence of smoking habits and the incidence of lung cancer in various Carcinogenic Dosage and of Sex on the Induction of occupations, including workers in gold mines rich in Epitheliomu and Sarcomas inthe Dorsal Skin of arsenopyrite and asbestos workers. The latter have a risk Rats. British Journal of Cancer 25(3):544-564, Sep- of developing and dying of lung cancer that is 90 times tember 1971. that of nonsmokers not exposed to asbestos. Evidence suggests that the risk may be substantially reduced in The effect of varying the numbers (4, 5, 10, 20, and asbestos workers if they do not smoke. Smoking may 40)ofweeklyapplicationsof9,10-dimethy1-1,2,- enhance the action of the inhaled respiratory carcinogens benzanthracene (DMBA) to the dorsal skin of intact and

213 216 NEOPLASTIC DISEASES

castrate male and female rats on the induction ofbasal 71-1138. Ferrara, F. A. Ecological Analysis and squamous celled epitheliomas and of sarcomas has of Lung Cancer in the City of 1.4 Plata.In: Englund, H. M., been investigated. Basalcelled tumors originate mainly in Beery, W. T. (Editors). Proceedings of hairfollicles and squamous-celled the Second neoplasms inthe International Clear Air Congress. Air Pollution interfollicular regions of the epidermis and differ in their Control Association. New YorL, Academic Press.1971, pp. Progression to malignancy. Penetration of the panniculus 244-247. carnosus is neither a sufficient nor necessary criterion of malignancy since growing hair follicles pass through the A study was conducted to determine the influence muscle layer and carcinomas and sarcomas, whichare still of confined to the dermis, spread along the perineural the smoking habit among patients withcancer of the lung, larynx, and bladder in La Plata, Argentina.The results lymphatics and metastasize to the lungs. Sex andcastra- demonstrated a highly significant association tion do not affect carcinogenesis of epitheliomas in the between dorsal skin at any dose level. Significantly these diseases and the smoking habit. The significanceof more sarcomas an "urban factor" in the etiology of these pathologies result from 20 weekly paintings in male than in femaleor was also shown which, in the specificcase of La Plata, led to castrate rats. The induction period for all tumor types is the asAmption shortened in sensitive individuals only by thatthereareadditional significant an increase from etiological factors. 5 to 10 weekly applications. For less sensitive animalsthe rate of oncogenesis is accelerated with number of adminis- trations up to 20, but slowed down from this level by 40 71.1139. Garbc, E. Tabac et Cancer, Problemes paintings. The optimal dose for speed of induction ofall Epide- tumor types, for maximal yield of basal celled vithe- miologiques. (Tobacco and Cancer. EpidemiologicalPro- blems.]Vie Medicate 52(30):3453, 3454, 3457-34 60, lionras, and for that of sarcomas in male rats is 20 weekly 3462, October 1')71, French. applications. The progression to malignancy varies with tumor type:itisfastfor sarcomas and slow for Epidemiological investigations have establishedthat basal-celled neoplasms. Of the 336 rats at riskonly 1 life expectancy of male smokers is three percent have fibromas or other precursor lesions, while to five years 40 lower than that of nonsmokers and that this reductionin percent have sarcomas; animals with squamous-celled life expectancy reaches eight papillomas account for12 percent, but those with years for those smoking two packs of cigarettes per day. The epidemiologicaldata carcinomas for 66 percent; there are, however, 64percent indicate a link between the number of cigarettes of rats with basal-celled papillomas and only 9 smoked percent and the general mortality and certain diseasessuch as with carcinomas. The optimal dose phenomenonin myocardial infarct and lung cancer The carcinogenesis is discussed. (Auth. Abs.) present report deals with the place of tobacco in the etiologyof certain cancer localizations as reported in major epidemiological investigations. The studies include a Frenchinvestigation 71 -1137. Ederer, F., Leren, P., Turpeinen, 0.,Frantz, I. D. (Jr.) Cancer Among Men on Cholesterol-Lowering on 3937. cancer patients, first reported in 1960. The author also discusses the manner in whichepidemiological Diets. Experience From Five Clinical Trials.Lancet 2(7717):203-206, July 24,1971. investigations on tobacco should be conductedfor valid results. Multivariate analysis, andone of its variants, "cluster analysis" may reveal environmental A comparison of the cancer experience in clinical factors in trials certain diseases which are susceptibleto elimination. ofserum-cholesterol-lowering dietsinOslo, London, Helsinki, and Faribault (Minnesota) with that reportedin a trial at a Los Angeles veterans' institution revealed that 71-1140. Gsell, 0. R. Epidemiology of one of the four studies accorded with the Los Angeles Bronchial Car- cinoma in a Mountain Region. Oncology25(5):410-4 14, findings of increased cancer incidence and mortalitywhile 1971. the remaining three had opposite results.For four studies combined (excluding Los Angeles), the estimatedrisk of An analysis of 102 lung cancers in cancer development in the experimental group relative men in a Swiss to alpine district showed that of the 100smokers, 96 that in the control group was 0.75, and therelative risk percent were heavy smokers. Approximately becomes 1.15 for cancer incidence and 1.08 22 percent for cancer were pure cigarette smokers, 60 percent were cigar death. None of the relative risksare significantly different or pipe smokers, and 18 percent were mixed cigarand cigarette from unity, so that the combinedresults of the five smokers. The average age of death due studiesareconsistentwith the hypothesis that the to lung cancer in these men was 58 years in cigarette smokersand 66 years cholesterol-lowering diets do not influencecancer risk. in pipe and cigar smokers. This Age and cigarette smoking were compared suggests that in cigarette between the smokers, the carcinogens reach the lower experimental and control groups in theLondon, Los respiratory tract in greater quantities than in cigar smokersand that this is Angeles, and Oslo studies and when theywere included as covariables in the reason for an earlier lungcancer death for cigarette calculating relativerisk of death and smokers. These results also indicate that chi-square by the MantelHaenzel method, itdid not cigar smokers have a lung cancer risk, especially when cigarsare smoked appreciably affect the results. The Helsinki serieswas also for many years and in a large daily quantity. closely matched for age and smoking. Cigarettesmoking, but not age, was used as a stratifying factorin randomis- ing the Faribault men, More data arc needsd to determine 71-1141. Guira, A. C. Bladder Carcinoma whether serum-cholesterol-lowering dietsincrease, de- in Rubber Workers. Journal of Urology 106(4):548-552,October crease, or leave unaltered the cancer risk. Combined data 1971. from the five studies show that deaths fromall causes were lower, though not significantly so, in the experi- A study was begun on the incidence of bladder mental groups than in the controlgroups. cancer among rubber workers and an attempt is being madeto

214 NEOPLAST1C DISEASES discover possible carcinogens used in the rubber industry. when repeated, exposure to even small doses of car- Various facts concerning working conditions, type and cinogens sustained over long periods in a carcinogenically grade of tumor, smoking habits, and family history are polluted environment create definite cancer risks. The being gathered. The incidence of bladder cancer appears concept of a "safe" dose for carcinogens is without to be significantly higher among rubber workers. The scientificbasis,isdeceptive and,iflegally adopted, history of industrial carcinogens has been reviewed and its represents a potentially highly dangerous public health bearing on this study has been shown. Presently, the policy. While protecting special economic and profes- epidemiological portion of the study is in progress. sional interests, its application tends to raise gradually and insidiously the level of carcinogenic contamination of the human environment. Moreover there does not exist a 71-1142. Homburger, F. Mechanical Irritation, Polycyclic reliable method or procedure for determining and de- Hydrocarbons, and Snuff. Effects on Facial Skin, Cheek fining a "safe" dose. All avoidable environmental car- Pouch, and Oral Mucosa in Syrian Hamster. Archives of cinogens therefore should be eliminated and prevented Pathology 91:411-417, May 1971. from entering the human environment. All unavoidable carcinogenicrisks should be reduced tothe lowest Syrian golden hamsters (B10 RB strain) were sub- possible minimum and the exposed individuals should be jected five days of each week for up to one year to kept under life-long medical surveillance for the detection immobilization in a stanchion by means of a collar and of precancerous and early cancerous lesions which might insertion of a bit containing either cotton or cotton result from such contacts. Since many carcinogens are impregnated with benzo(a)pyrene, 9,10-dimethy1-1,2. also mutagens and teratogens, such a policy would protect benzanthracene (DMBA), or snuff (a form of pulverized the population against many of these hazards likewise tobacco) into the ginevolingual fold. While the polycyclic associated with the growing chemicalization of the human hydrocarbons, especially DMBA, caused a few carcinomas environment with man-made and often avoidable danger- of the oral mucosa and a much higher number of perioral ous products and wastes. Since close and extensive skin cancers, the exposure to tobacco caused no changes similarities exist between the biologic characteristics of more intensethan those seen in animals biting on chemical carcinogens mutagens and teratogens with those cotton-containing bits. Skin responded to known car- displayed by carcinogenic radiations the principles and cinogens more readily than oral mucosa and, thus, is the criteria found useful and valid in the identification and best test object for this kind of contact carcinopneris. control of chemical cancer risks are applicable also for the (Auth. Abs.) preventive management of radiationcancer hazards. (Auth. Abs.)

71-1143. Hoover, R., Cole, P. Population Trends in Gift. rette Smoking and Bladder Cancer. American Journal of 71-1145. Inui, N., Takayama, S. Acceleration of Prolifera- Epidemiology 94(5):409-4 1 8, November 1971. tion and Tumor Production Rate of L-Strain Cells by Treatment With Cigarette Tar. Gann 62(4):315.320, An association between cigarette smoking and bladder August 1971. cancer has frequently been demonstrated. The causal nature of the association has, however, remained in L-strain cells were treated with cigarette tar for 3 hr. doubt. Because of this, trends in smoking habits and The cellstreated with 25 (LT-25) or 100 (LT-100) bladder cancer experience were examined for successive micrograms /ml of tar showed enlarged and vacuolated birth cohorts of men and women in the United States, cytoplasms, and giant cells were found immediately after Denmark, England, and Wales. Increasing rates of the the treatment. Cells treated with 250 or 500 micro - disease were observed in populations characterized by an grams /ml of tar died within 24 hr after the treatment. increase in smoking among successive birth cohorts. The Cells of LT-100 and LT-25 showed a remarkable growth association is consistent in both sexes, different national- 50 or 60 days after the treatment as compared with ities, and in urban and rural groups. This makes it unlikely control cells. Plating efficiency was also different in that the findings result from an association both of treated and ilontreattd cells. About 70 days after the smoking and bladder cancer with a third variable. treatment, 10to 10cells from the treated and control cells were injected into the newborn C3H mice. Tumor formation was observed in animals injected with LT-100 71-1144. Hueper, W. C. Public Health Hazards From and LT-25 cells, but not in animals inoculated with Environmental Chemical Carcinogens, Patera, and Tem LA-100 (ethanol-treated cells), or non-treated cells except togens. Health Physics 21(5):689-707, November 1971. in only one case. Some numerical changes in chromosome number were of -srved but no cytomorphological changes Environmental chemical cancer hazards, together with occulted in the treated cells. (Auth. Abs.) radiation cancer hazards, form the principal segments of the human environmental spectrum of carcinogenic risks. The cancer hazards from both types of carcinogenic 71-1146. lnui, N., Takayama, S. Effect of Cigarette Tar agents have been rising during the past 75 years because Upon Tissue Culture Cells. Hoopla* Transformation of of the growing contamination of the human environment Hamster Lung Cells by Tobacco Tea in Tissue Cul- with products and wastes of modem industry. This ture. BritishJournal of Cancer 25(3):574-583, Sep- development is responsible for the moderate to marked tember 1971. increases in frequency of certain cancers in many indus- trialized countries and for the shifts in age and sex Hamster lung fibroblastic cells were transformed into distribution of certain cancers in general or circumscribed malignant cells in vitro by exposure to crude cigarette tar population groups. Since carcinogenic effects on cells are for 3 hours. Primary injuries of cells were observed largely irreversible and thus persistent and cumulative between 2 and 48 hours after the treatment. Tar-treated

215 218 NEOPLASTIC DISEASES

cells showed nuclear pyknosis, cell necrosis, and enlarged, attempts have to be matched and experimentation is vacuolated cytoplasm. In one case giant cells put were found into its proper perspective. Sessions Ill and IVsurvey the at about 48 hours after treatment. Transformation occur- various animal models now available for the study red over 100 days after the treatment. The characteristics of respiratory carcinogenesis. Various speciesare compared of transformed cells were random orientation of cells, interms of their lung tumor response to different with piling-up and crisscrossing, and continuous growth in carcinogens. administered by different routes andat vitro for over 300 days. Plating efficiency with treated different dose levels. An extensive morphological descrip- cells was different from untreated cells. The transformed tion is made of the most common "spontaneous" cells, cultured for 100 to 160 days, produced and tumors experimentally induced respiratory tracttumors in vari- when transplanted in cheek pouch of hamsters. Five of ous domestic and laboratory animals. The most recent nine animals inoculated with 100 micrograms/ratof tar advances in the field of respiratory carcinogenesis. treated cells (HT-100 strains) over 160 days in vitro in- died chiding the successful induction of bronchogeniccar- from tumors. The others were killed for histological cinoma in primates by administration of polycyclic examinations and one of the five animals was transplanted hydrocarbons, are described in Session V. The develop- with the cells of HT-10 strains within 121 daysafter the ment of a unified lung tumor classification which is tartreatment. Histologically, the tumors were pleo- applicabletothe most important laboratory animal morphic fibrosarcomas. Low doses (1 X 105 or less) of species is discussed in Session VI along withtwo tentative control cells failed to produce tumors after 270days in proposals for classifying respiratory tract neoplasms. culture. Contrarily, higher doses of 107 of controlcells produced tumors when injected into the animalsafter 270 days in culture. (Auth. Abs.) 71-1149. Radomski, J. L., Brill, E. The Roleof N- Oxidation Products of Aromatic Amines in the Induction of Bladder Cancer in the Dog.Archiv fur Toxikologie 71-1147. Ivakhno, G. 1. 0 Roll Kureniyav Zabole- 28(3):159.175, November 25, 1971. vayemosti Rakom Legicogo. [Role of Smokingin the Incidence of Lung Cancer.]Vrxhebnoe Delo9:99-101, 1971, Russian. Highly sensitive gas chromatographic methods for the determination of the N-hydroxy and nitroso derivativesof 1- and 2-naphthylamine, and 4-aminobiphenyl inurine The smoking habits of 1600 male lungcancer patients have been developed. Dogs given a single oral 70 mg/kg in the Ukraine have been analyzed statistically.Two types dose of 1-naphthylamine were found to of controls were utilized in the study, excrete almost as (1) 1600 healthy much of these N-oxidation productsas dogs given the persons and (2) 1200 cancer patients other than lung same dose of 2-naphthylamine. However, when 5 mg/kg cancer cases. The incidence of lung cancer was foundto of 2-naphthylarnine was given, a total of approximately be greatest in the smoker group. The incidencewas also 0.2 percent of the administered dos: greater for heavy smokers, those beginning the habit was found in the wine as N-oxidation products, while thesame dose of earlier and smoking for a longer period of time, andthose 1-naphthylamine produced only smoking a variety of tobacco products. Smoking fainttraces. The N- on an oxidation products presentwere2- empty stomach also had a similar adverse effect.A preliminary study on the relationship between lung naphthylhydroxylamine and 2-nitrosonaphthalene. In ad- cancer dition, blood methemoglobin production,a measure of and the consumption of tobacco in theUkraine also the level of N-hydroxylation occurring, observed with demonstrated that smoking is an important etiological 2-naphtliyhuninewas muchgreaterthanwith 1- factor in the development of lungcancer. naphthylamine at the 70 mg/kg dose. 4-Aminobiphenyl, the most potent carcinogen, produced even higher levels of N-oxidation products in the urine and blood methemo- 71-1148. Nettesheim P., Hanna, M. G. (Jr.),Deatherage, J. W. (Jr.) (Editors) Morphology of Experimental globin than 2-naphthylamine. These results indicatethat Respira- N-oxidation may be a key process in the production of tory Carcinogenesis. Proceedings ofa Biology Division, bladder cancer by 2-naphthylamine and 4 aminobiphenyl. Oak Ridge National Laboratory conference,GatlInburg, (Auth. Abs.) Tennessee, May 13.16, 1970. U.S. Atomic EnergyCom- mission, Division of Technical Information,Oak Ridge, Tennessee, AEC Symposium Series 21, December1970, 483 pp. 71-1150. Reddy, C.R.R.M., Kameswari, V. R., Ramulu C., Reddy, P. G. Histopathdlogical Study of Stomatiris Niootina. British Journal of Cancer 25(3):403-410.Sep- The primary purpose of this conferencewas to tember 1971. evaluate critically the adequacy of the availableexperi- mental mod..11s for studying the multifactorialetiology of lung cancer. The methodologies, experimental One hundred and thirteen biopsies of the palate in designs, people accustomed to smoking cigars, most of them with and biological end points used inthese studies are the burning end of the cigar inside the mouth, have been reviewed. These proceedings deal specifically with the studied. Thirty-eight of these showed mild tosevere morphological characteristics of tumors in therespiratory atypical changes in the epithelium. There were 19 lesions tract of common laboratory and domestic animals,and showing their induction by various carcinogens orthokeratosisand53showinghyper - and methods of orthokeratosis. The earliest atypical change isseen in the exposure. Session I reviews the cellular elements ofthe mouths of the ducts of the glands. There lung, their morphological characteristics, were three cases and their proli- showing microinvasivecarcinomas. Pigmentationis a ferative and differentiative potential. Session11 deals with prominentfeature inthese the morphogenesis, classification, and cases. The papules with epidemiology of umbilication could be due to hyperplasia of themucous human lung tumors. The necessary backgroundis pro- glands. It is suggested that stomatitis nicotina occurring in vided on the human disease with which allexperimental men and women with the habit of reverse smoking is

216 NEOPLASM DISEASES

probably precancerous because of the presence of atypical from tobacco condensates; 2) tobacco can induce cellular changes in the epithelium and also the finding of three change and tissue atypia; 3) there is increased use of microinvasive carcinomas without any macroscopic evi- tobacco among patients with oral carcinoma when com- dence. There is no acceptable explanation why the soft pared with control groups; 4) tobacco used in various palate escapes getting either stomatitis nicotina lesion or forms has been associated with an unusually high pre- carcinoma in reverse smokers. (Auth. Abs.) valence of carcinoma of specific oral sites; 5) continued smoking appears to be a factor in the development of multiple oral carcinomas; and 6) there is an increased 71-1151. Shabad, L. M. Dose-Response Studies in Experi- mortality ratio from oral cancer when comparing smokers mentally Induced Lung Tumours. Environmental Re- with nonsmokers. search 4(4):305-315, October 1971.

The number of mouse lung adenomas induced by urethane is dose-dependent. This is true both for newborn 71-1153. Takahashi,T., Yanagisawa, T., Majima. S. mice and adult mice and also under conditions of Induction of Carcinoma of Glandular Stomach in Raft by transplacental transmission. The existence of a dose- Local Application of 7,12-Dinethylbenz(e)anthracene. responseeffect has also been shown for adenomas Gann 62(4):259-265, August 1971. induced in embryonic lung tissue organ cultures by the injection of urethane into pregnant mice. The estab- After a long-term observation of the local application lishment of an experimental model of human lung cancer of7,12-dimethylbenz(a)-anthracene(DMBA) to the by intratracheal instillation of carcinogenic compounds mucosa of the glandular stomach of rats. 11 of 46 rats into rats made possible a systematic study of dose- exhibited carcinoma at the site of application of the response effects in the induction of experimental bron- carcinogen. Microscopically nine were adenocarcinoma chogeniccarcinomas and precancerous lesionsusing and two were anaplastic growth patterns consisting of benzo(a)pyrene,1,2,5,6-dibenzanthracene,and epithelial-like cells originating either in glandular epithe- 7,12-dimethyl-benz(a)anthracene. A decreaseinthe lium or in non-epithelial cells. Two of the animals with amount of carcinogen always resulted in a decrease in the carcinoma had hemorrhagic ascites containing tumor cells. induction rate of malignant tumors and precancerous One of these showed an ascites tumor in a pure culture lesions. Repeated injections stimulated the blastomogenic gtateof tumor cells.Autoradiographic studies using effect. "Borderline" doses did not induce cancer but 'H-thymidine revealed that the regenerating epithelium at precancerouslesions were found. "Noncarcinogenic" the margin of the ulcer, which was induced by DMBA doses can be determined for each experiment and each treatment, showed the highest DNA synthesis and that carcinogen. The problem of maximum permissible dose or the heterotopic epithelium without cytological atypism concentration of carcinogenic substances has been dis- almost failed to synthesize DNA. Transplantation of six cussed but there is some difference of opinion on this nodules induced by DMBA was attempted and one question. Nevertheless, the regular experimental finding carcinoma was successfully transplanted up to the second of a dose-response effect can serve as a basis for cancer generation. (Auth. Abs.) prevention. (Auth. Abs. Mod.)

71-1154. Xipell, J. M. The Incidence of Benign Renal Nodules. (A Clinicopathologic Study). Journal of Uro- 71-1152. Silverman, S. (Ir.), Galante, M. Oral Can- logy 106(4):503-506, October 1971. cer. University of Califooia, San Francisco Medical Center, 1970, 56 pp. The incidenceand histologicalfeaturesof renal nodules in a series of 250 necropsies were studied. This monograph deals with the entire problem of oral Adenomas were found in 22.4 percent of cases medullary cancer control: 1) epidemiology; 2) etiology; 3) premalig- fibrous nodules in 26.8 percent miscellaneous cortical mutt factors and prevention ; 4) diagnosis; 5) treatment; 6) mesenchymal nodules in 8.4 percent and adrenal rests in rehabilitation; and 7) survival. The use of tobacco in all 4.4 percent. The findings were further analysed in relation formscigarettes, cigars,pipes, chewing, and snuff to renal vascular disease and scarring, smoking, and increases the risk for eventually developing oral carcinoma alcohol consumption. A statistically significant associa- and appears to be related causally. This is based on the tion between adenomas and smoking was demonstrated. following facts: 1) carcinogenic agents have been isolated (Auth. Abs.)

See also, 71-1127, 71.1133, 71-1134, 71-1188, 71-1237 NONNEOPLASTIC RESPIRATORY DISEASES

71-1155. Auerbach, 0., Hammond, E. C., Garfinkel, L. bac coAllergyinPatients WithBronchial Epithelia ChangesinEx-Cigarette Smokers.Cancer Asthma.]Polski lygodnik Lekarski26(49):1902 1905, Cytology 11(1):542,1971- December 6, 1971, Polish.

This study was undertaken to determine whether there The harmful effects of tobacco and tobacco smokeon is any difference in the changes in the bronchial epithe- theclinical course of allergic bronchial asthma were lium between ex-cigarette smokers and men who had analyzed in1000 patients.It has been shown that continued to smoke. The study of ex-smokers was part of independently of active smoking about 30 percent of a large study of changes in the bronchial epithelium of patients regarded their clinical manifestations ascon- 758 subjects (456 men and 302 women) who had died of nected with exposure to tobacco smoke. Skin tests with cancers other than lung cancer. Regardless of age or sex, tobacco allergen carried out in 304 patients confirmed the very few cells with atypical nuclei were found in the allergiccharacter of immediate typereactions. The bronchial epithelium of persons who had never smoked frequency of positive skin tests was demonstrated to be and had never been occupationally exposed to certain twice as high in allergic patients than in healthy subjects. dusts or vapors. Many cells with atypical nucleiwere The possible biochemical and immunologic mechanisms found inthe bronchial epithelium of most cigarette of tobacco allergy are discussed. smokers, and the number of such cells increased markedly with the amount of cigarette smoking. Among men who smoked cigarettes regularly up tothe time of their 71-1158. Da Costa, J. L., Tock, E.P.C., Boey, H. K. Lung terminal illness, the number of cells with atypical nuclei Disease With Chronic Obstruction in Opium Smokers in increased with age, that is, with years of exposure to Singapore. Clinical, Electrocardiographic, Radiological, cigarette smoke. Upon cessation of smoking the number Functional,andPathologicalFeatures.Thorax of cells with atypical nuclei diminished and manyyears 26(5):555-571, September 1971. after cessation of smoking few of these cells were found inthe bronchial epithelium. Cells with disintegrating Fifty-four opium smokers with chronic obstructive nuclei were found in the bronchial epithelium of the lung disease were studied for two-and-a-half years. Forty- ex-smokers, but such cells were not present in the eight patients had a cough for at least two years before bronchial epithelium of smokers and nonsmokers. Origi- the onset of inappropriate exertional dyspnea. Fine, nally these may have been cells with atypical nuclei but bubbling adventitious sounds suggesting small airway there is not enough evidence to justify this claim. disease were heard on auscultation over the middle and lower lobes in 38 patients. The prevalence of inflamma- tory lung disease and chronic respiratory failure in this 71-1156. Bowden, D. H. The Alveolar Macrophage.Cur- series is suggesed as the main cause for the frequent rent Topics in Pathology55:1-36,1971. finding of right ventricular hypertrophy and congestive heart failure. Physiological studies revealed moderate to The interrelationships of the structure and function of severe airways obstruction with gross over-inflation and, alveolar macrophages, the intrinisic and extrinsic factors in 32 patients, an additional restrictive defect probably which modify macrophage function, and the influence of due to peribronchiolar fibrosis. Radiological evidence of these changes on pulmonary homeostasis and the develop- chronic bronchitis and bronchiolitis was observed in 45 ment of pathological changes in the lung are reviewed. patients, 'pure' chronic bronchiolitis in 6 patients, and The dominant role of the macrophage in pulmonary 'widespread' emphysema in 25 patientsrespectively. defense against infection, the variety of agents that injure Necropsy examinations in nine patients, however showed this cell, and the remarkable proliferative capacity ofits destructive emphysema of variable severity in all. Chronic precursors explain the broad spectrum of pulmonary bronchiolitisoftenassociated withstrikingbrow diseases characterized by a macrophagic response. The chiolectasis was present in six cases. More severe bron- macrophage response to cigarette smoke is of interest chiolar rather than bronchial inflammation was noted. because of the suspected relationship between heavy The heavy opium smokers had characteristic nodular smoking and chronic bronchitis. Alveolar macrophages shadows on chest radiographY, sometimes associated with from the sputum of smokers containa pale brown a striking reticular pattern not seen in 'pure' cigarette sudanophilic pigment which is fluorescent. Accumulation smokers. This was due to gross pigmented dust (pre- of this lipoproteinis accompanied by a decrease in sumably carbon) deposition in relation to blood vessels, oxidative metabolism which may impair phagocytic activ- lymphatics, and bronchioles, and also within the alveoli. ity. Fresh cigarette smoke depresses the bactericidal itis speculated that the initial lesion is an acquired activity of alveolar macrophages. This effect is blocked by bronchiolitis. Opium smoking induces an irritative bron- glutathione or cysteine in culture which suggests that chopathy favoring repeated attacks of acute bronchiolitis smoke toxicity may result from peroxidation of lipid and eventuallyresultingin obliterative bronchiolitis, components in the cell membrane. One investigator found peribronchiolar fibrosis, chronic bronchitis, and destruc- that cigarette smoke does not inhibit bactericidal activity tive emphysema. (Auth. Abs.) but reduces the overall clearance of bacteria by impairing mucociliary transport from the lung. 71-1159. Dobisova, M., Tmka, L., Fiser, F., Tomanek, A. Abhangigkeit der mikrobiellen Flora bit Bronchlalbaum 71-1157. Chyrek-Borowska, S., Kama, T., Zietkowski, B., von den Bronchiaheluetion and den Hustensymptomen Zakowska, J. Czestosc Wystepowania Uczulenna Tyton u bei chronischLungenlcranken.[Dependence Of the Chorych na Dychawice Oskrzelowa. [Incidence of To- Bronchial Secretion and Cough Symptoms on the

218 NONNEOPLASTIC RESPIRATORY DISEASES

Microbial Flora in the Bronchial Tree of Chronic Lung Assessment of Respiratory Function in Convalescents DiseasePatients.)Praxisder Pneumologie AfterTuberculosis.)Gru:licaiChorobyPluc 25(5):249-254, May 1971, German. 39(7):610.615, July 1971, Polish.

In a prospective study of 255 bronchoscopic patients One hundred men, aged from 40 to 65, convalescent with chronic lung diseases, a correlation could be shown after tuberculosis were examined by means of question- between duration and intensity of cough symptoms and naires, miniature films, and spirograms Manifestations of endobronchial secretion. However, no connection could chronic bronchitis were found in 18 percent of them, and be discovered between subjective complaints and the ventilatory disturbances in 48 percent. Ventilatory dis- presence and composition of microbial florainthe turbances were more frequent in patients who had bronchialtree. The lack of correlation occurred in extensiveresidual lesionsinthe lungs and restricted patients having the typical bronchial syndrome where no movements of the diaphragm than in the remaining ones; acute exacerbations were present. Analysis of the smoking complication with chronic bronchitis enhanced obstruc- habits of the patients showed that 84.6 percent of those tive disturbances. The effect of smoking on the incidence with chronic cough were smokers, as were 70.7 percent of of chronic bronchitis in convalescents after tuberculosis those with alb-acute cough. Only 58.3 percent of the was shown. Among these patients, there was a greater controls were smokers. The possiblesignificance of percentage of cigarette smokers than of nonsmokers and secondary bacterial invasion as well as the chemical and ex-smokers, the percentage rising with the duration of the antibiotic pretreatment are discussed. The results demon- smoking habit. The patients with chronic bronchitis were, stratethe limitation on the possible uses of micro- on the average, five years older than those without biological routine examinations in patients with chronic chronic bronchitis. lung diseases. 71-1163. Huttemann, U., Oswald, P., Lode, H., Huckauf, 71-1160. Dowell, A. R., Kilbum, K. H., Pratt, P. C. H. Veranderungen der Lungenfunktion Jugendlicher aLs Short-Term Exposure to Nitrogen Dioxide. Effect on Folge langjahrigen Zigarettauauchens. [Changes in Pul- Pulmonary Ultrastructure, Compliance, and the Surfac- monary Function of Young People as a Result of tantSystem. Archives of InternalMedicine Cigarette Smoking Over Many Years] Deutsche Medizi- 128( l):74-80, July 1971. nische Wochenschrift 96(46):1791-1793, November 12, 1971, German. Eleven beagles were exposed to nitrogen dioxide in concentrations ranging from 3 to 16 ppm for one hour. Lungfunctionstudies(spirometry,body - Two control dogs were air-ventilatedfor one hour. plethysmography and esophageal pressurethrough a Widespread bleb formation, loss of pinocytotic vesicles, balloon catheter) were performed on 20 young smokers and mitochondrial swelling of endothelial cells ensued. and nonsmokers without heart or lung disease. Average Intraalveolar edema occurred in most dogs exposed to 7 age was 29 years, There was no difference in lung volumes ppm nitrogen dioxide or higher and membrane damage or bronchial flow resistance between nonsmokers and without edema occurred inthe others. Intraalveolar smokers. Viscous work of breathing of nonsmokers edema by light microscopy was associated with impaired averaged 3.58 p cm/ml; those of smokers 5.17 p surfactant activity and lung compliance. Exposure to an/ml, a statistically significant increase. Static maximal nitrogen dioxide of 5 ppm or greater resulted in decrease retraction pressure of the lung was within normal limits in of recovered lung lavage saturated lecithin. Exposure to 3 both groups. Static compliance of nonsmokers was 0.25 ppm nitrogen dioxide resulted in bleb formation in I/cm H2O (within normal limits), while that of smokers alveolar endothelium without biochemical or physio- at 0.39 I/cm H20, was significantly increased. Dynamic logical changes. (Auth. Abs.) compliance of smokers showed a marked (statistically significant) rate dependence. The observed abnormalities in smokers are thought to be due to changes in the 71-1161. Ferris, B. G. (Jr.), Higgins, I.T.T., Higgins, M. peripheral respiratory pathways. They correspond to the W., Peters, J. M., Van Gann, W. F., Goldman, M. D. initial phase of chronic obstructive pulmonary disease. Chronic Nonspecific Respiratory Disease, Berlin, New (Auth. Abs.) Hampshire, 1961-1967: A Cross-Sectional Study. Ameri- can Review of Respiratory Disease104(2):232-244, August 1971. 71-1164. Jones, M. C., Thomas, G. 0. Alphai-Antitrypsin Deficiencyand PulmonaryEmphysema. Thorax A repeat study of a sample of the population of 26(6):652 .662, November 1971. Berlin, New Hampshire in 1967 showed slightly lower disease prevalences than in 1961 after standardization for An association between a genetically determined age, sex, and smoking habits. Results of some of the deficiency of the serum enzyme alpharantitrypsin and pulmonary function tests were slightly better in 1967. pulmonary emphysema is now well established. Serum Levels of air pollution were less in 1967. It is believed antitryptic activity was measured in 103 patients sus- that the decrease in air pollution could account for the pected of having emphysema. Eighty-seven fulfilled the decreased prevalence of disease and the slight improve- diagnostic criteria for emphysema and, of these, 16 had ment in pulmonary function. (Auth. Abs.) deficient levels, 5 had intermediate levels and 66 had normal levels. The results of clinical, radiographic, and physiological studies of each group were then compared. 71-1162. Graczyk, J., Bukalska, Z. Paewlekle Zapalenle Characteristicfeaturesnoted inthe deficient group OskrzeliiOcena WydolnosciOddechoweju included onset of dyspnea during the third or fourth Ozdrowiencow zGruzllcy.[Chronic Bronchitis and decades and uniformly symmetrical radiographic lower

219 222 NON NEOPLASTIC RESPIRATORY DISEASES

zone involvement. In the deficient group, the mean age at There were 5 homozygotes and 25 heterozygotes for the onset of dyspnea was 35.6 years, yet symptoms did not deficiency gene found in a group of 103 patients with develop until the age of 49 years in the only nonsmoker in obstructive lung disease. There were 14 and 8 heter- the group. Among non-deficient patients no such ozygotes in two control groups with respective mean ages difference between smokers and nonsmokerswas appar- of 36 and 80. There was only one heterozygote among 39 ent. Other factors such as sex distribution and chronic healthy males over 70 years of age. Of the 8 hetet- bronchitis are discussed. Sixty-eight Mat:Ives of the 16 ozygotes in the older control group, only 2 were light patients with deficient levels were also studied. The cigvette smokers. Of the 25 heterozygotes with obstruc- findings inthese are compatible with an autosomal tive lung disease, only 2 were over 70 years of age. both recessive mode of inheritance although difficulties in were female and nonsmokers; all of the remaining 23 were identifying the heterozygous state were encountered. Six cigarette smokers. The very low incidence of healthy male relatives had deficient levels and three of these had heterozygotes over the age of 70 might be explained by emphysema. their selective predisposition to obstructive lung disease related to cigarette smoking. 71-1165. Khosla, T. indices of Ventilatory Measure- ments. British Journal of Preventive and Social Medicine 25(4):203-209, November 1971. 71-1168. Lebrun- Brais, L., Blanchette. G., Provost G. Emphysema Pulmonaire par Deficience en Alpha-1 Anti- Ventilatorymeasurements of about 8,000steel trypsine: Une Etude Familiale. (Pulmonary Emphysema workers at Ebbw Vale and over 10,000 at Port Talbot Caused by Alpha-1 Antitrypsin Deficiency: A Family were recorded as part of the extensive bronchitis survey in Study.]Union Medicak du Canada 100(10):1920-1934. the steel industry. Forced expiratory volume in one October 1971, French. second (FEV1),forcedvitalcapacity(FVC), and FEV/FVC percent decrease with age and withinage A family of 12 persons is described in whom variable groups increase with height. Height itself decreases with serum levels of alpharantitrypsin were detected. Four of age. Because of these interrelations the usual regression these patients also suffered from a familial type of approach is complex. Three simple indices have therefore pulmonary emphysema. In a double blind studythe been derived from the Port Talbot study and have then histories and clinical, physiological, and radiological find- been applied to the Ebbw Vale study to validate them. ings of these patients were compared with those of an Although the two works populationsare different, the emphysematous control group. The particular features of indices are in good agreement. The calculation of indices familial emphysema associated with this type of protein requires minimal information on mean age,mean height, deficiencyare demonstrated. The various modes of and mean values of FEVI, FVC, and FEC percentto genetic transmission for this disease are discussed, its compare groups which are different by other criteria such pathogenic mechanisms are assessed, and suggestions are as symptomatology grades, smoking habits, occupation, made as to its diagnosis, treatment, and prevention. race, and diseased state. Results derived from multiple regression analysis and indices are shown to bevery similar for the age range 30.55 years. (Auth. Abs. Mod.) 71-1169. Lewis, G. P., Lyle, H., Miller, S. Association Between Elevated Hepatic Water-Soluble ProteinBound 71-1166. Kilpatrick, G. S. Advances in the Treatment of Cadmium Levels and Chronic Bronchitis and/or Emphy- Respiratory Disorders. Practitioner 207(1240):460467, sema. Lancet 2(7634):1330-1333, December 20, 1971. October 1971. The cadmium, copper, and iron levels in concentrated A brief review is made of advances in: themanage- water-soluble protein extract prepared from 60 human ment of lung cancer and bronchitis; the search for liver specimens were estimated. Extracts from patients mucolytic agents, respiratory stimulants, and influenza dying with mention of chronic bronchitis and/or emphy- vaccines; and the treatment of related conditions(i.e. sema were found to have a mean cadmium level greater alpha-antitrypsin deficiency, the smoking habit,acute than three times that found in the rest. Possible sources of respiratoryinfections, respiratorytuberculosis, super- cadmium intake in these cases included air pollution and infection, and iatrogenic respiratory disease).Alpha- cigarette smoking. antitrypsin deficiency has been found in emphysematous patients, and smoking in these patientsseems to hasten the onset of this type of emphysema. Despite thefact -71-1170. Lieberman, 3. Heterozygous and Homozygous that many smokers want to quit, little progress has been Alphai-Antitrypsin DeficiencyinPatients With Pul- made in treating the smoking habit. There hasbeen no monary Emphysema. New England Journal of Medicine government action on a possible lower taxon a less 281(6):279 -284, August 7, 1969. harmful tobacco. Hypnotism has been foundto have only a transient effect, drugs have failed, and so have smoking Homozygousdeficiencyofalpharantitrypsinis withdrawal clinics. known to predispose to pulmonary emphysema. Measure- ment of the trypsin inhibitory capacity (TIC) of serum specimens from 28 relatives of a homozygous proband 71-1167. Kueppers, F., Fallat, R., Larson, R. K. Obstruc- suggested that both heterozygotes and homozygotes tive Lung Disease and Alphai-Antitrypsin Deficiency may have an increased predisposition to lung diseaseand GeneHeterozygosity. Science165(3896):899-900, possible to peptic ulcer. Four of 19 heterozygotes and August 29, 1969. two homozygotes in this family had definite histories of pulmonary disease. After this family study, the TIC of fi The phenotypes of serum alpha[-antitrypsinwere serum was measured in 66 patients 'hospitalized for determined by antigen-antibody crossed electrophoresis. pulmonary emphysema at a Veterans Administration

frs .*0.0 220 NONNEOPLAST1C RESPIRATORY DISEASES

hospital. Of these, 25.8 percent were found to be 71-1173.Morgan,W.K.C. Coal Workers' Pneumo- deficient; 7 were homozygotes, and 10 heterozygotes. Of coniosis. American Industrial Hygiene Association Jour- 23 patients with emphysema under 50 years of age, 48 nal 32(1):29-34, January 1971. percent were deficient. A history of peptic-ulcer disease was obtained from 35.3 percent of the antitrypsin- The medical indications of a specific pneumoconiosis deficient, as compared to28.6 percent of the non- resulting from inhalation of coal dust are presented. The deficient patients with emphysema, a difference statisti- characteristics of simple pneumoconiosis and of progres- cally not significant. (Auth. Abs.) sive massive fibrosis are discussed. The effects of cigarette smoking obscure and complicate the respiratory change induced by coal workers pneumoconiosis. The etiology of 71 -! 171. Martin, P., Kanarek, D., Zwi, S., Boyd, A. V., the disease is certainly associated with the inhalation of koornhuf,H.J. The Incidenceof Fungiinthe coal dust, therefore prevention of the disease can be Throat.MycopathologiaetMycologiaApplicata achieved by control of such dust exposures. (Auth. Abs.) 45(2):165-187, October 13, 1971.

A brief literature review on the incidence of fungi 71.1174. Morgan, W.K.C., Burgess D. B., Lapp, N. L., from various sites in the body is presented. Throat swabs Seaton, A., Reger, R. B. Hyperinflation of the Lungs in were taken from 468 patients attending the Johannesburg Coal Miners. Thorax 26(5):585-590, September 1971. General Hospital between March 1968 and February 1969. The fungi obtained comprised yeasts only and no The residual volume and total lung capacity of 1,455 filamentous species. The overall incidence of fungi was 44 working Pennsylvania coal miners were determined as part percent, but various factors were shown to influence this. of a larger epidemiological study. The age of the subjects The main factors appeared to be age, chronic lung disease, varied between 18 and 65 with a mean of 48.7 years. The seasonal fluctuations, use of drugs (particularly digoxin total lung capacity of the subjects was determined from and antibiotics), heavy smoking, and sex. A higher standard posteroanterior and lateral chest films while the incidence of yeasts was found in heavy smokers (those forced vital capacity was determined by spirometry. The smoking more than 30 cigarettes daily). However, no effect of increasing radiographic category of simple coal significant change was recorded below this level. Alcohol workers' pneumoconiosis on lung volumes was investi- decreased the incidence rate as the quantity of drink gated. The residual volume increased with radiographic consumed increased. Excessive drinkers had a significantly category; this occurred whether or not the minars had lower incidence than the average. obstructive airways disease. The presence of obstruction had an additional effect over and above that due to coal dust alone, so that the largest increase in residual volume 71-1172.Miller,G.J.,Ashcroft, M. T.,Beadnell, was found in miners who had both obstruction and H.M.S.G., Wagner, J. C., Pepys, J. The Lipoid Pneumonia radiographic evidence of simple coal workers' pneumo- of Blackfat Tobacco Smokers in Guyana. Quarterly coniosis. Smoking had an additive effect and the highest Journal of Medicine 40(160):457 -470, October 1971. residual volume ratios were in general present in the pneumoconiotic smokers. (Auth. Abs. Mod.) In Guyana, a large number of patients have been diagnosed as having a diffuse pulmonary fibrosis of unknown etiology, characterized by typical radiological 71-1175.Naeye,R.L. The Antitracotic Pneumo- appearances, dyspnea, cough, weight loss, and eventually conioses. Otrrent Topics in Pathology 55:37-68, 1971. pulmonary heart disease. Investigation of 56 patients showed that all had smoked a tobacco known as 'blackfat' A brief history of carbon-related pneumoconiosis is or 'black tobacco.' In a community survey, 20.4 percent presentedfollowed by adetailed discussion of the of the population aged 55 years and over smoked this deposition and retention of anthracotic particles in the tobacco. Altogether, 19.6 percent of the blackfat smokers lung, and anthracosis related to graphite, carbon black, but no non-blackfat smokers showed definite radiological carbon electrodes, and tobacco and other comratmly evidence of pulmonary fibrosis. Smokers with, but not encountered air pollutants. Coal workers' pneumoconiosis those without fibrosis, had severe airways obstruction. is given special emphasis. The retention of the gaseous Immunological studies made it unlikely that an extrinsic components from tobacco smoke has been shown to allergic alveolitis had caused the radiological changes. depend in part on their absorption on particulate com- Three post-mortem open-lung specimens were obtained ponents of the smoke. Cigarette smoke particles range and in each case the histology showed a diffuse interstitial from 0.1-0.5 microns in diameter and as they pass fibrosis and vasculitis associated .with large deposits of through the respiratorytract, they absorb moisture, lipid surrounded by black amorphous material. Blackfat is thereby increasing their diameter to a size at which lung a tobacco leaf to which mineral oil and vaseline are added retentionismaximal. The longer such particles are for flavoring and as humectants. The presence of oil in the retained in the lung, the smaller the percentage of exhaled tobacco, and the post-mortem findings of oil in the lungs, particles. The pulmonary deposition pattern of cigarette indicate that the diffuse pulmonary fibrosis can be more smoke particles is maximal at segmental airway bifura- accurately described as a lipoid pneumonia caused by the cations. Clearance of tobacco particles is slowed by inhalation of mineral oils when blackfat is smoked. The components of the smoke that reduce ciliary activity, potential health hazards of many tobacco additives, cause loss of ciliated cells, and reduce phagocytic activity particularlyoils, employed by the tobacco industry of alveolar macrophages. The latter may be related to should be recognized. A similar type of disease as that decreases in cellular oxiodoreductase and hydrolase acti found in Guyana may be present in other parts of the vities induced by the effects of smoke components on world where blackfat or related tobaccos are smoked. mitochondria. Macrophage output is increased in smokers (Auth. Abs.) but their bronchial clearance of bacteria may be reduced.

t 221 2!?4 NON NEOPLAST1C RESPIRATORY DISEASES

Thereisa modest effectof cigarette smoking on chronic bronchitis, on the one hand, and the smoking bronchitis and emphysema in coal workers' pneumo- habit and lung diseases of the last three years, on the coniosis but some nonsmoking miners also develop these other hand. Chronic bronchitis was present in12.3 respiratory disorders. Many nonsmoking and smoking percent of the smokers of Fundata and in 1.4 percent of miners also chew tobacco or use snuff. These products the nonsmokers. In the Delta, the percentages were 7.6 sometimes contain pathogenic bacteria and nicotine can and 0.85, respectively. The prevalence of chronic bron be absorbed from them. Miners smoke about as muchas chitis increased with the age of the smokers. nonminers but the miners' consumption is confined toa short period each day since smoking is prohibited underground. Coal workers' pneumoconiosis is usuallya 71-1178. Rachel, G. Effect of Air Pollution on the disease of mixed etiology and additional research is Prevalence of Respiratory Diseases in West Germany. In: needed to explore individual and combined effect of Englund, H. M., Beery, W. T. (Editors). Proceedings of the tobacco products, various mine dusts, trace elements, Second International Clean Air 7.onpess. Air Pollution infection, and immunologic factors on the disease process. Control Association. New York, Academic Press. 1971, pp. 186-191. 71-1176. Owsinski, J., Janus, T., Mysik, M. Wystepowanie The results of an epidemiolcsical field study of Przewleklych Nieswoistych Charob Ukladu Oddechowego respiratorydiseasesinthree West German districts (P.N.Ch.U.0.) Wsrod Pracownikow Zakiadu Paemydu (Duisburg, Bocholt, and the rural district of Borken) with Gipsowego "Do lina Nidy" w Gackach. [Occurrence of different air polluted environme.na are presented. The Chronic Unspecific Diseases of the Respiratory System survey was conducted on a random sample of 8162 men Among Workers in the Plaster Works at "Doika Nkly" In and women. The sulfur dioxide levels in the threeareas Gacki.] Pneglad Lekared 28(7):476480, 1971, Polish. fluctuated between 0.03 and 0.3 ppm and the concenur don of suspended particulates from 0.01 to 0.39 mg/m'. A total of 343 workers in the Plaster Works at Gacki, There were no differences in prevalence of persistent including 285 men and 58 women, were examined. Of cough and expectoration between men andwomen living these, 149 worked in very dusty, 105 in moderately in the three areas, if the groups were standardized forage, dusty, and 89 inslightly dusty conditions. Chronic sex, smoking habits, and social conditions. There was no bronchitis was found in 45.2 percent of those examined, evidence that community air pollution in limited levels obstructive bronchitis in 16.9 percent, and dyspnea in 22 leads to an impairment of the mechanics of breathing and percent. The occurrence of chronic unspecific respiratory the gas exchange. Respiratory symptoms and lung func diseases was three times higher in men than in women, tion showed a strong relationship with age, smoking habit, and it was shown that smoking had a distinct influence on and sex. Persistent cough and sputum productionwas the frequency. Chronic bronchitis occurred in 21 percent higher in men and smokers particularly cigarette smokers, of nonsmokers, in 34.5 percent of former smokers, and in than in nonsmokers and women. 54.6 percent of actual smokers. The influence of dust, both as regards the amount and the length of employ- ment, was clear in the groups of nonsmokers, former 71-1179. Resnick, H., Lapp, N. L., Morgan, W.K.C. Serum smokers, and recent light cigarette smokers, while in the Trypsin Inhibitor Concentrations in Coal Miners With poup of those who had been smoking for over 10 years, Respiratory Symptoms. Journal of the American Medi- thu influence of smoking predominated, wipingout the a:1i Association 215(7):1101.1105, February 15, 1971. differences caused by breathing in plaster dust. Frequent catarrhs of the upper respiratory tract were found in 22 The repeated demonstration of chronic obstructive percent of those examined. No cases of pneumoconiosis airwaydiseasein coal miners suggests the possible were found. (Auth. Abs.) involvement of hereditary factors. Since the only known association between heredity and irreversible airway obstructive disease is related to alpharantitrypsin inhibi- 71-1177. Racoveanu, C., Manicatide, M., Nicokescu, V. tors, the sera of a group of symptomatic coal miners were Cercetad Epidemiologice Asupa Brondtei Cronies In studied for antitryptic activity. No homozygous deficient Doua Zone Fara Po lusre Atmoderica Industrials. [Epide- subject was found in the group of coal miners studied. miological Study of Chronic Bronchitis in Two Regions The distribution of trypsin inhibitor capacity suggests Without Industrial Air Pollution.] Study si Cercetari de that a gaussian distribution provides a good fit to the Medicine Intern° 12(4):359-367, 1971, Rumanian. data. Miners smoke slightly fewer cigarettes than non- miners, but since they are unable to smoke at work, they The incidence and prevalence of chronic bronchitis must smoke relatively more in their available leisure time. among the inhabitants of two regions free of industrial air This intense cigarette smoke concentration ina shorter pollution(Sf. Gheorghe inthe Danube Delta and time may play a part in the increased prevalence of Fundata, North of Brasov) were studied. The investigation obstructive airway disease. was carried out in two groups of 300 subjects each, by means of standard questionnaires, clinical examination, and respiratory function tests which included bronchial 71-1180. Rylander, R. Free Lung Cell Studies in Cigarette reactivityto acetylcholine. The incidence of chronic Smoke Inhalation Experiments. Scandinavian Journal of bronchitis was higher among the inhabitants of the Respiratory Diseases 52(2):121-128, 1971. mountainous region than among those in the Delta. The probable relationship between the higher incidence of The number of free lung cells was studied in guinea- chronic bronchitisinthe mountain village and the pigs using a modified lavage technique whereby the lung bronchial reactivity also more marked in that region is was repeatedly washed with the same fluid. Control discussed. Correlations are made between the incidence of experiments showed the wash-out efficiency was good. 295 222 NONNEOPLASTIC RESPIRATORY DISEASES

When normal and SPF animals were compared, a lower W. Effects of Urban Residence on Pulmonary Function number of macrophages with less deviation was found in Values. Environmental Research 4(4):283-304. October the latter. The number of leukocytes was the same. 1971. Animals having received cigarette smoke showed a reduc- tion of free lung cells, especially macrophages, after acute The effects of urban residence on prevalence of exposure. An increase was found in the number of respiratory symptoms and on pulmonary function in a macrophages after 2-4 weeks exposure. (Auth. Abs.) population of white male nonsmokers are presented. Residence in urban areas of 50,000+ population during childhood was positively related to the peak expiratory 71-1181. Shephard, R. J. Atmospheric Pollution and flow rate (PEFR); the effect at age 21 was estimated as ChronicChestDisease. CanadianFamily Physician approximately +261/min. Residence in urban areas during 17(11):39-44, November 1971. adult life showed a significant nonlinear relationship to PEFR. Values increased during the rust seven years of Possible relationships between chronic bronchitis and urban residence as an adult, and then declined; this effect, air pollution are reviewed. Attention is drawn to the at 30 years of urban residence after age 21, was estimated difference in incidence of chronic bronchitis between at 44 I/min. No effect on forced expiratory volume in England and Canada, and the recent increase in mortality one second was found. Results for the prevalence of from respiratory diseases in Canada. Neither air pollution cough and phlegm are consistent with the results for the nor smoking habits can fully account for these pheno- PEFR, but numbers were too small to allow definite mena. Methods of measuring pollution are described. It is conclusions to be drawn. The variance about the regres- concluded that Toronto is intrinsically as dirty as other sions was studied, and it was discovered that social class cities of comparable size, and that although there have and urban residence affected the relationship of the been substantial decreases of smoke over the past decade, variance about the regression to the age of the respond- levels of gaseous acid have shown little improvement. ents. (Auth. Abs.) Urban/rural comparisons suggest that high concentrations of pollutants can double the prevalence of chronic bronchitis; however, the effect is much less obvious if 71-1184. Stevens, P. M., Hnllica, V. S., Johnson, P. C., comparisons are restricted to nonsmokers of comparable Bell,R. L. Pathophydology of Hereditary Emphy- social status. Longitudinal surveys suggest a worsening of sema. Annals of Internal Medicine 74(5):672 -680, May condition in bronchitics during periods of intense pollu- 1971. tion. Justification for air pollution control programs lies more in the prevention of damage to buildings and beauty Patients with decreased serum alpharantitrypsin were then in a specific effect upon human health. (Auth. Abs. designated as severely deficient (7 to 15 percent of Mod.) normal) or intermediately deficient (30 to 65 percent of normal) by quantitativeradial immunodiffusion. All severely deficient patients were symptomatic and had 71-1182. Simonsson,R. G. Rokning och Andnint severeemphysema. Among intermediatelydeficient sorganen.[Smoking andtheRespiratoryOr- patients emphysema was clinically evident only after age gam] Lakartidningen68(321:3581-3590, August 4, 50. Younger subjects had significant loss of lung elastic 1971, Swedish. recoil and hyperinflation without expiratory flow ob- struction. Older patients with an intermediate deficiency Smoking has been a custom in Sweden since about had abnormalities that were radiographically and physio- 1600 and cigarette consumption since 1850. Tobacco logically identical to those of younger severely deficient smoke contains both organic and inorganic constituents, patients. Postmortem examination of the lung of two is an aerosol containing 60 percent gas and 40 percent patients with severe deficiency and one patient with solids, and is always accompanied by droplets of liquid. intermediatedeficiency showed extensivepanlobular Cigarette smoke with a pH below 7.0 is less irritating than emphysema of the lower two-thirds of the lungs, with the pipe or cigar smoke which has a pH above 7.0. The relative sparing of the upper third. It is concluded that lungs are endowed with a natural cleansing system, but patients with intermediate alpharantitrypsin deficiency this is attacked by the gases. In a typical attack, a cell may develop emphysema identicalto that found in reaction is evoked which leads to damaged ciliated cells. severely deficient patients but at an older age. (Auth. Such damage in the large bronchi can lead to a metaplasia Abs.) from the formation of atypical cells, thus causing cancer which is manifested by coughing and hemoptysis. This damage can also lead to emphysema, chronic bronchitis, 71-1185. Vatic, F., Zuskin, E. A Comparative Study of and other afflictions. The disturbance of the lung func- Respiratory Function in Female Nonsmoking Cotton and tion is ascertained on the basis of certain measurements. Jute Workers. British Journal of Industrial Medicine Thus a ref ectoric bronchus constriction is measured as an 28(4):364 -368, 1971. increased airway resistance, and a lowered value of the diffusion capacity is found on the basis of the single- To compare the effect of cotton and jute dust, breath or steady-state CO method. All such changes affect respiratory symptoms were studied and respiratory func- the lung function, and the carcinogens in the tobacco tion measured in 60 cotton and 91 jute nonsmoking smoke aggravate the situation as they create a basal cell female workers of similar age distribution, similar length hyperplasia which renders the person afflicted more prone of exposure to dust, and exposed to similar respirable to carcinoma. airborne dust concentrations. Cotton workers had a significantly higher prevalence of byssinosis, persistent cough, and dyspnea than jute workers. Among cotton 71-1183. Stebbings,J.H. (Jr.) Chronic Respiratory workers, 28.3 percent were found to have characteristic Disease Among Nam moken in Hagerstown, Maryland. symptoms of byssinosis, whereas none were found among

223 226lr NON NEOPLAST1C RESPIRATORY DISEASES

jute workers. Exposure to cotton and also to jute dust 71-1188. Weiss, W. Survivorship Among Men With Bron- caused significant reductions of forced expiratory volume chogenicCarcinoma. ThreeStudiesinPopulations in the rust secondforced vital capacity, and peak Screened rvery Six Months. Archives of Environmental expiratory flow °vet the rust working shift in the week. Health 2211):168 -173, January 1971. Functional grading of jute and cotton dust effects has shown that about 30 percent of cotton workers had Three prospective studies of lung cancer in older men functional grades F 1 and F2, while only 13 percent of are compared: the Philadelphia Pulmonary Neoplasm Jute workers were found in the same grades (Fl). It is Research Project, the North West London study, and the concluded that cotton dust may be considered more South London study. Comparison of survival in men with active than jute though the latter cannot be considered lung cancer is difficult because of differences in methods, inactive. (Auth. Abs. Mod.) materials, and analyses. However, despite semiannual roentgenographic screening, the prognosis of lung cancer in older men remains poor. The results in Londonwere 71.1186. Walker, D. D., Archibald, R. M., Attfield, hi. D. slightly better than might be expected without screening. Bronchitis in Men Employed in the Coke Industry. Bri- The results in Philadelphia were not as favorable. The tishJournal of Industrial Medicine28(4):358-363, differences were due primarily to the fact that the lung October 1971. cancer patients in Philadelphia were older than those in London. The prognosis of lung cancer depends largely on An epidemiological survey to determine the prevalence factors other than "early" detection and therapy, such as of bronchitis in men employed at two of the National age of the host, prevalence of concomitant chronic Coal Board's coking plants is described. Eight hundred obstructive lung disease and pulmonary fibrosis associated and eighty-one men (91 percent) of the total working with cigarette smoking, a factor common to lung cancer population were examined. A strong association was and such respiratory diseases. The vicious biologic charac- found between bronchitis prevalence and cigarette smok- ter of bronchogenic carcinoma is its tendency to grow ing. In addition, men who smoked and who were exposed rapidlyand metastasize before current methods can to high temperatures, dust, and fumes in the environment detect it. In view of the incontrovertible evidence that of the coke-ovens had more bronchitis than men who cigarette smoking is the major etiologic factor in this worked elsewhere in the cokeworks. Both the presence of disease, effort to convince people to stop smoking is very bronchitis and employment in the environment of the important. The high cost of detection might be reduced coke-ovens had significant and independent effectson by restricting screening to high-risk segments of the ventilatory capacity. The combination of cigarette smok- population, such as older men who are heavy cigarette ing and previous employment in a dusty industry also had smokers. a significant effect on ventilatory capacity. The investi- gation suggests that cigarette smoking, and the combina- tion of smoking and pollution from the coke-ovens and previous occupation, appear to be important factors in 71-1189. Weissbecker, L., Creamer, R. M., Carpenter, R. the etiology of bronchitis and reduced ventilatorycapa- cityin men employed inthe coke manufacturing D. Cigarette Smoke and Tracheal Mucus Transport Rate. industry. (Auth. Abs. Mod.) Isolation of Effect of Components of Smoke. American Review of Respiratory Disease 104(2):182-187 August 1971. 71-1187. Weiss, W. Cigarette Smoking, Asbestos, and Anesthetized cats were exposed to cigarette smokegas Pulmonary Farads. American Review of Respiratory phase of varied composition, and their tracheal mucus Disease I04(2):223-227, August 1971. flow was measured in vivo. The composition of thegas phase was correlated with the change from pre A group of 100 asbestos textile workers was examined - exposure mucus flow. Several compounds (isoprene, nitric oxide, by chest roentgenogram and a questionnaire concerning and nitrogen dioxide) added in combination to cigarette age, sex, smoking habits, and duration of occupational smoke gas phase were effective in reducing the mucus exposure to asbestos. The roentgenograms were examined flow compared with gas phase per se. Other compounds for evidences of pulmonary fibrosis without knowing the (methyl results of the questionnaire. Seventy-five workers chloride, hydrogen, and carbon monoxide) were diminished the mucostatic effect of cigarette smoke cigarette smokers and 25 were nonsmokers. The gas pre- phase, with the rate approaching the mucus flow of the valence of pulmonary fibrosis was 40 percent in the unexposed animal. Compounds that produced mucostasis molten, and 24 percent in the nonsmokers. The factors of per se were ineffective when added to cigarette smoke. An age, sex, and duration of exposure to asbestos did not interaction between components of cigarette smoke and account for this difference. The prevalence of pulmonary the mucous blanket was believed to exist. Even when fibrosis increased with increasing amount and duration of compounds were added to saturate the actual sites of the cigarette smoking and with increasing duration ofex- posure to asbestos. (Auth. Abs.) mucus, complete stasis could not be achieved. (Auth. Abs.)

See also, 71-1133,71-1134,71-1193

224 CARDIOVASCULAR DISEASES

71-1190. Banks, D. C., Raftery, E. B., Oram, S. Clinical the Study of Chronic Disease With Particular Reference to Significance of the Coronary Arteriogrant.British Neat the Relation of Smoking to Cardiovascular and Pul- Journal33(6):863-870, November 1971. monaty Diseases.Ada Medico Scandinavica(Supple- mer.tum 523) 1971,40 pp. A method of scoring the degree of obstruction of all three coronary arteries as revealed by coronary arterio- For some years a program of research into the effects graphy so that thedisease process as a whole can be of tobacco on health has been carried out on Swedish and assessed is described. The score was correlated with the U.S. twin registries. The Swedish research in particular has clinical details of 107 patients having ischemic heart been focused on cardiovascular and pulmonary effects of disease,rheumatic heartdisease, or both. Of those smoking. The methods used have included questionnaires patients with a clinical history of myocardial infarction, clinicalevaluationsand mortalitystudies. An inter- 87 percent had complete, or almost complete, obstruction national symposium was held in San Juan, Puerto Rico, in one of the coronary arteries. Serum cholesterol level December 1-4, 1969,to evaluate how twin studies would was related to the severity of the obstructive disease in compare with and supplement data from more commonly the whole group even when the level remained within used epidemiologic investigations and to provide addi- normal limits. There was no correlation between the total tional advise on the most effectiveuse of available score and the length of history of angina pectoris or the resources.Participants were asked to review previous number of cigarettes smoked. Patients with a history of work, to consider designs for new studies in twins, and to congestive cardiac failure had a higher score than those suggest methods forthe effective conduct of these without. No close correlation was found between the investigations. The recent work of the joint SwedishUS. particular diseased artery and the area of myocardial twin studies had demonstrated the feasibility and unique damage as predicted from the ECG either at rest or on value of epidemiologic studies on large samples of the exercise.Neitherthe ECG nor clinicaldiagnosis of only genetically identical individuals available in human myocardial infarction, alone or together, correlated with populationsmonozygotic twin sets An additional advan- complete obstruction on the arteriogram. (Auth. Abs. tage of studying monozygotic twins is that not only are Mod.) both members of the set genetically identical but, even within smoking discordant sets, they tend to share a much more comparable environment than smokers and non- 71-1191. Banks, D. C. Smoking and Leucocyte-Counts. smokers in general. Furthermore, data on dizygotic twins, (Letter)Lancet2(7728):815, October 9, 1971. although no more geneticallysimilarthan ordinary siblings, provide useful comparison groups matched for A reduction in the total leucocytecount was observed age, and sex, and with a tendency to have common by the author upon cessation of smoking. The mean environments. count decreased from 9123 to 7318. AU counts were performed on venous blood taken at the same time of day, so that diurnal variation could not account for the 71-1194. Ciampolini, E., Dringoli, R., Ravaioli P. Azione differences. It thus appears that cessation of smoking can del Fumo di Sigarette su Akuni Parametri del Ricambio produce a reduction in the total leucocytecount. Lipidico. [Action of Cigarette Smoking on Several Para- meters of Lipid Metabolism,'Atti dell'Acrademia dei Fisiocritici in Siena: Sesione Medico-Fisica17:474.480, 71-1192. Cassel, J. C. (Editor) Evans County Cardio- 1968, Italian. vascular and Cerebrovascular Epidemiologic Study,Ar- chives of Internal Medicine128(6):883-986, December The action of free fatty acidsfree glyceroltotal 1971. cholesterol, and glycerides has been studied in healthy young subjects of both sexes after smoking cigarettes. An A total of 17 articles in this issue ofArchives of increase in the concentrations of all the lipid fractions Internal Medicinereport some of the findings from the studied has been noted. Evans County Cardiovascular and Cerebrovascular Epide- miologic Study. A 1960 through 1962 prevalence study documented the fact that all manifestations of coronary 71-1195. Desplaces, A., Charreire 1., Izard, C. Action de heart disease occurred very rarely in black men, their la Phase Gazeuse de Fumee de Cigarette our la Transfor- age-adjusted rate being only one half that of white men. mation Lymphoblastique du Petit Lymphocyte Humain The Evans County Study has undertaken a full invest'. (Observations Preliminaires). [Action of the Gas Phase of gaticn of this observation, and of the various risk factors Cigarette Smoke on the Lymphoblastic Transformation of related to coronary heart disease, including cigarette SmallHuman Lymphocytes(Preliminary Observa- smoking, blood pressure, serum cholesterol, and body tions).]Revue Europeenne d'Etudes Cliniques et Blob- weight. Although several factors need further exploration, gigues16(8):822-826, October 1971, French. it is suggested that the variations in the level of physical activity between the various ethnic and social class groups The action of tobacco smoke on the blastic trans- accounted, at least in part, for the difference in their formation of human small lymphocytes cultured in vitro CMS. with or without phytohemagglutinin was examined. Several doses of smoke were tested. In the presence of phytohemagglutinin, tobaccosmoke inhibitssmall 71-1193. Cedulof, R., Epstein, F.IL,Friberg, L. T., lymphocyte transformation, without phytohemagglutinin, Hrubec, Z., Radford, E. P., (Editors) Twin Registries in it stimulates transformation. In both cases, the effect

225 CARDIOVASCULAR DISEASES

increased with the dose in the range studied. Further nicotine is toxic at the early stage of heart development studies are in progress to determine the active substances and can lead to cardiac anomalies. (Auth. Abs.) in the smoke and whether they can be removed by filtration through activated charcoal. (Auth. Abs.) 71-1199. Golovchiner,1.Y. Nekotoryye Sotsiarnyye Faktory Zabolevayemosti Infuktom Miodarda. [Some 71-1196. Duggan, J. J., Schiess, W. A., Hilfinger, M. F. SocialFactorsin the Incidence of Myocardial In- (Jr.)UnheededSignalsofFatal CoronaryArtery farct.]ZdravookhrancnieRossiiskoiFederatsii Disease. NewYorkStateJournalof Medicine 15(9):12-14, 1971, Russian. 71(22):2639-2642, November 15, 1971. Statistics on various social factors having a possible The incidence of warning chest pain in 110 victims of bearing ontheincidenceof myocardial infarct are sudden death outside of the hospital was studied by presented. The data were gathered from an analysis of interviewing their family or friends. Seventy-one victims 530 myocardial infarct patients treated in Leningrad had been known to have had heart disease. Nine men with hospitals. The factors studied include age occupation, no known symptoms died within one hour of the onset of seasonal influences, domicile income, diet, paticipation in chest pain. Three of these had high blood pressure, one sports, time and method of travel to work, and the had diabetes, and eight were cigarette smokers. The smoking and drinking habits Half (50.5 percent) of the nonsmoker was a 74-year-old man with hypertension. smokers consumed an average of one pack of cigarettes Thirty victims had pain an hour or more before their per day, 18.3 percent more and 31.2 percent less than one death. Of 24 whose smoking habits were recorded, 20 pack of cigarettes per day. The 30-39 year age group smoked cigarettes, 1 smoked cigars, and another dipped containedthegreatest percentage of smokers (82.3 snuff. percent). Over-all, 51.9 percent of the male patients were smokers and 21.1 percent ex-smokers. In female patients the corresponding ratios were 1.8 and 12.9 percent. 71-1197. Eastwood, M. R., Trevelyan, H. Stress and Smoking and drinking were both seen as statistically Coronary Heart DiseaseJournal of Psychosomatic Re significant factors in the development of myocardial search15(3):289-292, September 1971. infarct.

Stress, as measured by psychiatric disturbance, and its relationship to coronary heart disease was investigated in 71-1200. Grannis, G. F. Cigarettes and Heart Disease. a group with psychiatric disorders (mostly chronic, mild, (Letter)New EnglandJournal of Medicine neurotic anxiety and depressive states) and a matched 284(24):1384-1385, June 17, 1971. control group, each group containing 37 men and 87 women. The numbers with probable coronary heart This letter-to-the-editor criticizes C. C. Seltzer for his disease were too small to test significance in different recent data which purported to show a poor correlation disease categories, but when the two categories were of secular changes in cigarette consumption with heart pooled there was, for each sex, a statistically significant diseasemortalityrates. The kind of statistics used excess of all coronary heart disease among the psychiatric (percentage changes rather Than absolute changes, and group as compared with the control group. Men with combined death rates of males and females rather than presumed heart disease tended to smoke more tobacco death rates of males) were inappropriate for evaluating daily and to have higher blood pressure, and those with a this nonproportional, sex-related correlation. Seltzer dis- psychiatric disorder tended to have a higher psychiatric counted the major role of cigarette smoking in causing severity score than the rest of the psychiatric sample. premature mortality of males, particularly from heart Women with coronary heart disease were more obese, had disease, and his choice of statistics confused an otherwise higher blood pressure, serum cholesterol, and uric acid clear situation. values, were more likely to have undergone menopause, and were less likely to be in full-time employment. 71-1201. Kjeldsen, K., Astrup, P., Wanstrup J. Reversal 71-1198, Glint S. H. Nicotine and Cardiogenesis. An of Rabbit Atheromatosis by Hyperoxia.Journal of Experimental Study.PathologiaetMicrobiologia AtherosclerosisResearch 10(2):173-178,September- 37(5):38's-392,1971. October 1969.

The effects of nicotine on the cardiac development Twenty-four rabbits were fed standard rabbit pellets were studied in the chick embryos of 2-4 days of plus 2-percent cholesterol. Twelve animals were exposed incubation. Hearts were observed to be smaller than for 10 weeks to 28-percent oxygen (atmospheric air + normal with irregular beat. Circulation of the blood was oxygen) and 12 animals to 21-percent oxygen (atmos- slow and erratic. In most of the embryos, hematomas pheric air). The degree of visible aortic atheromatosis and were prominent in the cephalic and heart regions. The the aortic content of total cholesterol, phospholipids, and following cardiac malformations were obtained: aortic triglycerides were significantly lower in the hyperoxic stenosis (14 percent), common truncus arteriosus (5.7 rabbits. Microscopic examinations supported the macro- percent), ventricular septal defects (10.3 percent), malfor- scopic findings. (Auth. Abs.) mations of the aortic valve (12.3 percent) and pulmonic valve (10 percent). Other malformations included atrial septal defects (5 percent), thin atrial wall (6.3 percent) 71-1202. Jenkins. C. D. Psychologic and Social Precursors and thin ventricular wall (7 percent). No defects were of Coronary Disease.New England Journal of Medicine found in controls. These studies have demonstrated that 284(5):244-255, February 4, 1971. 2f9c) 226 CARDIOVASCULAR DISEASES

An extensive literature review of the psychologic and between smoking and mortality in Yugoslavian cohorts, it social variables associated with therisk of coronary was thought worthwhile to instigate an inquiry as to disease and the timing of its onset is presented. This first physical and chemical difftrences between Yugoslavian half of a two-part report organizes the wide diversity of and U.S. tobacco. empirical findings according to the following topics: recent review papers, sociologic indexes, social mobility and status incongruity, and anxiety and neuroticism. 71-1206. Lundman, T., Liljefors, I., Cederlof, IL, Friberg, L. The Validity of Questionnaire Diagnosis. "Angina Pectoris."Archivesof EnvironmentalHealth 71-1203. Keys, A. Sucrose in the Diet and Coronary 22(5):597-599, May 1971. HeartDisease. Atherosclerosis14(2):193-202,Sep- tember-October 1971. Validationof a mailedquestionnaire concerning angina pectoris has been performed using 69 male twins The widely publicized theory that sucrose in the diet with the diagnosis "angina pectoris" according to the is a major factor in the development of coronary heart questionnaire. Of these, 22 percent could be verified at disease (CHD) is examined. The theory is not supported the clinical examination. If all clinically suspected cases by acceptable clinical, epidemiological, theoretical, or were included together with the cases with a pathological experimental evidence. No relationship was found bet- electrocardiogram (ECG) the confirmation rate was 57 ween the use of sugar and indications of CHD but there percent. The confirmation rate was higher, but not was a significant correlation between the use of sugar and significantly so, if the criteria for angina pectoris were the use of cigarettes. The nonsmoker averaged 83 grams altered so that only those with central chest pain were of sugar dailywhile the average for the pack-a-day included. The frequency of pathological ECGs in cases smokers was 103 grams. Claims thatthe theoryis with a clinical diagnosis of angina pectoris was signi- supported by international statistics, by the time trend of ficantly higher than in those with a questionnaire diag- the incidence rate, by comparison of dietary habits of nosis, which indicates that the validity of the clinical coronary patients and "controls," and by experiments diagnosis is greater. The results indicate that the question- were not justified by the actual evidence. naire is very useful for screening cases with coronary heart disease. if it is used at prevalence studies or effect studies, one has to be aware of the relatively high frequency of 71-1204. Kornitzer, M., Demeester, M., Deno lin, H. false- positives. (Auth. Abs.) Enquete Dans une Population d'Employes. Relation des Habitudes Tabagiques Avec d'Autres Parametres, [Investi- gation of a White-Collar Population. Relation of Tobacco 71-1207. Medical Journal of Australia. Is Smoking Tera- HabitstoOtherParameters.]BruxellesMedical togenic? Medical Journal of Australia 2(13):644, Sep- 51(10):687-691, October 1971, French. tember 25, 1971. The relationship of the smoking habits of 539 male A follow-up of the survivors of the 1958 British employees to three important risk factors for coronary Perinatal Mortality Study has led to a reconsideration of disease was investigated. All were white-collar employees the role of maternal smoking as a cause of congenital of a Brussel's bank and ranged in age from 40 to 59 years. heart disease. Approximately 92 percent of these seven- Cigarette smokers had average lower systolic and diastolic year-old children were traced and a medical history taken. arterial pressures than the nonsmokers and cigar or pipe The analysis was restricted to single births, and cases of smokers and the skin folds were also thinner in the congenital heart disease associated with anencephalus, cigarette smokers than in the other groups. Only minimal spina bifida, or Down's syndrome were excluded. There non-significant differences in blood lipidlevels were remained 290 cases of congenital heart disease, mostly found between cigarette smokers and the other groups. fatal, and in 39.7 percent of these, the mother had These results were in general agreement with the work of smoked after the fourth month of pregnancy. Even after other investigators. allowing for the effects of maternal age, maternal parity, and social class, the effect of smoking was still significant. The small number of cases of each particular deformity 71-1205. Kozarevic, D., Pirc, B., Dawber, T. R., Kahn, H. made itdifficultto determine whether any specific A., Zukel, W. J. Prevalence and Incidence of Coronary defects were particularly associated with smoking, al- Disease in a Population Study. The Yugoslavia Cardio- though this may be true of patent ductus arteriosus and vascular Disease Study. Journal of Chronic Diseases Fallot's tetralogy. 24(7/8):495-505, September 1971.

A prospective study of the incidence of several 71-1208. Mittal, S. R. A Clinical Review of 'fluombo- manifestationof coronary heartdisease (CHD) was Angitis Obliterans. Indian Practitioner 24(4):217-224, undertaken in two Yugoslavian communities, Tuzla in April 1971. Bosnia and Remetinec, a suburb cif Zagreb in Croatia. Low rates of CHD prevalence and incidence were found in Seven cases of peripheral vascular disease were divided both communities. The low rates are associated with into two groups. The first included five males, ages 18-48, overall low levels of cholesterol and weight, but until the of low socioeconomic status, all of whom were heavy data are analyzed in more detail it cannot be determined smokers. They showed either normal or low blood if this is a causal or coincidental relationship. There was pressure, and the absence of peripheral pulse. Femoral no evidence to suggest that subjects developing CHD and popliteal pulsations were normal in almost all cases. smoked more cigarettes than those in the total population The second group included a 52-year-old smoking male at risk. Because of similar reports of no relationship and a 65-year-old nonsmoking female, both of middle

227 230 CARDIOVASCULAR DISEASES

class, who showed high blood pressure and involvement of group. Altogether. 37.91 percent of the patients were peripheral vessels and femoral and popliteal pulsations. smokers: 27.91 percent chewed tobacco. From 20 to 25 On the basis of these observations, the clinical entity percent of the patients were moderate and heavy smokers tluomboangiitisobliterans should be used forcases of long duration and many both smoked and chewed resembling those in the first group and arteriosclerosis tobacco. Excess of saturated fat in the diet, hypertension. obliterans for cases similar to the second group. and diabetes were considered to be significant pre- disposing factors, while smoking, obesity, and syphilis were not significant. Some 40 percent of the patients 71-1209. Paffenbarger, R. S. (Jr.), Wing, A. L. Chronic were cultivators and manual laborers and 15.47 percent Disease in Former College Students. XI. Early Precursors gave positive family histories of coronary heart disease. of Nonfatal Stroke.American Journal of Epidemiology Pain was the predominant symptom. Infarction and 94(6):524-530, December 1971. ischemic changes occurred in 49.16 and 38.75 percent, respectively. Doctor-diagnosed stroke was reported by 102 of 10,327 men who had attended .Harvard University, 1916.1940,and who had retumed a usable,self- 71-1212.Tibblin, G., Wilhelznsen,L. Ateroskleros administered mail questionnaire in 1966. A 67-percent Nikotinsyraterapi(1):HjartinfarktensRiskfaktorer. response was achieved from a single mailing and the [AtherosclerosisNicotine Therapy (1): Heart infarct reliability and validity of answers were found to be Risk Factors.]Lakartidningen68(15): I 738-1743, April generally acceptable. The mean age of subjects was 54 7, 1971, Swedish. years at time of stroke occurrence, while the mean age of respondents ranged from 64 for the five earliest college The population of this Swedish study was classified by classes to 47 for the five most recent classes. Examination sex, blood lipids, age, pulse rate, blood pressure, smoking, of university medical records of these former students and physical activity. Risk factors for an infarct include revealed four characteristics in youth that predisposed to cholesterol,triglycerides,bloodpressure, pulserate, increased incidence of nonfatal stroke in later life: higher smoking, stress, and sedentary occupation. Smokers be. levels of blood pressure, increased weight for height, long to the high-risk group and the chance of their shorter bodystature, and cigarette smoking. Paired developing a heart infarct or cerebrovascular disease is combinations of any of the four characteristics had an 17.9 percent whereas in the low-risk group this value is additive or greater effect on stroke incidence. Similarly, 1.2 percent. It is difficult to assign to smoking alone the questionnaireresponses in1966 from these former role of culprit when, for example, a hyperlipcmia is also students revealed four highrisk characteristics that asso- induced by alcohol consumption. To establish the host. ciated with an increased prevalence of nonfatal stroke: illness-disease relationship. both etiological and psycho. high blood pressure, coronary heart disease, diabetes, and logical factors which affect the development of any such a history of parental hypertension. High blood pressure syndromes must be considered. exerted the strongest influence on prevalence of nonfatal stroke, both singly and when paired with the three other characteristics. High blood pressure in the former students 71-1213. Wray, R., DePalma, R. G., Hubay, C. H. Late and a history of parental high blood pressure, both Occlusion of Aortofemoral Bypass Grafts: Influence of determined by questionnaire, were each better predictors Cigarette Smoking.Surgery70(6):969-973, December of nonfatal stroke than higher levels of blood pressure 1971. assessed in college. (Auth. Abs.) A series of 100 patients undergoing aortic reconstruc Lion for aneurysmal or aortoiliac occlusive disease during 71-1210.Pandey,M.R.Myocardial Infarctionin the period 1965 to 1968 was studied. The striking clinical Nepal.Indian Heart Journal22(2):73 -82, April 1970. observation in' this study is the constant association of cigarette smoking and late occlusion of aortofemoral Of 150 cases of myocardial infarction reported during reconstruction for occlusive disease. This association was the 1960-1968 period in Nepal, 66.6 percent occurred in not observed in patients operated upon for aneurysm. The the 41.60 age group, 74.6 percent occurred in the high contribution of cigarette smoking to decreased peripheral income group, and 65.3 percent occurred in moderate and blood flow may, under normal circumstances be inconse heavy smokers. The disease affected males 6% times more quential. When superimposed upon progressive obstruc- than females. Hypertension, diabetes, gout, and hyper- tive atherosclerosis,it may assume major proportions cholesterolemia significantly increased the risk of infarc- decreasing already compromised flow through a prosthesis tion. Arrhythmia was the most common complication and allowing thrombosistooccur.Individuals with followed byleftventricularfailure, right ventricular peripheral atherosclerosis who continue to smoke have a failure, shock, and thromboembolism. higher amputation rate than those who relinquish the habit. Since smokers with aortofemoral reconstruction appear to be more liable to late thrombic complications involvingthe graft, cessation of cigarette smoking is 71-1211. Singh, A. P., Singh, S. P. Coronary Heart recommended to all patibnts undergoing vascular recon- DiseaseSome Epidemiological, Clinical and Electro- struction. cardiographic Observations.Journal of the Association of Physicians of India19(9):629.6 35, September 19 71. 71-1214. Wright, H. B. Casualties of Middle Age.Public Some epidemiological and clinical aspects of coronary Health85(6):326-332, September 1971. heart disease were analyzed in 240 cases with emphasis on the role of various risk factors. There was a marked Causes of death among middle-aged men are briefly preponderance of the disease in males in the 51-60 age examined with particular emphasis on coronary heart 231 228 OTHER DISEASES AND CONDITIONS

disease. Risk factors involved in coronary heart disease, group of 70 years and over there were fewer smokers than such as obesity, cigarette smoking, high cholesterol levels, in the general population. Within the entire group there and high blood pressure, arediscussed. The use of were fewer who had ever smoked than in a group of screening programs to identify high-risk individuals, advis- patients with gastric cancer. A large proportion of the ing patientsto stop smoking, and other preventive original smokers had stopped smoking or had reduced measures are mentioned. their smoking before pernicious anemia was diagnosed, the majority because it no longer tasted good. After the 71-1215. Zacho, A., Nielsen, 1., Larsen, V. Smoking treatment was instituted only a few quit or reduced their Habits of Patients With Pernicious Anaemia in Whom smoking. Achlorhydria and lack of intrinsic factorare Gastric Cancer Has Not Been Demonstrated. Acta compatible with heavy smoking. Some of the intolerance Chirurgica Scandinavica 137:541-545, 1971. symptoms in smoking may be due directly or indirectly to the lack of vitamin B12 and may be an early sign of A questionnaire survey was made of the smoking pernicious anemia. Gastric cancer was not detected in any habits of 93 patients with pernicious anemia. In the age of the patients with pemicious anemia. See also, 71-1134, 71-1237

OTHER DISEASES AND CONDITIONS

71.1216. Alp, M. H., Hislop, I. G., Grant, A. K. Gastric effects of certain drugs on pregnant women, immuniza- Ulcer in South Australia, 1954. 1963.2. Symptomatology tion, and cryosurgery. andResponsetoTreatment. MedicalJournal of Australia l(7):372-374, February 13, 1971. 71-1218. Gilder, S.S.B. Cigarettes and Gastric Secre- A retrospective study of chronic gastric ulcer has been tion. Canadian Medical Association Journal 104(9):758, carried out on 638 patients over the 10-year period 1954 May 8, 1971. to 1963. There was no difference in symptomatology between ulcers of the body of the stomach and antral The effect of smoking three cigarettes in one hour on ulcers. Associated duodenal ulceration was more common the gastric secretion of 12 healthy volunteers (both in patients with antral ulcers, while in females antral smokers and nonsmokers) was studied. The overall effect ulcers were more liableto perforation. Hemorrhage of smoking on acid output was negligible, although one occurred more frequently from ulcers in the body of the subject showed a 30-percent stimulation and another stomach. In 202 of 274 patients, assessed after three or 30-percent inhibition through smoking. Apart from the more weeks of medical treatment, the ulcer had healed. fact that the person with increased acid response also had Eighty-seven percent of the patients whose ulcer recurred an increase in pepsin output, the effect of smoking on the had continued to smoke, drink alcohol, or ingest aspirin, latter was negligible. but so had 49 percent of those whose ulcer remained healed. (Auth. Abs.) 71-1219. Goldstein, H. Factors Influencing the Height of Seven Year Old ChildrenResults From the National 71-1217. Dixon, G. Advances in Obstetrics and Gynae- Child Development Study. Human Biology 43(1):93411, cology. Practitioner 207(1240):433-441, October 1971. February 1971. The results of various studies on the risk to the The heights of the children in the National Child offspring of mothers who smoke during pregnancy are Development Study (all children born in England, Scot- reviewed. These findings show a low birth weight, land, and Wales during the week of March 3-9, 1958) have retarded growth atall gestational stages, and death been measured between seven and eight years of age. associated with growth retardation in these babies. Chil- Information was also obtained on the social class of the dren of mothers who smoked more than 10 cigarettes child's father, the age and height of the child's mother, daily after the 4th month of pregnancy were 4 months her smoking habits during pregnancy, the parity, birth- retarded in reading at the age of 7. Although there is a weight and length of gestation of the child, and the lowered incidence of pre-eclampsia in smoking mothers, number of younger siblings. The associations of these the risk to the baby increases if the mother who develops variables with height were analyzed both singly and pre-eclampsia also smokes. In addition, babies of smoking jointly, in all cases making allowance for the age and sex mothers are more likely to abort, to be stillborn, to die of thechild. No evidence of statisticalinteractions neonatally, or to have congenital heart disease. New between sex and any of these variables was found. After advances inobstetrics and gynecology are discussed, allowing for the other variables, rust born children are, on including intro- uterine detection of genetic disorders, the average, 2.3 cm taller than fourth or later born children, active management of labor, contraceptive techniques, and those children with no younger siblings are 1.1 cm sterilization, the effects of the 1967 Abortion Act, the taller than those with three or more. Birthweight and

229 2:rie OTHER DISEASES AND CONDITIONS length of gestation are both associated with height at range of the homozygotes for the common gene. The seven years. The average gain in height for each kilogram frequencyofthegene determining a deficiencyof of birthweight is 2.8 cm. Children born before the 38th alpharantitrypsin in a population sample of 100 indivi- week of gestation are on average 1.1 cm shorter than duals was 0.075. (Auth. Abs.) those born between 38 and 42 weeks. When all the other variables are allowed for, the gestation effect becomes non-significant; but the average gain in height for each 71-1223. Laugier, P., Extermann, J. C., MicheauC., kilogram of birthweight is only slightly reduced, being 2.1 Reiffers,J.L'Ouranite Glandulaire.[Papule' Leuko- cm. The correlation coefficient between the height of the keratosis of the Palate.]Dennatologica 142(6):344-352, mother and the height of the child is 0.33 for boys and 1971, French. 0.32 for girls, with a standard error of 0.013 in both cases. The average gain in height for each cm of mother's The designation 'ouranite glandulaire' is preferrable to height is 0.27 cm, after allowing for the other variables. that of 'leukokeratosis' because the latter term describes a Children of mothers who were under 25 years old when lesion which is secondary to the essential glandular lesion. the child was bom, after allowing for the other variables The disease primarily affects the palatine salivary glands, are on average 0.6 cm smaller than the children of particularly those of heavy smokers and those of persons mothers aged 25 or over. After allowing for the other smoking menthol cigarettes or sucking large amounts of variables, the children of mothers who smoked 10 or mentholated candy. Histological and clinical descriptions more cigarettes a day after the 4th month of pregnancy, are presented based on 14 cases studied. Prognosis is are on average about 1.0 cm shorter at age seven than the considered good, and treatment consists of suppressing children of mothers who did not smoke. (Auth. Abs. the irritating causal factor. Mod.)

71-1224. Marks, E., Swiecicki, W. Wplyw Tlenk Wegla, 71-1220. Hosko, M. J. The Effect of Carbon Monoxide on Wibracjii Obnizonego Cisnienia Atmosferycznego na the Visual Evoked Response in Man. And the Spon- Mozgowy UkladNeurosekrecyjnyi Poziom Amino- taneous Electroencephalogram. Archives of Eviron- lcatecholi. [Effect of Carbon Monoxide, Vibration and mental Health 21(2):174-180, August 1970. Lowered Atmospheric Pressure on the Cerebral Neuro- secretory System and Catecholamine Levels.] Medycyna Human volunteers were exposed to carbon monoxide Pracy 22(3):335-342, 1971, Polish. at concentrations ranging from 1 to 1,000 ppm for 0.50 to 24 hours. Carboxyhemoglobin levels greater than 20 The effects of carbon monoxide, lowered atmospheric percent produced changes in the visual evoked response pressure, and vibration on the cerebral neurosecretory similar to those previously described in animals. The system and catecholamine level in blood of rats were amplitude of the 2-3-4 wave complex was increased and investigated. Carbon monoxide and lowered atmospheric was accompanied by a negative-going shift in the 5a-6 pressure produced a decrease in the amount of neuro- waves. Carboxyhemoglobin levels approaching 33 percent secretion in the nucleus of the thalamus and neural part did not alter gross spontaneous electroencephalographic of the hypophysis. Vibration resulted in a significant activity. (Auth. Abs.) increase in catecholamine levels.

71-1221. Konturek,S.J.,Radecki,T.,Thor,P., 71-1225. Morales, A., Silva, S., Alcalde, J., Waissbluth, J., Dembinski, A., Jacobson, E. D. Effects of Nicotine on Ramos, J., Bey, H., Sanz, R. Cigarillo y Secrecion Gastric Secretion and Ulcer Formation in Cats. Pro- Gastrica. I. Analisis de Is Secrecion Gastrica en Pacientes ceedings of the Society for Experimental Biology and Digestivos Fumadores y No Fumadores. [Cigarettes and Medicine 138(2):674-677, November 1971. Gastric Secretion. I. Analysis of Gastric Secretion in Smoking and Nonsmoking UlcerPatients.]Revista Nicotine infused intravenously in doses corresponding Medica de Chile 99(4):271 -274, April 1971, Spanish. to the nicotine absorbed by smoking 4 to 8 cigarettes/hr failed to alter basal and pentagastrin-induced gastric acid A study of 231 patients of both sexes suffering from secretion in conscious cats with gastric fistulas. In these gastric or duodenal ulcer demonstrated some differences dosei,nicotineexhibitedapotentiatingeffecton ingastricacid secretion between smokers and non- pen tagastrin4nduced peptic ulcer formation, probably smokers.Significantlyhigherlevels of baseline acid due to its interference with the neutralization of acid in output were found among the male smokers with duo- the duodenum. (Auth. Abs.) denal ulcer. Average post-histamine acid output was higherinmalessmokerswithgastriculcer. The smoker/nonsmoker ratio in patients with duodenal or 71-1222. Kueppers, F. Identification of the Heterozygous gastric ulcer was greater than that of a control group State for the Alpha' Antitrypin Deficiency Gene in composed of 81 individuals with other digestive disorders. Man. Biochemical Genetics 3(3):283-288, 1969. Acid production did not correlate with age, sex, site of ulceration, or duration and intensity of the smoking Alpha' -antitrypsin of individuals homozygous for a habit. gene determining low serum concentrations of this pro- tein can be distinguished electrophoretically from alpha! - antitrypshi of homozygotes for the more common gene. 71-1226. Morales, A., Silva, S., Osorio, G., Alcalde, J., Heterozygotes possess both electrophoretic species, and Waissbluth, J. Cigarillo y Secrecion Gastrica. II. Efecto they may have alphas-antitrypsin levels intermediate del Cigarillo Sobre Is Secrecion Gastrica. [Cigarettes and between those of both homozygotes or may be in the Gastric Secretion.II. Effect of Cigarettes on Gastric 2 ;3 I 230 OTHER DISEASES AND CONDITIONS

Secretion.]Revista Medico de Chile99(4):275-279, Data from the Institute of Directors Medical Centre April 1971, Spanish. are presented refuting previously reported findings by Khosla and Lowe on obesity and smoking habits. No The effects of smoking cigarettes on the volume of convincing weight differences between smokers and non- gastric secretion, and the hydrochloric acid concentration smokers were found. The author argues that social class andloss from gastric secretion were investigatedin must be takeninto consideration in obesity studies individuals with and without ulcers. The two groups were because heavy smoking. heavy drinking, and overeating studied both in the absence of stimulation and after may be part of a syndrome of general overindulgence. The subcutaneous or intravenous infusion of histamine. No increased financial opportunities for this type of behavior significant variations in volume or output of gastric acid occurring in upper class patients may account for the lack were detected while smoking during the non-stimulus of differences inrelative weight found between non- experiments. Smoking during histamine stimulation pro- smokers and heavy smokers. The author also reports that voked transient decreases in gastric secetion which lasted out of 222 men who had given up smoking at follow-up a approxiamtely 15 minutes after the end of inhalation. year or more after their lust visit, 50 percent had the These changes were not detected when gastric secretion same weight CI 5 lb), 28 percent had gained weight, and was determined as volume/hour or output/hour after 22 percent had lost weight. stimulation. Individual variations with respect to gastric secretory activity after cigarette smoking occurred in both ulcer and non-ulcer patients. 71-1230. Primrose, T., Higgins, A. A Study in Human Antepartum Nutrition. Journal of Reproductive Medi- cine 7(6):257-264, December 1971. 71-1227. Ochsner, A. Influence of Smoking on Sexuality and Pregnancy. Medical Aspects of Human Sexuality A method of dietetic management on the pregnant 5(10:78,79,83,84,88,89,92, November 1971. woman ispresentedwith emphasis on augmenting protein-intake according to a predetermined general stan- Various studies on the adverse effects of smoking dard. This method is feasible for use in public clinics used during pregnancy report increases in the rate of abortion, by the most deprived socioeconomic section of a large stillbirth, prematuritY, neonatal deaths, and low birth metropolitancity. The results demonstrate thatthis weight in infants of smoking mothers. Smoking produces method can produce fun-term babies of superior birth- the deliterious changes in the fetus by decreasing placen- weight in a high percentage of cases. Generally recom- tal circulation which retards growth by decreasing nutri- mended maternal weight gain standards are not applicable ents to the fetus. Carboxyhemoglobin levels were higher, and if held at too low a level, may actually harm the respiration was depressed, and peripheral cyanosis re- baby. The risk to the baby also exists if the mother's mained longer in infants whose mothers smoked. Similar pre-pregnancy weight was five percent or more below her results were found in studies on offspring of animals average group weight. Babies born to mothers in this exposed to cigarette smoke or nicotine injections. There is study had lower neonatal morbidity and mortality than some evidence that the degree of morphologic masculinity those born to mothers not in the study. The birth weight is a factor in the incidence of smoking. A study of for infants of mothers who smoked was less even though smokers matched with nonsmokers according to age, sex, the calorie intake of the mother was greater on this diet. race, and social level found that smokers more There was a lower incidence of toxemia and other diseases often, move snore frequently, change jobs moremore often, are of pregnancy and the mothers delivered their babies easier hospitalized more often, and participate in more sports. with a higher percentage of spontaneous deliveries and Smokers were also found to be consistently more neurotic fewer cesarean sections. than nonsmokers. Great differences were also found between personalities of smokers and nonsmokers. Several case histories are briefly described which illustrate that 71-1231. Suomi, J. D. Prevention and Control of Peri- discontinuance of tobacco results in an increase in libido. odontal Disease. Journal of the American Dental Asso- ciation 83(6): 1271-1287, December 1971. 71-1228. Pettersson, F. Smoking in Pregnancy. Retro- There is sufficient evidence that keeping the teeth spective Study of the Influence of Some Factorson Birth cleanis effectiveincontrolling periodontal disease. Weight. Acta Socio-Medica Scandinavica 1:13-18, 1969. Toothbrushing is the method most commonly recom- mended for removal of deposits of oral debris and plaque In a retrospective study of birth weight in 3782 from the teeth. At least two daily brushings are recom- children born to women questioned about smoking habits mended. DentifAces are useful for cleansing the teeth, but during pregnancy, it was found that children born to the overzealous use of dentrifices with strong abrasives is nonsmoking women weighed 100 g more than children contraindicated especially is softer portions of teeth are born to smoking women. In the analysis performed with exposed. No wisp particular kind of toothbrush should be multiple regression analysis there was also taken into recommended for use by an persons. Dentists should account the age of the mother, pregnancy order, marital advise their pr,tivnts to receive prophylaxes at a frequency status, socioeconomic group, previous pregnancy experi- consistent with the rapidity with which deposits are seen ence, length of pregnancy, sex of the child, place of to form and v.ith the patient's oral hygiene habits and home, and alcohol habits. (Auth. Abs.) periodontal condition. The evidence indicates that oc- clusaltrauma does notinitiate gingivitis or pocket formation, therefore, prophylactic grinding of teeth 714229. Pincherle, G. Obesity and Smoking Habits. should be done 7electively. No systemic factors that (Letter) British Medical Journal 4(5782):298, October initiate periodontal disease in the absence of local irritants 30, 1971. have been identified. There is some evidence that diabetes 234 231 BEHAVIORAL AND EDUCATIONAL RESEARCH

and pregnancy may predispose to periodontal disease. concerning the association of tobacco consumption with Available data are inadequate to prove a beneficial effect periodontal disease, furthcz research is needed in this area. of systemic fluoridesin preventing or reducing peri- Diet is apparently not an important consideration in the odontal disease. Since there have been conflicting reports causation or prevention of periodontal disease.

See also,71.1130, 71.1134, 71.1150, 71.1207, 71.1215

BEHAVIORAL AND EDUCATIONAL RESEARCH

71-1232. Akgun, N., Durusoy, F., Kocaturk, E. Lise nonsmokers, dark cigarettes were preferred by the smo- Ogrencaerinde Sigaza Kullanimi. (Smoking Habits Among kers, sex differences were small. and the significance Lycee Students.]Ege Universitesi Tip Fakultesi Mec- threshold was exceeded only in the data as cigar and pipe muasi10(1):15-21, 1971, Turkish. smoking. A significant correlation was found between alcohol and tobacco consumption. Regular alcohol and The smoking attitudes and habits of 5564 students cigarette consumption was correlated with socially critical (3881 boys and 1683 girls) aged between 12 and 23 from attitudes regarding church, state, and sexual mores, The seven lycees located in Izmir, Turkey were surveyed by belief in an injurious effect of smoking was strongly means of a questionnaire. The results showed that 21 correlated with conservative-traditional attitudes regard- percent of the boys and 24 percent of the girls were ing politics, church, and state. The music test revealed a smokers. Among the male smokers, 67 percent were clear divergence in the mean values of individual factors regular and 33 percent were occasional smokers; among between abstainers and alcohol users and between smo- the girls, 25 percent were regular and 75 percent were kers and nonsmokers. occasional smokers. The majority of the smokers (42 percent of the boys and 74 percent of the girls) smoked 1.5 cigarettes per day. About 16 percent of the boys and 714234. Bernholm, B. David och Goliat. (David and 3 percent of the girls smoked 16-20 cigarettes per day; Goliath.]Socialmedieinsk Tidskrift2(Special No.):103- none of the girls and a very small number of boys smoked 105, February 1971, Swedish. more than 20 cigarettes per day. In general, the students began to smoke between 14 and 16 years of age. Boys The effect of the daily press upon the smoking habit is tended to smoke more heavily than girls. The students, compared to the story of David and Goliath. David especially the girls, preferred filter-tipped cigarettes. The represents the text information furnished by a newspaper reasons for first smoking were curiosity, the influence of about the bad effects of smoking and Goliath represents friends, adaptation to social environment, relief of anx- the attractive advertisements which the cigarette manu- iety, and the influence of physicians or a member of the facturers place in the same newspaper. The six largest family. Of the regular smokers, 59 percent of the boys Swedish newspapers and 13 weekly publications contain and 94 percent of the girls had knowledge of the harmful 1300 advertisements in favor of tobacco smoking, and effects of smoking, 35 percent of the boys and 77 percent 150 articles providing correct information on the evils of of the girls enjoyed smoking, and 60 percent of the boys smoking which ought to have had a restrictive effect. The and 70 percent of the girls inhaled deeply. In comparison reader often has the attitude, "smoke first, ask later." He with the findings for similar populations, the percentage triesto find in the correctly reported article which of smokers among the students was not as high as that of describes the noxious effects of tobacco something similar other countries. Prophylactic measures against the hazards to what he is accustomedtoseeing inthe ads. A of smoking should include close cooperation among the well-known Swedish advertisement is described in which a student, family, teacher, and physician. prince woos and wins a beautiful young maiden with a cigarette inthe mouth. Such advertisements can be combated only by showing them to be ridiculous. 71-1233. Battig, K. Penordichkeitsaspekte und subjekdve Einstellungen bei Rauchern und Nichtnuchern, Abstin- enten und AlkohoUconsinnenten. (Personality Aspects 71-1235. Brody,S., Rybo, G. Rokning och Logik. and Subjective Attitudes in Smokers and Nonsmokers, [Smoking and Logic.] (Letter)Lakartidningen Abstainers and Alcohol Consumers.]Zeitschrift fur 68(12):1302-1303, March 17, 1971, Swedish. Proventivniedizin16:409-410, 1971, German. Anything said for or against smoking has value only if The studyis based on the interrogation of 415 the causal relationship is clearly established. A published students (346 males, 69 females) of both Zurich univer- article about smoking must furnish explanations, argu- sities. Responses to 50 questions on alcohol and tobacco ments, and present a debate, not merely dictate an opin- consumption, socialstatus, geographic location, and ion. A statement such as "smoking should be prohibited" subjective attitudes on current political problems were is meaningless since it is necessary to define clearly first of recorded. The subjects were also tested, with the 100 all who is issuing the prohibition and, secondly, who shall musical selections of Cattcll's IPAT-Music Preference Test enforce any such restriction on smoking. Should the en- of Personality. About 50 percent of the subjects were forcer be the ombudsman, the board of directors of a

22,5 232 BEHAVIORAL AND EDUCATIONAL RESEARCH

hospital, the Public Health Administration, the Social 71-1238. Estes, J. W., Johnson, M. Relationships Among Security authorities, the local government, or the national Medical and Nonmedical Uses of Pharmacologically government? Statements which are not identified as to Active Agents.Clinical Pharmacology and Therapeutics issuing or enforcement authorities are simply categorical 12(6):883-888, November-December 1971. imperative statements which are used as a safety valve. Psychoactive drug use was admitted by 14 percent of 328 high school students (a 22 percent sample) in a small 71-1236. Creswell, W. H. (Jr.), Stone, D. B., Huffman, W. suburban New England town. Marihuana was used by 75 .1., Newman, 1. M. Antismoking Education Study at the percent of those who used drugs at least once, followed University of Illinois.HSMHA Health Reports by the barbiturates (28 percent), the hallucinogens (25 86(6):565 -576, June 1971. percent), and the amphetamines (23 percent). Eighty- seven percent of the students had ingested alcohol at least The rust phase of the University of Illinois anti- once. One third of the students surveyed smoked. Of the smoking study was a modified replication of an earlier smokers, 1 in 5 smokes rarely, 1 in 5 smokes a pack a day, study in Portland, Oregon. Results from the rust of three and Iin 12 smokes more than a pack a day. The inci- surveys of the Winnebago County (Illinois) school popula- dence of smoking was about 40 percent in grades 8 tion, 7th through 12th grades, tended to concur with through 11, but it fell to 23 percent among seniors. Par- findings from previous studies on the behavior of youth- ental drinking and smoking habits were not related to ful smokers. While findings for the overall rate of smoking whether or not the students used drugs, alcohol, or cigar- by youth in the Illinois study were similar to those of ettes. There were no sex differences in use of drugs, al- earlier studies, certain differences were revealed. The early cohol, or tobacco, although the boys became intoxicated adolescent girl was smoking at a considerably higher rate more often. Drug users were more likely to use alcohol than her counterpart of 10 years ago. A higher rate also and tobacco. The incidence of drug abuse was found to be was observed for ninth grade boys, but the difference was significantly related to the frequency of aspirin ingestion not as pronounced as for girls. Baseline data obtained among the students. from the initial survey served as a reference point for evaluating a series ofcontinuing and related studies andas the information necessary for effecting a comparative analysis with the mass communication experiment of the 71-1239. Frankenhaeuser, M., Myrsten, A.-L., Post B., Portland study. The Illinois experiment indicated that the Johansson, G. Behavioural and Physiological Effects of contemporary message theme (immediate effects of smok- Cigarette Smoking in a Monotonous Situation.Psycho. ing) was most effective in reducing the rate by which pharrnacologia22(1):1-7, October 20, 1971. youth take up smoking. In contrast, the remotemessage theme was found to be most effective in Portland. In Sustained performance in a visual reaction time test addition to the comparison studies, 12 separate butre- was examined in 12 moderate smokers. In a control con- lated studies were also completed. Among these investi- dition without smoking, efficiency decreased over time. gations were the development of test instruments, educa- In a condition, where three cigarettes were smoked at tional materials, classroom teaching4earning experiments, 20-minute intervals, the subjects were able to maintain and prospective surveys designed to test the predictability their initial level of performance throughout the session, of selected factors in relation to future smoking behavior. mean reaction times being significantly shorter in the (Auth. Abs.) smoking than in the control condition. Smoking produced a significant increase in adrenaline excretion and heart rate. (Auth. Abs.) 71-1237. Dalhamn, T. Fram for Saklighet i Rokdebatten! [Objectivity in Debates About Smoking! (Letter)]Lakartidningen68(19)12198-2200, May 5, 71-1240. Fry, 1. N. Personality Variables and Cigarette 1971, Swedish. Brand Choice.Journal of Marketing Research 8:298-304, August 1971. The general public is exposed to heavy smoking as well as to antismoking advertising in radio and television com- An investigation of relationships between personality mercials, in which no clearcut difference is made between dispositions and brand choice is reported. Attention is the smoking of cigarettes and of cigars and pipes. The given to determining the attributes which differentiate presentation of numerical values in such advertising is brands and to choosing brands for study that differ sub- highly desirable. Thus, in the U.S. for nonsmokers be- stantiallyintheseattributes.Personality and socio- tween 45 and 64 years of age the mortality is 708 per economic measures are cast in the role of both moderator 100,000, whereas for smokers this value rises to 1329per and predictor variables. The results justify a more opti- 100,000. The diseases most affected by smokingare bron- mistic view of the use of personality variables for under- chial carcinomas and cardiac and vascular diseases.For standing brand choice than is currently apparent in the 100,000 persons of the same age range, the incidenceof literature. bronchial cancer is 11 cases for nonsmokers and 87for smokers. The corresponding values for cardiac diseasesare 422 and 802, respectively. Any comparison ofcigarette 71-1241. Golli, V. Studio Asupra Obiceiului de a Fuma. smoking with cigar and/or pipe smoking generally lacks [Study of the Smoking Habit.]Igiena20(3):167 -178, objectivity. The cigarette smoker has a personalitycom- 1971, Rumanian. pletely different from the cigar smoker. The latter often abstains from alcohol, but enjoys overeating. The deleteri- A survey of the over-age-15 population of a suburban ous effect of smoking cannot be equated in the case of a district of Craiova showed that 33.27 percent of the males cigarette chain smoker when compared toa person who and 4.34 percent of the females were smokers. Among puffs on one cigar for a prolonged period. males the percentage of smokers was 26.78 percent under

233 236 BEHAVIORAL AND' EDUCATIONAL RESEARCH

30 years of age, 44.22 percent in the 3140 age group, and One important step is to ban cigarette advertising in all 32.7 percent over age 40. Among females, the percentage modes of mass media, including smoking by television of smokers was 2.16 percent under the age of 30, 5.28 performers and high government officials. percent in the 3140 age group, and 5.57 percent over age 40. In general, the number of smokers fell with age. More than half the men began smoking before they were 20 71-1244. Hill, D. Peer Group Conformity in Adolescent years old, 34.7 percent between the ages of 21 and 30, Smokbig and Its Relationship to Affiliation and Auto- and 12 percent after age 30, whereas 22.9 percent of the nomy Needs.Australian Journal of Psychology women started smoking before the age of 20, 38.5 per- 23(2):189.199, August 1971. cent between the ages of 21 and 30, and 38.6 percent after age 30. Altogether, 16.3 percent of the males and The role of peer group conformity in adolescent ciga- 4.3 percent of the females smoked over 20 cigarettes a rette smoking was investigated in children attending a day. The average number of cigarettes smoked annually rural high school. Analysis of questionnaire responses and was 6310 for men and 4480 for women. Psychological sociometric data showed homogeneity among members of and social investigations are needed to determine why sociometric groups for both smoking behavior and smok- youth start smoking in order to control scientifically the ing attitudes. A subsequent experimental manipulation smoking problem. The increased incidence of smoking re- provided evidence that the "peer group conformity" lated diseases such as coronary thrombosis, lung cancer, motive can be instrumental in changing the attitudes of and chronic bronchitis ought to trigger a sustained cam- adolescents. Subjects informed that their previous re- paign against smoking, especially among the younger sponses deviated from their own friendship groups' norms generation. tended to change their opinions in the direction of the bogus norms. More or less conforming subjects were iden- tified in advance on the basis of appropriate combinations 71-1242. Haglund, S. Attitydteoriemas Roll vid Mantis's of high and low affiliation and autonomy needs. (Auth. av Informadonseffekt. [The Role of Attitude Theories in Abs.) Measuring the Effect of Information.]Socialmedicinsk Tidskrift2(Special No.):105-107, February1971, Swedish. 71-1245. Huttner, I., Huttner, H. Die Motivation des Gesundheitsverhaltens. Tell 4. [Motivation in Health Be- In the case of smoking, it is shown how information havior. Part 4.)Zeitschrift fur Aerztliche Fortbildung received must be correctly weighed and weighted before 64(12):634642, June 15, 1970, German. answers received from a questionnaire on smoking can serve as a basis for drawing conclusions. A questionnaire Human behavior has an increasing influence on health. respondent answering "1 smoke a lot" could give this an- The problem consists in internalizing a stable behavior for swer in the same spirit as he would when stating "I own a health. For this, itis important to know the motives blue Volkswagen". But he could have the attitude that which control this behavior. In the present work, which is smoking improves one's virility and in this case his answer a completion of earlier presentations, a motivation model would imply "I am very masculine." There is a dis- is developed and then tested in a pilot study. The model is crepancy between answers such as "1 smoke a lot" and "I in the form of a hypothesis matrix based on the assump- know that smoking causes cancer of the lungs." In such tion that motives are basically externally determined, but replies one must evaluate tile degree of conviction so as to internally these motives depend on the hierarchical re- fmd out how much of an ego-defensive attitude the an- quirements of the individual. In all, 13 motives are de- swer contains. Social values play their role in such answers fined. Their dependence was hypothetically formulated since the party answering wishes either to identify with and tested. Special attention was directed to an economic his surroundings or to show the contrast. His answer sample. The final sample was based on three initial sam- serves as a baseline, showing the degree of acceptance of ples (nutrition, the smoking habit, and engagement in smoking. An answer may imply that "one should be on sports). The resulting errors were taken into account and the lookout for a healthier smoking habit", but it could the hypotheses of the motivation model verified. The also imply "one should not change this habit". Behavorial needs and requirements for health education are summa- attitudes gleaned from a smoking questionnaire must be rized. judiciously evaluated for personal bias.

71-1246. Jacobs, M. A., Spilken, A. Z. Personality Pat- 71-1243. Harefuah. Seger 'AI Hergele Ishun Ben Rorbn terns Associated With Heavy Cigarette Smoking in Male Weligho. [An Investigation of the Smoking Habits Among College Students. Journal of Consulting and Clinical Israeli Physicians and Its ImplicadonalHarefuah Psychology 37(3):428432, December 1971. 80(3):156-157, February 1, 1971, Hebrew. Male heavy cigarette smokers were hypothesized to A number of surveys concerning the smoking habits of evidence (a) personality traits of defiance, impulsivity, physicians in various countries are reviewed. These sur- and danger seeking; (b) oral preoccupations; (c) manifest veys show that nonsmokers total 45.8 percent of the distress; and (d) perception of having experienced mini- physicians and 34.2 percent of the nurses in Canada, 70 mal warmth, protection, and affection while growing up. percent of the physicians in Great Britain, 76 percent of Both self-rating scales and projective techniques were uti- the physicians in Massachusetts, and 73 percent of the lized to test the assumptions. On all measures, the heavy physicians inIsrael. These findings demonstrate that smokers scored significantly higher than did the non- physicians are convinced of the hazards of smoking. The smokers. These results were interpreted as support for the most important practical problem concerning smoking is view that although people smoke for a variety of reasons, how to convince young people not to begin the habit. the habituated or addicted smoker often engages in the

237 234 BEHAVIORAL AND EDUCATIONAL RESEARCH

practice as an extension of his personal style and utilizes only 29.4 g and 1.63 g, respectively. This means that the it to deal with characterologic as well as situational as- consumption of smoke condensate and nicotine in the pects of his life which may engender tension, irritation, or Federal Republic has decreased during the last ten years. boredom. (Auth. Abs.) The number of smokers having remained almost the same, the consumption of smoke condensate and nicotine per smoker has decreased by about 27 percent and 20 per- 71-1247. Lindstrom B., Tibblin, G. Personlighetsdrag cent, respectively, during the years between 1961 and Rokning. En Pflotstudie. [Personality Features in Smok- 1970 despite an increased cigarette consumption. (Auth. ing. A Pilot Study.]Soclalmedicinsk 7Ydskrift2(Special Abs.) No.):85-87, February 1971, Swedish.

Of 973 men invited to participate in a 1963 Gotes- 71-1250. Newman, 1. M., Irwin, R., Ang, J., Smith, J. burg, Sweden study, 855 or 88 percent of them complied. Adolescent Cigarette Smoking in Two Societies.Inter. Based on their smoking habits, these men were divided national Journal of health EducationI4(3):114-120. into several groups, and each group was evaluated psycho- 1971. logically. An assessment was made of such factors as: how strongly they would stick to a principle, how strongly A total of 353 matched pairs of New Zealand and U.S. they would retain their habits, to what degree they would cigarette smokers were compared on the basis of a num- feel bound by rules, and how impulsive they were. Heavy ber of descriptive characteristics to ascertain the nature of cigarette smokers showed a weaker personality, were in- adolescent cigarette smoking in the two societies. The re- clined to asthenia, and tired easily. Statistics are provided sults indicated that New Zealand females smoked inure for pipe smokers and light, moderate, and heavy cigarette cigarettes than did U.S. females, while males in both soci- smokers. eties smoked about the same number. New Zealand stu- dents, both males and females, tended to select filter- tipped cigarettes more often than U.S. students. New 71-1248. Meares, R.. Grimwade, .1., Bickley, M., Wood, C. Zealand smokers of both sexes had smoked for a longer Smoking and Neuroticism. (Letter)Lancet time than U.S. smokers. Compared to U.S. students, more 2(7727):770-771, October 2,1971. New Zealand males planned to reduce their smoking habit, while more New Zealand females indicated that Data are presented which are contrary to those pub- they wished they had never started smoking but did not lished by Eastwood and Trevelyan concerning the exis- plan to stop. Significantly more New Zealand male smo- Lance of a relationship between smoking and neuroticism. kers had fathers who smoked than did U.S. male smokers. Neuroticism was studied in a group of 102 smoking and New Zealand parents were more likely to forbid smoking 102 nonsmoking women who were attending an antenatal by young people than were U.S. parents and more U.S. clinic and who were also asked about their smoking parents expressed attitudes indicating disinterest in their habits. An attempt to divide the smoking group into light young people's smoking behavior than did New Zealand and heavy smokers was abandoned as only seven women parents. New Zealand adolescents were more likely to smoked more than 20 cigarettes a day. The mean neuro- smoke in the presence of their parents than were U.S. ticism score of the nonsmokers was 11.67 (standard devi- smokers. Attention is drawn to the danger of a superficial ation 4.59) compared with 13.34 (s.d. 5.10) for the smo- educational approach to the smoking problem, as the kers. The difference was found to be significant using the smoking act among adolescents has an important function unpaired t-test. This study also confirmed a previous re- as a mechanism for overtly exhibiting independence. port that extraversion and smoking are associated. Mean scores on Eysenck's extraversion scale were, for non- smokers 10.08 (s.d. 3.3), and for smokers 11.27 (s.d. 71-1251. Nilsson, A., Tibbling, L. Personlighetsskillnader 3.72). This difference was alsosignificant.Possible Mellen Rokare Med Olika Cigarrettkonsumtion. [Person- methodological reasons for the differences between the ality Differences Among Smokers With Different Ciga- two studies are briefly discussed. rette Consumptions.] SoclalmedicinskTidskrift 2(Special No. ):87-90, February 1971, Swedish. 71-1249. Misfeld, J., Timm, J. Trendanalysen zum Pro- Persons who smoked about 20 cigarettes a day were blem des Verbrauches an Nikotin and Rauchkondensat in tested under conditions of stress and were classified as der Bundesrepublik Deutschland fur die Jake 1961-1970. hypersensitive, desensitive, sensitive, and hyposensitive, [Trend Analysis in the Problem of the Consumption of measured on the basis of oculogyral illusions and color- Nicotine and Smoke Condensate in the Federal Republic word tests. Clearcut differences were found. Only two out of Germany From 1961-1970.]Beltrage zur Tabak- of 17 heavy smokers had no neurotic signs in the person- forschung6(0:51-55, July 1971, German. ality test, whereas 10 out of 16 moderate smokers did show these signs. These differences become more appar- On the basis of numerous research results and data on ent when smokers of less than 13 cigarettes daily were the development of nicotine and condensate contents of compared with those smoking more than 20. German cigarettes, their respective shares in the market, the smoked length of cigarettes, and the per capita con- t. sumption of cigarettes in the Federal Republic of Ger- 71-1252. Pincherle, G., Williamson, J. Smoking and Neu - many, an estimate has been prepared on the yearly per roticism.(Letter)Lancet2(773 I ):98I, October 30, capita consumption of smoke condensate and nicotine in 1971. the Federal Republic covering the years 1961-1970. The values for 1961 amount to 40.2 g of smoke condensate Support is given for the observed relationship between (crude) and to 2.04 g of nicotine. The values for 1970 are cigarette smoking and psychiatric state. Heavy smoking

235 238- BEHAVIORAL AND EDUCATIONAL RESEARCH

(20 or more cigarettes a day) was found to be more com- 1969. [Use/Abuse of Euphoriants Among Conscripted mon in patients judged by the examining doctor to be Youth at the 1969 Oslo Session.)Tidsskrift for Den under excessive stress, than in non-stressed patients. There Norske Laegeforening 90( 16) : 1549-1556August15. was no difference between those stressed from work and 1971, Norwegian. those stressed from their home circumstances. Persons registering for the draft show certain habits (smoking of tobacco and marijuana) which they acquired 71-1253.Piper, G. W., Jones, J. A., Matthews, V. L. The in school or at home. Twenty draftees were interviewed Saskatoon Smoking StudyResults of the First daily from January 30 to April 29. 1969. A total of 210 Year. Canadian Journal of Public Health62(5):432.441. were rejected for service in the Armed Forces. 7 of which September-October 1971. were narcotic addicts. The remainder were questioned as to the reasons why they smoked marijuana, or used opi- The Saskatoon Smoking Study is a continuing study ates, and the answers were tabulated according to age, of the smoking habits of students in a particular area and place of birth, broken home environment, model set by the effect on smoking behavior of a student-directed pro. parents, schooling, and work done. Special attention was gram in antismoking education. This portion of the study paid to simultaneous use or abuse of alcohol and tobacco. discusses changes in smoking behavior in Grades VII and The non-marijuana smokers, as a rule, drank alcohol VIII students before and after various educational pro. sporadically, but 22 percent of the smokers used alcohol jects. These included a seminar on smoking and health daily. Of the marijuana smokers, 80 percent also smoked attended by student opinion leaders and completion of a tobacco, whereas only half of the nonmarijuana smokers self-administered questionnaire on smoking and health by smoked ordinary tobacco products daily. Altogether, 141 all students. (Auth. Abs.) (8.3 percent) of the draftees had past experiences with marijuana between the ages of 14 and 18; 3.4 percent had used it from one to five times, and 23 percent more than 71-1254. Ramstrom, L. M. Napa Inknnadonsteltniska six times. Of these, 6 percent were dependent upon marl Synpunkter. (Some Viewpoints on Information Techno- juana: logy.]Socialmedicinsk Tidskrift 2(Special No.):97-100, February 1971, Swedish. 71-1257. Vuori, H., Himanen, P., Hanninen, J., Jarvinen, In regard to advertisements directed against the use of M., Rantanen, T. The Smoking Habits of Finnish Physi- tobacco, the correct way of disseminating information is cians.International Journal of Health Education discussed. The Swedish National Union for Explaining 14(2):68-74, 1971. Damage due to Tobacco, first furnishes a communication to a larger organization (e.g., a chain of newspapers) The smoking habits of a sample of 1067 Finnish physi- which in turn provides the channel (a full-page ad), which cians were investigated by means of a mailed question. subsequently affects the party for whom it is intended (a noire. Forty-four percent of the 843 respondents had smoking schoolboy). The effectiveness of the ad can be never smoked, 23 percent had stopped smoking, 10 per- determined by feedback from the schoolboy to the cent smoked irregularly, and 23 percent regularly. For Swedish National Union. Each individual party in this in- male physicians, these figures are considerably lower than formation chain is of importance and the channel must those of the general male population whereas female contain information which creates an opinion. The physicians smoke as much or even more than the general schoolboy forms this opinion, accepts it as valid, and pre- female population. Among the younger physicians, there vails upon the other students in his class to accept his is a clear tendency to stop smoking or not to start at all. opinion and to stop smoking. The opinion formed is a There are no differences between the representatives of selective one and it must lead to a positive action on the different medical specialities with regard to frequency of part of the schoolboy. Otherwise, the whole communi- smoking, changes in smoking behavior, and reasons for cation is worthless. It was found that of students from the stopping smoking. From the point of view of health edu- 4th to the 9th grade who were exposed to such advertise- cation, it seems that the great majority of physicians are ments, 12 percent of them stopped smoking, and a con- aware of, and acknowledge, the health hazard of smoking. siderable number did not start. There were significantly Efforts should be concentrated on making those physi- fewer "starters" than there would have been if such adver- cians who still smoke show a good example by stopping tisements had not appeared. smoking and making all physicians aware of their oppor- tunities and responsibilityinantismoking activities. (Auth. Abs.) 71-1253. Resnick, J. H. Modification of Smoking Be- havior: Good Designs Inaccurate Reporting. Journal of Consulting and Clinical Psychology 37(3):323, December 71-1258. Wirsen, C. TV:, Roll i Informationen. [TV's 1971. Role in Information.]Socialmedicinsk Tidskrift 2(Spe- cial No.):100-103, February 1971, Swedish. The importance of accurately reporting aspects of methodology in a replication and extension study is dis- The information on smoking disseminated by tele- cussed. Methodological difficulties in doing research on vision was evaluated for a large segment of the Swedish smoking are sufficient by themselves so that care should population. The television messages impress the listener in be taken to avoid reporting nonexistent ones. (Auth. direct proportion to their increased objectivity. The lis- Abs.) tener will accept a message as objective if it agrees with his opinions and education. Facts which differ must be sold to the listening audience by presenting the right 71-1256. Stang, H. J. Bruk/Misbruk av Euforiserende approach. Television conveys information in such a way Stoffer Blant UtalcrivningspWctige ved Odo-Selionene that the listener sees himself in a kind of electronic 239 ,r 236 TOBACCO ECONOMICS mirror. Only after much experimentation directed toward compared to 40 percent among the general population, the desired message to be conveyed, can the television and that 30 percent are ex-smokers. Two-thirds of the program act as a psychopharmacological agent to combat ex-smokers stopped within the past ten years, the period smoking. The listener easily gets into a rut and has to be when most reports on smoking hazards were published. manipulated. The government now forces the manu- Of those still smoking, 62 percent want to quit and two- facturer to put a warning on the cigarette package which the listener sees when the various brands are portrayed on thirds of these have tried. Most of the unsuccessful the television screen and advertised by enhancing words. attempts involved those smoking 11 years and longer. Al- The antismoking message will be successful if the tele- most half of the smokers continue to smoke because of vision message works upon the emotions because the facts habit alone, one-third because smoking gives them plea- in themselves do not influence the listener as strongly. sure, and 19 percent to relax. Those not counted as regu- lar smokers and those who smoke five or fewer cigarettes 71-1259. Yarom, D., Lerer, T. Seger Hergele 'Ishun per day claim to smoke mostly during tension or social Balmy Harorim Beyisra'eL [A Survey of Smoking occasions. The number of cigarettes smoked by physicians Habits Among Physicians inIsrael.]Harefuah per day are comparable with findings among the general 80(3):150-151,February 1, 1971, Hebrew. population. Most physicians agree that they should set an example for the public by not smoking, that cigarette This random representative sample shows that 27 per- smoking should be combated, and that this can best be cent of Israeli physicians regularly smoke cigarettes as done through education and mass media.

See also,71-1262, 71-1264, 71-1265, 71.1266

TOBACCO ECONOMICS

71-1260. Menhart, F., Richter, R., Toussaint, J. Modell differently priced tobacco products. Because of the lack zur Bedarfsvorhenage fur Tabakwaren nach Preisklassen of suitable data from retail sources, its development has mit Milk der Trendrechnung. [Model for the Prediction been calculated from a combination of the turnover of Demand for Tobacco Products by Price Class With the trends observed in industry and in the wholesale trade. Aid of Trend Calculation.]LebenanitteUndustrie For calculating the trend, a method with variable pre- 18(6):227-229 , 1971 ,German. diction function is outlined which permits selection of the appropriate curve from an entire series of curves, and A model is described for the prediction of demand for which corresponds to the appropriate trend.

SMOKING CESSATION METHODS

71-126L Best, J. A., Steffy, R. A. Smoking Modification inducing procedure with pretreatment levels of dissonance Procedures Tailored to Subject Characteristics.Behavior as measured by Keutzer's Effective Cognitive Dissonance Therapy2(2):177-191, April 1971. (ECD) scale. The results failed to show promise for the control manipulation or its interaction with LOC scores, Explanations of treatment were devised to capitalize but the dissonance procedure alone and in interaction on the individual differences of smoking clinic clientele with the ECD scores produced positive findings. It was volunteering for a standard aversive conditioning treat- noticed that greater levels of induced dissonance pro- ment. The experimental design permitted study of the duced greater reductions in smoking, and that the best interactions of specially tailored explanations and the improvements occurred in subjects with high natural dis- individual difference dimensions from which the com- sonance scores who received the low dissonance pro- mentaries were derived. The primary goal of the study cedures, and low dissonance score subjects who received was to contrast theutility of an internalized the strong dissonance induction. (Auth. Abs.) "willpower"oriented approach to smoking control with an externalized environment-based approachtoself- control and to analyze the relative worth of these pro- cedures for clients falling at the high and low end of the 71-1262. Jacobs, M. A., Spilken, A. Z., Norman, M. M., Rotter Locus of Control (LOC) scale. Also, procedures Wohlberg, G. W., Knapp, P. H. Interaction of Personality designed to induce dissonance gave an opportunity to test and Treatment Conditions Associated With Success in a the application of a dissonance model; and, in post hoc Smoking Control Program.Psychosomatic Medicine analyses, to study the interaction of the dissonance- 33(6):545-556, November-December 1971.

237 240 SMOKING CESSATION METHODS

A total of 104 men who were heavy smokers (min- requites an analysis of the motives of the individual wish- imum of a pack, and averaging 35 cigarettes a day) parti- ingto discontinue smoking. The "Magic Mountain" cipated in a 10-week program to break the habit. The atmosphere of a treatment center is conducive for such majority (N=83) received group therapy, and the re- purposes. Lobeline and non-lobeline products are cur- mainder were seen individually. Each subject was ran- rently utilized in drug-assisted detoxification. Such drugs domly assigned to one of the following drug conditions: are most effective when combined with psychotherapy. nopills,placebo, lobeline, dextroamphetamine, and Detoxification also works best when physicians and par- imipramine. Pretesting established each subject as a good ents are nonsmokers. A questionnaire for background (N=67) or poor (N=37) risk to stop smoking. Results indi- data on the smoking habits of a smoking clinic candidate cated that, both at the end of treatment and at followup is included in the report. 3 months later, group was superior to individual therapy, treatment without drugs was more effective than taking medication (especially for high-risk cases), and low-risk 71-1265. Markiewicz, K. Niektore Aspekty Leczenia Far- did better than high-risk subjects. Successful subjects makologicznego Przewleklego Nikotynizmu. [Some As- stayed in treatment longer than did failures. Relapse was pects of Pharmacological Treatment of Chronic Nico- associated with life situations and loneliness, passivity, tinism.]Polskt Tygodnik Lekarski26(20):767.769, May boredom, tension, and personal tragedy. The best pre- 17, 1971, Polish. dictor of resistance to relapse was the abrupt and com- plete breaking of the habit during the first two weeks of A chronic nicotine addict is one who smokes 20 ciga- the program ("cold turkey"). (Auth. Abs.) rettes a day, or about 7300 cigarettes per year. Various drugs (lobeline, methylphenidate, Diazepam, and others) used to break the chronic tobacco habit are surveyed. 71-1263. Levinson, B. L., Shapiro, D., Schwartz, G. E., None of these drugs are free from side effects. While Tursky, B. Smoking Elimination by Gradual Reduc- taking lobeline, the patient gradually decreases his nico- tion.Behavior Therapy2(4)1477-487, October 1971. tine intake. For a certain period of time he is under the action of both alkaloids, which gives rise to a lobeline- Two methods of gradual reduction in smoking over a nicotine syndrome. Lobeline prompts a release of sero- 12-week period were compared. The first required sub- tonin, whereas tobacco smoking causes the release of jects to smoke at pre-set random times using a signalling 5-hydroxytryptamine, with the result that the patient device. The second allowed subjects to smoke at times of actually has to fight more toxins for a time. Lobeline their choice using a mechanical counter to self-regulate administration should be accompanied by psychiatric their daily smoking quota. Each method was tested with treatment. In such a combination therapy, 250. heavy and without group meetings. More subjects in the counter smokers were treated from two to four weeks with lobe- groups finished the program; however, groups using the line. Altogether, 70 percent of these showed partial or signalling device were more successfulin eliminating complete abstinence. Other drugs are not as effective as smoking at the time of a 3-month follow-up. The use of lobeline. For instance, of 23 patients treated from four to the signalling device was associated with a tendency to eight weeks with Atatax, only one ceased smoking. reduce the effects of situational cues C. .1 smoking, and Amphetamine given in doses of 10 mg can bring about a group meetings seemed to raise morale among parti- lowering of the tobacco intake by 50 percent. Other cipants. The greatest difficulty in further smoking reduc- methods are based on the chemical destruction of nico- tion occurred at the 12-14 cigarettes per day level for all tine such as treating the smoke with potassium perman- groups. It was hypothesized that, despite the decrease in ganate or silver nitrate before it reaches the mouth. learned cues, further reduction is inhibited by the mani- Patients in these cases complain of a number of symptoms festation of withdrawal symptoms caused by some (dryness of the mouth and a foul taste). Smoking can be physiological addiction. These results suggest that a suc- reliably stopped only if orders issued to this effect are cessful smoking elimination program should combine rigidly enforced. psychological and physiological approaches. (Auth. Abs.)

71-1266. Millet, A., Gimpl, M. Operant Conditioning and 71-1264. Luban-Plozza, B. Nikotin und Gesundheits- Self-Control of Smoking and Studying.Journal of Muting. [Nicotine and Health Behavior.]Monatskurse Genetic Psychology119(2):181-186, December 1971. fur dieArztliche Fortbildung20(12):1-6, 1970, German. Three treatment conditions were compared for their Required information for physicians dealing with the effectiveness in reducing smoking rates and increasing problems of tobacco detoxification is presented. As an study time for 43 volunteers. The treatments were as fol- introduction, the report discusses the conditions for the lows: recording responses, self-instructions, and reinforce- absolute and relative contraindications for smoking, rea- ment for conforming to self-instructions. All subjects sons for juvenile smoking, and the reasqps for, and drives recorded responses the rust week fora baseline and gave in,pleasure and compulsive smoking. The different self-instructions the second week for modifying their rate methods currently employed for detoxification are then of responding. In the third week smokers were separated discussed. These include non-drug methods such as re- into three groups, and nonstudiets were separated into liance on will-power alone, the substitution of sweets, comparable groups. For smoking an analysis of variance chewing gum, etc., a method which can work quite well yielded significant decreases in smoking rate across weeks, with occasional or pleasure smokers, and the use of but no significant differences among treatment groups. physiotherapy, especially when the lungs are heavily For studying an analysis of variance yielded significant stressed. A recommended course of breathing exercises is increase In studying across weeks and interaction effects outlined. Other non4rug methods include autogenous of treatments over weeks. The reinforcement condition training, hypnosis, and psychotherapy. Psychotherapy produced the greatest increase. (Auth. Abs.)

241 238 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Anastosov, A. cations Occasioned by Disorders of the Peripheral [Investigation of the Alkaloid Composition in Tobacco Circulation, 71.1057 Smoke by Gas Chromatography.], 71-0001 Aronow, W. S. [Investigation of the Paraffin Hydrocarbons in Main- The Effect of Smoking Cigarettes on the Apexcardio- Stream Tobacco Smoke by Gas Chromatography.], gram in Coronary Heart Disease, 71 -0287 71-0002 Heart Rate and Carbon Monoxide Level After Smoking ISpectrophotometric Determination of Benzo(a)pyrene High-, Low-, and Non-Nicotine Cigarettes. A Study in in Tobacco Smoke Condensate.1,71-0028 Male Patients With Angina Pectoris, 71-0467 (Chemical and Technological Characteristics of Ciga- Carboxyhemoglobin Caused by Smoking Nonnicotine rettes Produced in the Countries of the SIV. Report. Cigarettes. Effects in Angina Pectoris, 71-1031 Cigarettes Produced in the USSR, German Democratic Republic and Poland.], 71-0042 Arsenyan, E. Ander, S. (Quantitative ChangesintheAlkaloid Content of Points in the Matter of Giving Up Smoking. Who Stops Oriental Tobacco With Different Curing Processes], Smoking After Acute Myocardial Infarct? 71-0466 71-0003 Anderson, D. L. Arthes, F. G. Cause and Prevention of Lip Cancer, 71-0238 Thromboembolism and Oral Contraceptives: An Epi- Anderson, J. A. demiologic Case-Control Study, 71-0664 A Quantitative Study of Bronchial Mucous Gland Artho, A. Volume, Emphysema, and Smoking in a Necropsy (Acrolein and Hydrocyanic Acid Content in Cigarette Population, 71-0876 Smoke.(, 71 -0004 Anderson, J. P. Arvidsson, T. SmokinginPostgraduate Medical Centres.(Letter), Views on Smoking Withdrawal. Experiences With Smok- 71-0319 ing Withdrawal in Stockholm, 71 -0531 Anderson, .1. T. Cigarette Smoking in Man. Short-Term Effect on Muco- Mortality and Coronary Heart Disease Among Men ciliary Transport, 71-1007 Studied for 23 Years, 71-0779 Asano, M. Anderson, W. H. (Microcirculation and Smoking.], 71-0882 Acute Exposure to Cigarette Smoke as a Cause of Ascheim, R. Hypoxia, 71-0609 Shock After Acute Myocardial Infarction. A Clinical and Clinical Aspects of the Dyspneic Miner, 71-0760 Hemodynamic Profile, 71-0135 Ang, J. Ashcroft M. T. Adolescent Cigarette Smoking, 71-0169 A Community Survey of Respiratory Disease Among AdolescentCigaretteSmokingin Two Societies, East Indian and African Adults in Guyana, 71-0622 71-1250 The Lipoid Pneumonia of Blackfat Tobacco Smokers in Angulo, M. Guyana, 71-1172 Rat Gastric Secretion and Mucosal Serotonin Following Astakhova, L. G. Chronic Oral Nicotine Ingestion, 714315 Volatile Fatty Acids in Tobacco, 71 -0725 Chronic Effects of Nicotine on Gastric Secretion in Predecessorsof Organic Acidin Tobacco Smoke, Vagotomized Rats, 71-0511 71-0821 Some Effects of Nicotine on Gastric Secretion in Rats, Astrup, P. 71-0512 Effects of Carbon Monoxide Exposure on the Arterial Anker, .1. L. Walls, 71-0355 Drug Usage and Related Patterns of Behavior in Univer- Intraerythrocytic 2,3-Diphosphoglycerate and Carbon sity Students: I. General Survey and Marihuana Use, Monoxide Exposure, 71-0356 71-0697 The Effects of Exposure to Carbon Monoxide, Hypoxia Anklet, S. I. and Hyperoxia on the Development of Experimental Investigation of Central Cholinergic Mechanisms in the Atheromatosis in Rabbits, 71 -0468 Conscious Mouse, 71-0353 Red-Cell pH and Oxygen Affinity of Hemoglobin. Antonini, E. (Editorial), 71-0639 Studies of the Reaction of Haptoglobin with Hemo- Smoking and Coronary Disease (11): Vascular Damaging globin and Hemoglobin Chains. M. Observations of the Effect of CO and Hypoxia, 71-0640 KineticsoftheReactionof the Haptoglobin Carbon-Monoxide-Induced Mountain Sickness Provoked HemoglobinComplexeswith Carbon Monoxide, by Tobacco Smoking, 71-0775 71-0542 Reversalof Rabbit Atheromatosis by Hyperoxia, Appleton, R. A. 71-1201 Tobacco Chemistry. 3: Unsaturated Hydrocarbon Con- Atanasov, Y. stituents of Greek Tobacco, 71-0354 (Influence of Porosity of Cigarette Paper on the Smoke Archer, V. E. Condensate and Its Composition.], 71-1118 Histologic Types of Lung Cancer Among Uranium Atkinson, W. 0. Miners, 71-0259 Volatile Nitrogenous Bases and Aliphatic Secondary Metaplasia to Neoplasia, 71-1004 Amines of Burley Tobacco, 71-0010 Archibald, R. M. Attfield, M. D. Bronchitis in Men Employed in the Coke Industry, Bronchitis in Men Employed in the Coke Industry, 71-1186 71-1186 Arlt, E. Aue, W. A. Morphological Findings, Postoperative Complications, A Tobacco Related Epidemicof Congenital Limb Mortality and Duration of Bed Rest Following Ampu- Deformities in Swine, 71-0790

244 242 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX.

Auerbach, 0. Bahl, A. L. Thickness of Walls of Myocardial Arterioles in Relation Precocious lschemic Heart Disease. Evaluation of Differ- to Smoking and Age, 71-0106 ent Risk Factors, 71-0289 Histologic Types of Lung Cancer Among Uranium Bahrmann, E. Miners, 71-0259 [Angina Pectoris in Relation to Its Correlation With Effects of Cigarette Smoking on Dogs, 71-0428 Biological Predisposition, and Psychological and Socio- Lung Cancer From Cigaret Smoking, 71-0849 logical Influences.] , 71-0107 ElectronMicroscopicObservationson Pulmonary Bailar, J. C. (111) Fibrosis and Emphysema in Smoking Dogs, 71-0863 Certain Mortality Patterns of Esophageal Cancer in the Metaplasia to Neoplasia, 71 -1004 United States, 1930-67, 71-0051 Epithelial Changes in Ex-Cigarette Smokers, 71-1155 Bais, A. Augendre, P. Clinico-Pathological Study of Cancer of the Larynx, rrhe Five-Day Plan" or "A Controlled Tobacco Detox- 71.0994 ification."] , 71 -1097 Balestra, V. Aures, D. Classification Problems in Epidemiology Studied by Acute and Chronic Effects of Nicotine on Rat Gastric Multivariate Analysis, 71-0638 Secretion, 71-0916 Balint, J. A. Auzas, A. LecithinBiosynthesisinCigarette Smoking Dogs, The Effect of Altitude on an Index of Cerebral Blood 71-0186 Flow in Smokers and Nonsmokers, 71-0647 Ball, J. Awad, S. Rheumatoid Serum Factor in Populations in the U.K. I. Chest Symptomatology in an Egyptian Cement-Asbestos Lung Disease and Rheumatoid Serum Factor, 71-0619 Pipe Factory (A Field Survey), 71-0084 Ball, J. K. Spirometric Measurements in an Egyptian Portland Polycyclic Aromatic Hydrocarbons Covalent Binding to Cement Factory, 71-0270 DNA and Effects on Template Function, 71-0364 Awduche, E. 0. Ball, K. Colour Vision in Tobacco Amblyopia, 71-0307 Cigarette Smoking and the Responsibility of the Hos- Ayache, R. pital Physician, 71-0320 [Delayed After-Effects of Gastrectomy.] 71-1069 Ball, K. P. Aye, H. Dietary Sugar Intake in Men With Myocardial Infarction. [Some Aspects of Coronary Disease in Black Africans Report totheMedical Research Council by Its Observed in Abidijan.] , 71-0109 Working Party on the Relationship Between Dietary Ayres, S..M. Sugar Intake and Arterial Disease, 71-0133 MyocardialandSystemicResponsesto Carboxy- Banks, D. C. hemoglobin, 7 1-02 88 Clinical Significance of the Coronary Arteriogram, Azmeh, N. 71-1190 Chronically Administered Nicotine and the Blood Pres- Smoking and Leucocyteounts. (Letter), 71-1191 sure of Normotensive and Renal Hypertensive Rats, Banyai, A. L. 71-0141 Ominous Mesalliance: Inhalation of Carbon Monoxide Studies on the Acute and Chronic Depressor Actions of From Motor Vehicles and Cigarettes, 71-0005 Nicotine in the Rat, 71-0979 Barabe, P. [Some Aspects of Coronary Disease in Black Africans Observed in Abidijan.] , 71 -0109 Barach, A. L. Pulmonary Emphysema: Pathogenesis and the Illusion Burs, A. of Increased Incidence, 71 -0263 [Experimental Studies on Intake and Deposition of Barbenel, L.M.H. Smoke Particles in Golden Hamsters When Exposed to The Influence of Time of Examination, Eating, Smoking Cigarette Smoke.] , 71-0193 and Frequency of.flrushing on the Oral Debris Index, Experimental Studies on the Intake and Deposition of 71-1070 Smoke Particles in the Passive Smoking of Cigarette Barbiero, 0. Smoke by Golden Hamsters, 71-0960 [Second Infarct.] , 71-1039 Back, K. C. Baribaud, L. ToxicologicalEvaluationof Carbon Monoxidein [Carboxyhemoglobinemia in the Child Born to a Mother Humans and Other Mammalian Species, 71-0412 Who Smokes.] , 714)006 Hematological Effects of Long-Term Continuous Animal Presence of Carbon Monoxide in the Blood of a Child Exposure to Carbon Monoxide, 71-0843 Born of a Smoking Mother, 71-0807 Badakov, S. Barnes, R. H. [Experimental Research on the Microclimate of To- MaternalNutrition andtheCourse of Pregnancy, bacco FermentationChambers.I.Morphological. 71-0508 Changes in the Internal Organs and Nervous System of Bamett, L. W. Rabbits.] , 71 -0357 Relapse Rates in Addiction Programs, 71-1099 Badre, R. Barrett, H. S. [Deteimination of Nicotine by Gas-Phase Chromatog- Some Reminiscences Concerning the Contributions of raphy. II. Applications.] , 71-0362 the State Department of Health to the Smoking and Baer, D. J. Health Problem, 71-0348 Limitation of Smoking by Sons and Daughters Who Barrett, J. P. Smoke and Smoking Behavior of Parents, 71-0698 An Analysis of the Effects of Nicotine on the Cerebral

Individual has contributed to this reference but is not listed as part of the main citation. 243 CUMULATIVE AUTHOR AND ORGANIZATIONALINDEX

Circulation of an Isolated, Perfused, In Situ Cat Brain on the Digestive System.) , 71-0808 Preparation, 71-0204 Bayer, T. Barrillon, A. Effects of Chronic Administration of Nicotine on (How to Prevent the Development of Coronary Athero- Drug-Induced Hypnosis in Mice, 71-0957 sclerosis.) , 71-0108 Buell, R. 1. Barros, F. B. Smoking Dogs: Tobacco Institute Tries to Discount (Micromethod of Astrup. Normal Values of pH, PCO2, Cancer Studies, 71-0746 Standard Bicarbonates and Base Excess in Capillary Beadnell, H.MS.G. Blood", 71-0472 The Lipoid Pneumonia of Blackfat Tobacco Smokers in Bartel, A. G. Guyana, 71.1172 Occupation and Physical Activity and Coronary Heart Beal, G. M. Disease, 71-1034 Smoking Behavior, 71.1075 Body Weight and Cigarette Smoking as Risk Factors, Smoking Behavior. Data Book, 71-1076 71.1044 The Potential of Organizational Coordination as an Barter, C. E. InterventionProcess: Appliedtothe Problem of Pulmonary Emphysema and AlphavAntitrypsin Defi- Cigarette Smoking and Health, 71-1083 ciency, 71-0275 Beal, V. A. Bartle, K. D. Nutritional Studies During Pregnancy, 71-0305 Mass Spectrometric and Gas Chromatographic Evidence Beani, L. for Some New Components inthe Gas Phase of Effectsof Metoclopramide onIsolatedGuinea-Pig Tobacco Smoke, 71-0187 Colon.2) Base, B. Interference With Ganglionic Stimulant Drugs, 71-0008 (The Prevalenceof Chronic Non-specific Broncho- Beard, R. R. pulmonary Diseasein Wool Industry Workmen.), Carbon Monoxide Exposure and Cerebral Function, 71-0088 71-0358 Base, S. Behavioral Responses to Small Doses of Carbon Monox- (The Prevalence of Chronic Non-specific Broncho- ide, 71-0809 pulmonary Diseasein Wool Industry Workmen.) *Beard, R. R. 71-0088 Effects of Chronic Exposure to Low Levels of Carbon Bastide, H. Monoxide on Human Health, Behavior, and Perfor- (Epidemiology of Tobacco inFrance and inthe mance, 71-0399 World.', 71-0954 Bastos, W. P. Beaumont, 3.-L. lsoaminile as Inhibitor of Muscarinic and Nicotinic (Prevention of Certain Acute and Chronic Effects of Ganglionic Receptors, 71-0007 Nicotine With N-Acetyl-hydroxyproline.1, 71-0727 Basu, B. K. Becker, R. F. A Study of Bronchogenic Carcinoma, 71-0745 The Effects of Nicotine Administration In Utero Upon Basu, T. K. Activity in the Rat, 71-0394 Precocious Ischernic Heart Disease. Evaluation of Differ- Vital Effects of Chronic Nicotine Absorption and ent Risk Factors, 71-0289 Chronic Hypoxic Stress During Pregnancy and the Batra, P. P. Nursing Period, 71-0543 Accumulation of Lycopene and Inhibition of Cyclic The Effects of Maternal Nicotine Absorptionor Ily- poxic Episodes Upon Appetitive Behavior of Rat Carotenoids in Mycobacterium inthe Presence of Nicotine, 71-0820 Offspring, 71-0687 Rettig, K. Becker, W. Differential Effects of Nicotine and Tobacco Smoke (Students and Tobacco.), 71.0157 Alkaloids on Swimming Enduranceinthe Rat, Beckett, A. H. 71-0188 The Analysis of Nicotine-e-N-Oxide in Urine, in the The Effect of Nicotine and Total Alkaloids Extracted Presence of Nicotine and Cetinine, and Its Application From Cigarette Smoke on Avoidance Behavior in Rats to the Study of In Vivo Nicotine Metabolism in Man, Under Extinction Procedure, 71-0324 71-1107 The Effect of Filtrate Fractions of Tobacco Smokeon The Effect of Smoking on Nicotine Metabolism In Vivo Swimming Endurance in the Rat, 71-0675 in Man, 71-1108 The Effact of Filtrate Fractions of Tobacco Smoke on Beds, B. the Avoidance Behavior of Rats Under Extinction (Some Aspects of Coronary Disease in Black Africans Procedure, 71-0700 Observed in Abidijan.), 71-0109 (PersonalityAspectsandSubjectiveAttitudesin Begg, T. B. Smokers and Nonsmokers, Abstainers and Alcohol Dietary Sugar Intake in Men With Myocardial Infarction. Consumers.) , 71-1233 Report tothe Medical Research Council by Its Baue, A. E. Working-Party on the Relationship Between Dietary Effect of Carbon Monoxide on Function and Structure Sugar Intake and Arterial Disease, 71-0133 of the Lung, 71-0271 Behrman, R. E. Baumslag, N. Mr Pollution in Nurseries: Correlation With a Decrease Carcinoma of the Maxillary Antrum and Its Relationship in Oxygen-Carrying Capacity of Hemoglobin, 71-0641 to Trace Metal Content of Snuff, 71-0583 Bell, K. Bautista O'Farrill,3. Observations on the Diurnal Variation of Some In- (Symposium on Medical Problems Originating in To- organic Constituents of Human Parotid Saliva in baccoism. Ill. Effects of Nicotine and Tobacco Smoke Smokers and Non-Smokers, 71-0369

Individual has contributed to this reference but is not listed as part of the main citation. 246 244 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Bell, R. L. Bhown, A. S. Pathophysiology of Hereditary Emphysema, 71-1184 Ammonia Retention by Smokers: A Comparative Study, Benckert, A. 71-1109 Socio-Economic Consequences of Smoking, 71-0580 Bhown, M. Bender, W. Ammonia Retention by Smokers: A Comparative Study, (Effects of Low Carbon Monoxide Concentrations in 71.1109 Man.] , 71-0321 Bialek, R. Bendlova, J. Changes of the Serum Lipids Due to Smoking, 71-0890 ContributiontotheInvestigation of the Effect of Bianchi, C. Cigarette Smoking, 71-1133 Effectsof Metoclopramide onIsolatedGuinea-Pig Benndorf, S. Colon.2) Interference With Ganglionic Stimulant (Doctors and Smoking. Results of an Investigation of Drugs, 71-0008 the Smoking Habits and of the Attitudes on Smoking Bickley, M. Detoxification of Doctors in the Magdeburg District.] , Smoking and Neuroticism. (Letter), 71 -1248 71-0337 Biener, K. (Cytisine (Tabex)as a Drug Aid in Breaking the (Juveniles asthe Focus of PreventiveMedicine.], Smoking Habit.] , 71-0535 71-0796 Berenson, G. S. Consumption of Drugs by Smokers and Nonsmokers.] , The Detection of Individuals Prone to Coronary Artery 71-0920 DiseaseA Screening Program Conducted on Medical (Sugar Consumption, Cigarette Smoking, and Myo- Students, 71 -0642 cardial Infarct.] , 71-1032 Berg, J. W. Bierenbaum, M. L. Epidemiology of the Different Histologic Types of Lung The 5-Year Experienceof Modified Fat Diets on Cancer, 71-0986 Younger Men With Coronary Heart Disease, 71-0110 Berger, E. M. Biernacki, T. MMPI Item Differences Between Smoker and Non- (Treatment of Nicotinism as a Link inPreventive smoker College Freshmen Males, 71-0699 Medicine.] , 71-0947 Berger, J. Bignon, J. Long-Term Smoking in the Donkey, 71-0075 Incidence of Pulmonary Ferruginous Bodies in France, Bergstedt, E. 71-0424 Tobacco Chemistry. 4: Chemical and Ciliotoxic Studies Bilimoria, M. H. of Smoke From Freeze-Dried Tobacco, 71-1116 The Effect of Acrolein on L-Asparaginase 2 from Berkson, D. M. EscherichiaColl, 71-0718 Heart Rate: An Important Risk Factor for Coronary The Differentiation of Tobacco Smoke Condensates on MortalityTen-Year Experience of the Peoples Gas Co. the Basis of Reducing Properties, 71 -1110 Epidemiologic Study (195 8-68), 71-0290 Effect of Tobacco Smoke Condensates on Ascorbate, Bernhard, P. 71-1111 The Effectof Smoking on Women and Mothers, Bird, C. C. 71-0717 Embryopathic Effects of 7,12-Dhnethylbenz(a)anthra- CertainInjuriousEffects of Cigarette Smoking on ceneandItsHydroxymethylDerivativesinthe Women, 71-1064 Sprague-Dawley Rat, 71-0678 Bemholm, B. Bimstingl, M. A. (David and Goliath.] , 71-1234 The Effect of Short-Term Exposure to Carbon Monox- Bertrand, E. ide on Platelet Stickiness, 71-1112 (Some Aspects of Coronary Disease in Black Africans Bishop, D. Observed in Abidijan.] , 71-0109 The Mechanism of Carcinogenesis by the Neutral Frac- Best, J. A. tion of Cigarette Smoke Condensate, 71 -0258 Smoking Modification Procedures Tailored to Subject Bjartveit, K. Characteristics, 7 I-1 261 Restrictive Actions. The Influencing of Smoking Habits Bey, H. by Restrictive Measures, 71 -0515 (Cigarettes and Gastric Secretion. I. Analysis of Gastric Black, L. F. SecretioninSmokingandNonsmokingUlcer Maximal Static Respiratory Pressures in Generalized Patients.) , 71 -1225 Neuromuscular Disease, 71-0610 Bhagat, B. Black, R. A. Influence of Chronic Administration of Nicotine on the Characteristics of Longshoremen Related to Fatal Cora Turnover and Metabolism of Noradrenaline in the Rat nary Heart Disease and Stroke, 71.0659 Brain, 71-0189 Blackbum, H. Effect of Cigarette Smoke on the Cardiovascular System Mortality and Coronary Heart Disease Among Men in Dogs, 71-0883 Studied for 23 Years, 71-0779 Effect of Chronic Administration of Nicotine on the Blackmore, M. Concentrations of Adrenal Enzymes Involved in the Smoking Risks of Different Tobaccos, 71 -0870 Synthesis and Metabolism of Adrenaline, 71-0956 Blanchette, G. Effects of Chronic Administration of Nicotine on [Pulmonary Emphysema Caused by Alpha-I Antitrypsin Drug-Induced Hypnosis in Mice, 71-0957 Deficiency: A Family Study.), 71 -1168 Bhargava, S. Blazej, T. Bronchial CarcinomaAnAnalysisof120 Cases, Cocarcinogenesis Studies on Mouse Skin and Inhibition 71-0589 of Tumor Induction, 71-0415 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Blohmke, M. Detection of Coronary Heart Disease Risk Factors, Incidence of Risk Factors of Coronary Heart Disease in 71-0653. Different Age Groups and Social Classes in Men, Nutritional and Epidemiologic Factors Related to Heart 71-0643 Disease, 71-0776 Blum, K. Bourquin, J. Effects of Nicotine, Nicotine Monomethiodide, Lobe- (A Spectrophotometric Method for the Determination line, Chlordiazepoxide, Meprobamate and Caffeine on of Formaldehyde in Whole Smoke of Cigarettes.), a Discrimination Task in Laboratory Rats, 71-0927 71.1129 Bock, F. G. Boyce, H. H. Tumor-PromotingActivityofTobaccoExtracts, Use of Expired AirCarbon Monoxide for Carboxy- 71-0425 hemoglobinDeterminationsinEvaluating Carbon CompositionStudies on Tobacco. XLIV. Tumor- Monoxide Exposures Resulting From the Operation of Promoting Activity of Subfractionc of the Weak Acid Gasoline Fork Lift Trucks in Holds of Ships, 71-0291 Fraction of Cigarette Smoke Condensote, 71-0810 Bowden, D. H. Boey, H. K. The Alveolar Macrophage, 71.1156 Lung Disease With Chronic Obstructionin Opium Bowles, L T. Smokers in Singapore. Clinical, Electrocardiographic, Peripheral Arterial Disease in Ceylon, 71-0298 Radiological, Functional, and Pathological Features, Bowling, C. 71-1158 Effects of Nicotine on Self-Stimulation in Rats, 71-0215 Bogaard, J. Boyd, A. V. (The Influence of Smoking a Cigarette on Lung Func- The Incidence of Fungi in the Throat, 71-1171 tion.' , 71-0767 Boyland, E. Bolt, A.J.N. Enzymic Oxidation of (--)-Nicotine by Guinea-Pig Cholesterol Glucoside in Tobacco, 71-0009 Tissues In Vitro, 71-0544 Bondurant, S. Bracco, M. LecithinBiosynthesisinCigarette Smoking Dogs, (The Tensio-Active Substances of the Alveolar Lining: 71-0186 Chemical Structure, Origin, and Its Function in Pulmo- Bonnaud, G. nary Physiology. New Chemical and Histochemical Incidence of Pulmonary Ferruginous Bodies in France, Findings.' , 71 -0545 71-0424 Branch, L. G. Booth, J. Relapse Rates in Addiction Programs, 71-1099 Enzymic Oxidation of (--)-Nicotine by Guinea-Pig Branemark, P.-I. Tissues In Vitro, 71-0544 Smoking and Coronary Disease (13):Microvascular Boop, K. Ph. Effects, 71-0469 (Pathogenesis and Early Diagnosis of Chronic Bron- Brase, D. A. chitis.) , 71-0076 Studies on the Mechanism of Tolerance to Nicotine- Borowski, C. J. ! nducedElevationsofUrinaryCatecholamines, Deposition and Clearance of 2-Micron Particles in the 71.1131 Tracheobronchial Tree of Normal SubjectsSmokers Brehm, H. P. and Nonsmokers, 71-0620 Smoking Habits of Physicians and Preventive Care Bors, G. Practices, 71-0322 [The Role of Smoking in the Development of Tumors of Brennan, L. the Bladder.', 71-0426 Metaplasia to Neoplasia, 71-1004 Borzelleca, J. F. *Brennan, R. On the Mechanism of 14C- Nicotine Distribution in Rat MaternalNutrition andthe Course of Pregnancy, Sub maxillary Gland In Vitro, 71-0734 71-0508 Bottomley, A. C. Bresard, M. Vitamin B12 Content of Aqueous Humor. (Letter), (Food. Drink. Tobacco. Study of a Representative 71-0312 Sample of 706 Men, 21 to 65 Years of Ageat Boucot, K. R. Saint-Etienne. Chapter VI. Alcohol and Tobacco.), The Philadelphia Pulmonary Neoplasm Research Project. 71-0921 Survival Factors in Bronchogenic Carcinoma, 71-0603 Brewer, G. J. Boudik, F. Effects of Carbon Monoxide on DPG Concentrations in (Myocardial Infarction and Smoking.), 71-0884 the Erythrocyte, 71-0368 Bouhuys, A. Cigarette Smoking as a Cause of Hypoxemia in Man at Cigarette Smoking: Objective Evidence for Lung Dam- Altitude, 71-0470 age in Teen-Agers, 71.0459 Breysse, P. A. Bouley, G. Use of Expired AirCarbon Monoxide for Carboxy- Physiological and Biochemical Effects on Rats and Mice hemoglobinDeterminationsinEvaluating Carbon Exposed to Small Concentrations of Carbon Monoxide Monoxide Exposures Resulting From the Operation of for Long Periods, 71-0410 Gasoline Fork Lift Trucks in Holds of Ships, 71-0291 Bourbon, P. Bride!, D. A. [Carbon Monoxide Content in Blood: Normal and After (Anti-Nicotine or Anti-Tobacco Products.', 71-0180 a Few Minutes Exposure to an Atmosphere Containing Brigden, W. W. One Part per Thousand Carbon Monoxide in 43 Dietary Sugar Intake in Men With Myocardial Infarction. Subjects.) , 71-0569 ReporttotheMedical Research Council by Its Bourke, G. J. Working-Party on the Relationship Between Dietary Mediscan: A Population Screening Programme for the Sugar Intake and Arterial Disease, 71-0133

Individual has contributed to this reference but is not listed as part of the main citation. ' 246 11 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Brill, E. [Chronic Bronchitis Among Textile Workers. Clinical The Role of N-Oxidation Products of Aromatic Amines and Radii gical Detection.] , 71-0455 intheInduction of Bladder Cancer inthe Dog, Buchanan, J. 71-1149 Ballistocardiographic Smoking Tests in Myxoedema, Bril le, D. 71-0111 [Frequency of Chronic Bronchitis in Women. Role of Buck, C. Tobacco.] , 71-0077 Effect of Smoking During Pregnancy on the Risk of [Possibilitiesof Detecting Early Stages of Chronic Cancer in Children, 71-0595 Bronchitis and Pulmonary Emphysema.) , 71-0264 Bukalska, Z. Incidence of Chronic Bronchitis in Women. The Role of [Chronic Bronchitis and Assessment of Respiratory Tobacco, 71-0611 FunctioninConvalescentsAfterTuberculosis.], [Symposium on Chronic Bronchitis. I. Nosology and 71-1162 Epidemiology.] , 71-0614 Bulay, 0. M. Brinson, K. Carcinogenic Effects of Polycyclic Hydrocarbon Car- The Effect of Short-Term Exposure to Carbon Monox- cinogen Administration to Mice During Pregnancy on ide on Platelet Stickiness, 71-1112 the Progeny, 71-0239 Briscoe, W. A. The Study of Development of Lung and Skin Tumors in Alpha, -Antitrypsin Deficiency in Chronic Obstructive Mice Exposed In Utero to Polycyclic Hydrocarbons, Pulmonary Disease. (Editorial), 71-0439 71-0584 British Medical Journal. Buluk, H. Cowardice About Smoking. (Editorial), 71-0528 [The Effect of Occupational Dust Exposure on the Occupational Cancer of the Lung and Smoking, 71-1135 Prevalence of Chronic Bronchitis Among Workmen of World Action on Smoking, 71-1268 Sierzan's Wool Industry at Bialystok.] , 71-0078 Brittain, R. T. Burgess, D. B.. Investigation of Central Cholinergic Mechanisms in the Hyperinflation of the Lungs in Coal Miners, 71-1174 Conscious Mouse, 71-0353 Burke, D. H. Brody, J. S. Influence of Several Autonomic Drugs on Sodium Effects of Elevated Carboxyhemoglobin on Gas Ex- Nitroprusside and 0::otremorine-Induced Hypothermia change in the Lung, 71 -0546 in Immature and Mature Mice, 71-0190 Brody, S. Burrows, I. E. [Smoking and Logic.] (Letter), 71.1235 The Determination of Nicotine in Human Blood by Bronte-Stewart, J. Gas-Liquid Chromatography, 71-0644 Colour Vision in Tobacco Amblyopia, 71-0307 Bush, L. P. Brookes, P. Volatile Nitrogenous Bases and Aliphatic Secondary The Relation of Metabolism to Macromolecular Binding Amines of Burley Tobacco, 71 -0010 of the Carcinogen Benzo(a)pyrene, by Mouse Embryo Cholesterol in Cigarette Smoke. Condensate, 71-0019 Cells in Culture, 71-0015 Principal Alipathic Secondary Amines of Burley To- Carcinogenic Hydrocarbons and Human Cells in Culture, bacco, 71-0361 71-0958 Butler, N. R. *Browe, J. H. Certain Causes of Nvonatal Death. IV. Massive Pulmo- MaternalNutrition and the Course of Pregnancy, nary Haemorrhage, 71-1068 71-0508 Butters, D. Brown, A. M. Measurement of Paper Porosity, 71-0710 The Effects of Age and Smoking on the Maturation of Buxtorf, the Oral Mucosa, 71-0142 [Prevention of Certain Acute and Chronic Effects of Brown, D. A. Nicotine With N-Acetyl-hydroxyproline.] , 71-0727 Uptake of Nicotine and Extracellular Space Markers by Bychkova, I. P. Isolated Rat Ganglia in Relation to Receptor Activa- [Hyperplastic Changes in the Fibrous Structure of the tion, 71-0359 Walls of the Aorta of Rabbits During the Development Brown, J. of Experimental Atherosclerosis.] , 71-0112 Nutritional and Epidemiologic Factors Related to Heart Bye, A. Disease, 71-0776 Effects of Environmental Chemicals on the Metabolism Brozek, J. of Drugs, Carcinogens, and Normal Body Constituents Mortality and Coronary Heart Disease Among Men in Man, 71-0812 Studied for 23 Years, 71-0779 Bynum, T. E. Brubach, H. F. The Smoke Reflex in Rabbits. An Example of Auto- Effects of Smoke on Tolerance of Rats to Hypoxia, homic Control of Cardiorespiratory Function, 71-0306 71-0185 Byrd, G. D. Brun-Gulbrandsen, S. Effects of Nicotine on CulturedRat Heart Cells, Drugs in NorwayAttitudes and Use, 71-0799 71-0227 Bruni, A. Effect of Tobacco Smoke Poisoning on Phagocytosis, 71-0360 Brysiewicz, K. [The Effect of Occupational Dust Exposure on the Cahn, J. Prevalence of Chronic Bronchitis Among Workmen of [Prevention of Certain Acute and Chronic Effects of Sierzan's Wool Industry at Bialystok.] , 71-0078 Nicotine With N-Acetyl-hydroxyproline.), 71-0727

Individual has contributed to this reference but is not listed as part of the main citation. 247 249 ( CUMULATIVE AUTHOR AND ORGANIZATIONALINDEX

Cahoon, D. D. Casciu, G. Cigarette Addiction and Carbon Dioxide Inhalation: A On the Incidence of Cardiovascular Disease Among the Hypothesis, 71-0922 Workers of the Mining Industry of Sardinia. 2nd Calafat, J. Communication: Incidence in Relation to Habitual Studies on Lung Tumours. II. Morphological Alterations Smoking and Consumption of Alcohol, 71.1033 Induced by Dimethyhritrosamine in Mouse Lung and Cassel, J. C. Liver and Their Relevance to Tumourigenesis, 71.0747 Occupation and Physical Activity and Coronary Heart Calandra, J. C. Disease, 71-1034 Fate of Aflatoxins in Cigarette Tobacco, 71.0209 Review of 1960 Through 1962 Cardiovascular Disease Calay, R. Prevalence Study, 71-1035 [Congenital Polycystic Lung. A Case Study anda Body Weight and Cigarette Smoking as Risk Factors, Review of the Literature.], 71.0635 71-1044 Caldwell, A. B. Cassel, J. C. (Editor) The 5-Year .Experience of Modified Fat Diets on Evans County Cardiovascular and Cetebtovasculat Epi- Younger Men With Coronary Heart Disease, 71.0110 demiologic Study, 71-1192 Camner, P. Casten, D. 0. Cigarette Smoking in Man. Short-Term Effect on Muco- Inhibitory Effect of Smoking on the Lower Esophageal ciliary Transport, 71-1007 Sphincter, 71-0500 [TracheobronchialClearance inMan Studied. With Castellanos, D. lonodispersed Teflon Particles Tagged With "F and Lung Tissue Hysteresisin Pulmonary Tuberculosis, 71-1008 71-0089 Campbell, A. H. Catalin, J. Pulmonary Tuberculosis, Isoniazid and Cancer, 71.0052 [Determination of Nicotine by Gas-Phase Chromatog- Campbell, H. raphy. II. Applications.], 71-0362 Smoking and Chronic Respiratory Disease: Finding in Cau, G. Surveys Carried Out in 1957 and 1966 in Staveley in Derbyshire, England, 71.0444 [Carboxyhemoglobinemia in the Child Born to a Mother Canepa, R. Who Smokes.1, 71-0006 [Age and Value of Several Indices for Discrimination in [Thiocyanaturia of the Smoker.), 71-0040 Normal and Ischemk Subjects.1, 71.0774 [Can the Tobacco Origin of Chronic Carbon Monoxide Cano, .1.-P. Poisoning Be Determined?!, 71-0041 [Determination of Nicotine by Gas-Phase Chromatog- Presence of Carbon Monoxide in the Blood of a Child raphy. II. Applications.1, 71-0362 Born of a Smoking Mother, 71-0807 Cads, T. N. Can the Tobacco Origin of Chronic Carbon Monoxide Intoxication Be Determined? 71-0847 [Silent and Atypical Myocardial Infarct.), 71-0893 Carlens, E. Cawson, R. A. Harmful Clinical Effects of Smoking. Smoking and The Smoking Disease. (Letter), 71-0748 Cancer of the Respiratory Passages, 71.0585 Cazal, P. Carnow, B. W. [Chronic Familial Bronchopneumopathies and Homo- Air Pollution and Physician Responsibility, 71-0228 zygotic AlpharAntitrypsin Deficiency.], 71-0881 Carpenter, R. D. Cederlof, R. (Editor) Cigarette Smoke Formation Studies. 1Distribution and Twin Registries in the Study of Chronic Disease With Mainstream Products From Added "C-Dotriacontane- Particular Reference to the Relation of Smoking to 16, 17, 7I-0387 Cardiovascular and Pulmonary Diseases, 71-1193 Analysis of Tobacco and Tobacco Smoke by Neutron Cederlof, R. Activation, 71-0846 The Validity of Questionnaire Diagnosis. "Angina Pec- Cigarette Smoke and Tracheal Mucus Transport Rate. toris," 71.1206 Isolation of Effect of Components of Smoke, 71.1189 Cederqvist, C. Carpenter, R. L. Intolerance of Tobacco in Patients With Gastric Cancer, The Association of Cigarette Smoking With Respiratory 71-0605 Symptoms and Pulmonary Function in a Group of Cele, F. High School Students, 71-0074 [Micromethod of Astrup. Normal Values of pH, PCO2, Carr, C. J. Standard Bicarbonates and Base Excess in Capillary Dark Adaptation and Night Vision, 71-0679 Blood.1, 71-0472 Carr, C. J. Cendron, H. A Review of the Biomedical Effects of Marihuana on The Effects of Age on Masculine Sexual Activity. Man in the Military Environment, 71-0197 Incidenceof SeveralFactors Including Tobacco, Carts, G. 71-0158 On the Incidence of Cardiovascular Disease Among the [Tobacco and Sexual Behavior of Men.1, 71-0923 Workers of the Mining Industry of Sardinia. 2nd Cermakova, Z. Communication: Incidence in Relation to Habitual Early Skin Reaction Against Tobacco Extract in Res- Smoking and Consumption of Alcohol, 71.1033 piratory System Disease, 71-0453 Carter, W. S. Cesarz-Fronczyk, M. Epidemiological Aspects of Oral Cancer, 71.0991 [The Effect of Occupational Dust Exposure on the Carver, S. T. Prevalence of Chronic Bronchitis Among Workmen of Ecology of Coronary Heart Disease, 71-0471 Sierzan's Wool Industry at Bialystok.', 71-0078 Carsten, L. J. [Chronic Bronchitis Among Textile Workers. Clinical Toxicology: The Respiratory Tract, 71.0363 and Radiological Detection.), 71.0455

Individual has contributed to this reference but is not listed as part of the main citation. 250 0. 248 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Chailly, P. Induction of Epitheliomas and Sarcomas in the Dorsal (Congenital Polycystic Lung. A Case Study and a Skin of Rats, 71-1136 Review of the Literature.) , 71-0635 Chhabra, M. L. Chaklin, A. Chronic Cor-Pulmonale. (A Study of 1,000 Cases.), Oncological Research, 71-0987 71-0136 Chakrabarti, B. K. Chiancone, E. TheEffectofShort -TermExposuretoCarbon Studies of the Reaction of Haptoglobin With Hemo- Monoxide on Platelet Stickiness, 71-1112 globin and Hemoglobin Chains. III. Observations on Chakraborty, B. B. the Kinetics of the Reaction of the Haptoglobin Reduction in the Concentration of Aromatic Polycyclic Hemoglobin Complexes WithCarbonMonoxide, Hydrocarbons in Cigarette Smoke, 71-0547 71-0542 Chakraborty, M. K. Chiang, B. N. Changes of Ventilatory Function Amongst Smokers and Electrocardiographic Patterns in Persons With Bronchitis Non-Smokers, 71-0445 and Without Bronchitis in Tecumseh, 71-0872 Chakravorty, R. C. Chikos, P. M. Smoking and Cancer of the Lung, 71-0053 Human Sleep Patterns and Psychomotor Performance Chalmers, R. During Exposure to Moderate Concentrations of Car- Regional Aerosol ClearanceinSmokers and Non- bon Monoxide, 71-0831 smokers, 71-0607 Hematological Effects of Long-Term Continuous Animal Chan, E. W. Exposure to Carbon Monoxide, 7141843 Polycyclic Aromatic Hydrocarbons Covalent Binding to Effect of Carbon Monoxide Exposure on Human Sleep DNA and Effects on Template Function, 71-0364 and Psychomotor Performance, 71-0970 Chance, B. Childers, R. W. Mitochondrial Responses to Carbon Monoxide Toxicity, Nutritional and Epidemiologic Factors Related to Heart 71-0548 Disease, 71-0776 HerneHem Interaction of Crystalline Lamprey Hemo- Chin, C. T. globin. Kinetics and Equilibrium of the Reaction of The Effects of Betel-Nut Chewing on the Buccal Mucosa Carbon Monoxide, 71-0573 of 296 Indians and Malays in West Malaysia. A Clinical Chang, C. H. Study, 71-0143 (Studies of the Smoking Effect on the Atherosclerotic The Effects of Betel-Nut Chewing on the Buccal Changes of the Arteries. I. Smoking Effect on the Pulse Mucosa: A Histological Study, 71-0149 Rate, Blood Pressure and Skin Temperature in Normal Chisholm, I. A. Subjects.) , 71-0113 Colour Vision in TobaccoAmblyopia.71-0307 Chang, R. Biochemical Observations in Toxic Optic Neuropathy, Effects of Environmental Chemicals on the Metabolism 71-0786 of Drugs, Carcinogens, and Normal Body Constituents Chopra, N. M. in Man, 71-0812' Systematic Studies on the Breakdown ofApi-DDT in Chanial, G. Tobacco Smokes, 71-0365 Dermatitis in Tobacco Workers (Remarks on 9 Observa- Chouroulinkov, I. tions)., 71-0498 (Inhibiting Action of Chemical Carcinogens on the Chapman, R. F. Mitosis in the Cultures of Pulmonary Cells of Rats. I. Elimination of Cigarette Smoking by Punishment and Study of 3,4-Benzopyrene.] , 71-0020 Self-Management Training, 71-0948 Christie, D. Chappin, J.J.M.L. Australian Bronchitis Mortality, 71-0265 (Coronary Disease Risk 'Factors in Young Managers.] , Christine, B. W. 71-0900 Effects of Cigarette Smoking on Connecticut Residents, Chard, B. C. 71-0229 The Determinationof FormaldehydeinCigarette Chugh, R. N. Smoke, 71-1128 Precocious Ischemic Heart Disease. Evaluation of Dif- Charreire, J. ferent Risk Factors, 71-0289 (Action of the Gas Phase of Cigarette Smoke on the Churg, J. LymphoblasticTransformationof Small Human Occupational Exposure and Its Relation to Type of Lymphocytes (Preliminary Observations).] , 71-1195 Lung Cancer, 71-0988 Charzewslci, J. An Experimental Model for Study of Cocarcinogenesis (Clinical and Metabolic Studies in Men With Myocardial in the Respiratory Tract, 71-1005 Infarction at Young Age.) , 71-0885 Chutlian, A. Chavis, M. K. [Second Infarct.] , 71-1039 Cigarette Smoke Formation Studies. II. Smoke Distri- Chwat, M. bution Ind Mainstream Pyrolytic Composition of [Respiratory Symptoms and Byssinosis Among Textile Added l'C-Menthol (U), 71-0388 Workers in Israel.) , 71-1009 The Quantitative Recovery of Smoke From Radio- Chyle, M. actively Labeled Cigarettes, 71-1269 (Tobacco Mosaic Virus and Polyphenols as Naturally Chen, H. Y. Occurring Carcinogens in Tobacco.] , 71-0191 Adult Mortality in Berlin, NH, From 1961 to 1967, (Tobacco Mosaic Virus, Polyphenols and the Carcino- 71-0981 genicity of the Tobacco Habit.) , 71-0240 Cherry, C. P. Chyle, P. The Influence of Carcinogenic Dosage and of Sex on the /Tobacco Mosaic Virus and Polyphenols as Naturally

249 251 CUMULATIVE AUTHOR AND ORGANIZATIONALINDEX

Occurring Carcinogens in Tobacco.), 71-0191 juana and Tobacco, 71-0828 (Tobacco Mosaic Virus, Polyphenols and theCarcino- Cohen, B. genicity of the Tobacco Habit.) , 71-0240 The Effects of Exposure to Chewing Tobacco Chyrek-Borowska, S. on the Oral Mucosa of Monkey and Man. A Histological (Incidence of Tobacco Allergy in Patients With Bron- and chial Asthma.) Ultrastructural Study, 71-0676 , 71-1157 Cohen, M. M. Ciampolini, E. Effect of Nausea on Human GastricSecretory Re- (Action of Cigarette Smoking on Several Parameters of sponses, 71-0309 Lipid Metabolism.], 71-1194 Cierniak, E. Effect of Cigarette Smoking on Human GastricSec. retory Responses, 71 -0367 (Chronic Bronchitis in Textile Industry Workmen.), Cohen, S. D. 71-0079 Ciemiak, J. Classificationof Nicotine Block at Neuromuscular Junction, 714 113 (Chronic Bronchitis in Textile Industry Workmen.], Cohen, S. I. 71-0079 CiswickaSznajderman, M. Carbon Monoxide Uptake by Inspectors ata United StatesMexico Border Station, 71-0116 (Clinical and Metabolic Studies in Men With Myocardial Carbon MonoxideUptakeinCigarette Infarction at Young Age.), 71-0885 Smoking, Ciuca, A. 71-0117 Cole, P. (Social Factors of Aging.), 71-0308 Clancy, R. E. Smoking and Cancer of the Lower UrinaryTract, 71-0054 Nutritional and Epidemiologic Factors Relatedto Heart Disease, 71-0776 Coffee-Drinking and Cancer of the Lower Urinary Tract. 71-0850 Clark, I. J. Population Trends in Cigarette Smoking andBladder Studies on the Acute and Chronic Depressor Actionsof Cancer, 71-1143 Nicotine in the Rat, 71-0979 Colin, L. Clarke, R. E. Dermatitis in Tobacco Workers (Remarkson 9 Observa- Cholesterol Glucoside in Tobacco, 71-0009 tions), 71-0498 Claude, J. R. Colla, G. (Lipidemia, Tobacco Consumption andCorpulence. Nepiopharmacology From the Obstetric Viewpoint, Study of an Active Male Population of 7,972Sub- 71-0735 jects.) , 71.0405 Colley, J.R.T. Serum Lipids, Smoking and Body Build.Study of 7,972 Respiratory Disease in Childhood, 71-0266 Actively Employed Males, 71-0907 Collins, P. F. aiffton, E. E. An Automated Method for the Determination of Total Influence of Cigarette Smoking on Some Blood Coagula- Aldehydes in Gas Phase of Cigarette Smoke,71.0012 tion Tests, 71-0488 Colt, J. D. Clin, B. A Reproducible Treadmill Test for IntermittentClaudi- (Study by Nuclear Magnetic Resonance of Carcinogenic cation, 71-1037 and Non-Carcinogenic Isomers (Dibenzacridines and Comanescu, C. Dibenzanduacenes).), 71-0011 (Epidemiological Studies on Chronic Bronchitis ina Cline, M. J. Sample of the General Population of Bucharest.) The Human Alveolar Macrophage: Isolation, Cultivation 71-0451 In Vitro, and Studies of Morphologic and Functional Comas-Urrutia, A. C. Characteristics, 71-0612 Pharmacologic Effects of Nicotine Upon the Fetus and Cloarec, M. Mother in the Rhesus Monkey, 71-1130 ( Myocardial Infarct in the Young Adult (Under 40 Commins, B. T. Years).) , 71-0114 Cigarette Smoking and Exposure to Carbon Monoxide, [ Stress, Tobacco, and Arterial Disease.), 71-1036 71-0390 Coburn, R. F. Comroe, J. H. (Jr.) Effects of Elevated Carboxyhemoglobinon Gas Ex- Carotid Sinus Versus Carotid Body Origin ofNicotine change in the Lung, 71-0546 and Cyanide Bradycardia in the Dog, 71-0206 The Carbon Monoxide Body Stores, 71-0719 Comstock, G. W. Coburn, R. F. (Editor). Low Birth Weight and Neonatal Mortality Rate Related Biological Effects of Carbon Monoxide, 71-0366 toMaternal Smoking and SocioeconomicStatus, 71-0811 Coe, R. M. Smoking Habits of Physicians and Preventive Care Fatal Arteriosclerotic Heart Disease, Water Hardnessat Practices, 7143322 Home, and Socioeconomic Characteristics, 71-0886 Coffman, J. D. Concours Medical. [Cigarettes, Sugar or Hot Drinks?), 71-0118 Tobacco Smoking andthePeripheralCirculation, Conney, A. H. 71 -0115 Cohen, A. B. Cigarette Smoke: Stimulatory Effect on Metabolismof The Human Alveolar Macrophage: Isolation, Cultivation 3,4-Benzpyrene by Enzymes in Rat Lung, 71-0226 Effects of Environmental Chemicals In Vitro, and Studies of Morphologic and Functional on the Metabolism of Drugs, Carcinogens, and Normal Body Characteristics, 71-0612 Constituents in Man, 71-0812 Alveolar Macrophages. Structural and FunctionalDif- Conrad, F. G. ferences Between Nonsmokers and Smokers of Mari- Smoking-Withdrawal Clinics. (Letter), 71-1098

;,4 250 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX .

Cook, P.J.L. Creamer, R. M. Pulmonary Emphysema and AlpharAntitrypsin Defi- Cigarette Smoke and Tracheal Mucus Transport Rate. ciency, 71-0275 Isolation of Effect of Components of Smoke, 71-1189 Cooper, D. A. Creceius, W. The Philadelphia Pulmonary Neoplasm Research Project. (Determination of Nicotine in the Air of a Working Survival Factors in Bronchogenic Carcinoma, 71-0603 Area.) , 71-0961 Cooper, K. H. Crema, C. Physical Fitness in United States and Austrian Military Effectsof Metoclopramide on IsolatedGuinea-Pig Personnel. A Comparative Study, 71-0499 Colon. 2) Interference With Ganglionic Stimulant Corn, M. Drugs, 71-0008 Dose to the Respiratory Tract From Personal, Occupa- Cremonini, G. P. tional and Community Air Pollutants, 71 -0267 (Influence of Cigarette Smoke on the "In Vivo" Comoni, J. C. Sensitivity-to-Heparin Test, Studied by the Thrombo- Occupation and Physical Activity and Coronary Heart elastrographic Method.) , 71-0121 Disease, 71-1034 Influence of Cigarette Smoke on the "In Vivo" Heparin Body Weight and Cigarette Smoking as Risk Factors, Sensitivity Test Studied by the Thromboelastographic 71-1044 Method, 71-0649 Coronary Drug Project Research Group. Creswell, W. H. (Jr.) The Coronary Drug Project. Initial Findings Leading to Antismoking Education Study atthe University of Modifications of Its Research Protocol, 71-0043 Illinois, 71-1236 Corp, P. J. Crews, S. J. The Determination of Nicotine in Human Blood by Drug and Nutritional Factors in Optic Neuropathy, Gas-Liquid Chromatography, 71-0644 71-0677 Corre, F. Cristescu, I. Smoking and Leucocyte-Counts. Results of an Epi- (EpidemiologicalInvestigations on Ischemic Cardi- demiological Survey, 71-0887 opathyin Industry. Study of a Group Involving Corwin, E. Minimal Physical Work (Engineers, Technicians, De- SmokingA World Problem, 71-0804 signers).) , 71-0897 Cotes, J. E. Crocker, T. T. Cigarette Smoking and Pulmonary Diffusing Capacity, Enzymatic Conversion of Barto(a)pyrene. Hydroxy- 71-0634 lation vs DNA-Binding, 71 -0978 Cotten, D. J. Cronin, S. Immediate Effects of Cigarette Smoking on Simple Nutritional and Epidemiologic Factors Related to Heart Reaction Time of College Male Smokers, 71-0924 Disease, 71-0776 Cotterot, E. Cross, C. E. (Survey and Improvement of Efficiency of Cigarette Nicotine Effects on Alveolar Macrophage Respiration Filters.) , 71-0181 and Adenosine Triphosphatase Activity, 71-0211 Coudray, P. Currie, A. R. (An Approach for the Fight Against Tobacco Poisoning. EmbryopathicEffectsof7,12-Dhnethylbenz(a)- Epidemiologic Data on a Group of Adults of Both anthracene and Its Hydroxymethyl Derivatives in the Sexes.) , 71 -0376 Sprague.Dawley Rat, 71-0678 ( Epidemiologic Study of Chronic Bronchitis and Res- Curti, P. C. piratoryInsufficiency. Prevalence in a Sample of [The Tensio-Active Substances of the Alveolar Lining: Women 30 to 70 Years of Age.) , 71-0436 Chemical Structure, Origin, and Its Function in Pulmo- (Symposium on Chronic Bronchitis. I. Nosology and nary Physiology. New Chemical and Histochemical Epidemiology.) , 71-0614 Findings.), 71-0545 (Tobacco and Sexual Behavior of Women.) , 71 -0925 Czajkowska, L. Epidemiological Research on Chronic Bronchitis and (Pulmonary Tuberculosis and Cough and Expectoration Respiratory Insufficiency. Study of Prevalence in a in Inhabitants of Krakow.), 71.1021 Sample of Women From 30 to 70 Years, 71-1010 *Coursin, D. B. MaternalNutrition and the Course of Pregnancy, 71-0508 Da Costa, J. L. Court, J. H. Lung Disease With Chronic Obstruction in Opium Personality Pattern and Emotional Stress in the Genesis Smokers in Singapore. Clinical, Electrocardiographic, of Gastric Ulcer, 71-0785 Radiological, Functional, and Pathological Features, Cousin, M. 71-1158 (How to Suppress the Need to Smoke?) , 71-0949 Daftary, D. K. ('The Five-Day Plan" or "A Controlled Tobacco De- An Epidemiologic and Histopathologic Study of Leuko- toxification.") , 71-1097 edema Among 50,915 Rural Indian Villagers, 71-0681 Cragg, J. Reverse Smoking in Andhra Pradesh, India: A Study of Lung Cancer in Jersey: Its Incidence and Associated Palatal Lesions Among 10,169 Villagers, 71-0690 Biochemistry, 71-0851 Dahms, T. E. Crawford, A. M. Carbon Monoxide and Human Vigilance. A Deleterious Embryopathic Effects of 7,12-DImethylbenz(a)anthra- Effect of Present Urban Concentrations, 71-0965 ceneandItsHydroxymethyl Derivativesinthe Dalderup, L. M. Sprague-Dawley Rat, 71-0678 Sugar Consumption, Physical Activity, Smoking, and

"Individual has contributed to this reference but is not listed as part of the maincitation. 251 253 CUMULATIVE AUTHOR ANDORGANIZATIONAL INDEX

Serum Composition in Man, 71 -0292 Deal, W. B. Serum Lipids and Energy Expenditure in Old Men, Tobacco Cropper's Sickness, 71-0236 71-0787 Dean, G. Risk FactorsforCoronary Heart Disease (CHD), DrugsA Report on a Study in Dublin Post-Primary 71-1038 Schoolchildren, 1970,71-0702 Dalferes, E. F. Deatherage, J. W. (Jr.) (Editor) The Detection of Individuals Prone to Coronary Artery Morphology of Experimental Respiratory DiseaseA Screening Program Conducted on Medical Carcinogenesis, 71-1148 Students, 71-0642 Debas, H. T. D'Alfonso, G. EffectofNauseaon Human GastricSecretory [Nature of Primary Lung Cancer. (Epidemiological Responses, 71-0309 Note.)), 71.0055 EffectofCigaretteSmoking on Human Gastric Dalhamn,T. Secretory Responses, 71-0367 Effect of Different Aldehydes on TrachealMucosa, Decherd, J. F. 71-0192 The Medical Effects of Marihuana, 71-0549 Nasal Absorption of Organic Matter in Animal Experi- De la Paz, E. ments. 1. Experimental Technique and Tobacco Smoke [Analysis of the Smoking Habit in Discharged Absorption, 71-0268 Patients. Study of 453 Cases.', 71-0064 Reduction of Cigarette Smoke Ciliotoxicity by Certain Delarue, N. C. Tobacco Additives, 71-0959 Sputum Cytology Screening for Lung Cancer, 71-0749 Tobacco Chemistry. 4: Chemical and Ciliotoxic Studies Deleizhe, A. of Smoke From Freeze-Dried Tobacco, 71-1116 [Medico-SocialIncidenceofMyocardialInfarct.) [Objectivityin Debates About Smoking!' (Letter), 71-0044 , 71-1237 Deivoria- Papadopoulos, M. Daly, W. J. The Effects of Deoxygenation of Adultand Fetal Single-Breath Gas Distribution in Chronic Obstructive Hemoglobin on the Lung Disease. lsoproterenol Effect Synthesisof RedCell on Neon Dilution 2,3-Dephosphoglycerate and Its In Vivo Consequences, Volume and Diffusing Capacity, 71-0269 71-0132 Daneyrolle, C. Dellaportas, G. [Survey and Improvement of Efficiency of Cigarette Cigarettes and Heart Disease. (Letter), 71-0646 Filters.) , 71-0181 Dellinger, W. S. Daniell, H. W. Effects of Smoking on Lung Structure ofAppalachian Smoker's Wrinkles. A Study in the Epidemiologyof Coal Workers, 71-0091 "Crow's Feet," 71-1065 Pulmonary Arterial Changes With Age and Smoking, Dao, T. L. 71-1051 Inhibition of Tumor Induction in ChemicalCarcino- Delloue, M. genesis in the Mammary Gland, 71-0989 [Some Aspects of Coronary Disease in BlackAfricans Das, P. K. Observed in Abidijan.), 71-0109 Effects of Acetylcholine and Carbacholon the Blood Deloff, L. Vessels of the Frog, 71-0016 [EpidemiologicalSituationof Chronic Non-specific Effect on Ciliary Movements of Some AgentsWhich Diseases of the Lung in Inhabitants of the Town of Come in Contact With the Respiratory Tract, 71-0720 Zabrze.), 71-1024 Dana, P. K. Demange, J. Changes of Ventilatory Function Amongst Smokers and The Effect of Altitude on an Index of CerebralBlood Non-Smokers, 71-0445 Flow in Smokers and Nonsmokers, 71-0647 Dauner, 1. Demas, T. A. [Clinical and Social Aspects of Drug Dependencyin Young People. Part 1.) Obstructive Airway Disease in Patients With Treated , 71-0173 Pulmonary Tuberculosis, 71-0460 Davis, D. L. Dembinski, A. Cholesterol in Cigarette Smoke Condensate, 71-0019 Effects of Nicotine on Gastric Secretion andUlcer Davison, R. L. Formation in Cats, 71-1221 An Analysis of an Anti-Smoking Research Studyin a Demeester, M. College of Further Education, 71-0159 Dawber,T. R. [Respiratory Symptomatology in Epidemiology.Results From a Survey Effected ina Bank in Brussels.), Prevention of Myocardial Infarction, 71-0293 71-0449 Prevalence and Incidence of CoronaryDisease in a [Investigation of a White-Collar Population. Population Study. The Yugoslavia Relation of Cardiovascular Tobacco Habits to Other Parameters.), 71-1204 Disease Study, 71-1205 De Metz, H. Dayrit, C. Sugar Consumption, Physical Activity,Smoking, and Some Physico-Chemical Characteristics ofAcute Myo- Serum Composition in Man, 71-0292 cardial Infarction Among Manila Residents,71-0123 De Molo, G. Dayton, S. Incidence of Cancer in Men on [Incidence of Coronary Risk Factors in SubjectsWith a Diet High in Polyun- Myocardial Infarct.), 71-0119 saturated Fat, 71-0597 Dempster, W. J. Rationale for Use of Lipid-Lowering Drugs, 71.0645 Smoking and Frusemidc Diuresis. (Letter), 71-0013 De Acosta, V. M. Dendinger, J. (Cancer of the Larynx.), 71 -0588 Heart Rate and Carbon Monoxide Level AfterSmoking

254 252 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

High-, Low-, and Non-Nicotine Cigarettes. A Study in DiPaolo,1 J. A. Male Patients With Angina Pectoris, 71-0467 Characteristicsof Primary Tumors by Carcinogenic Den Engelse, L. Polycyclic Hydrocarbons in Syrian Hamsteis, 714)241 Studies on Lung Tumours. II. Morphological Alterations Discher, D. P. Induced by Dimethylnitrosamine in Mouse Lung and LS /MFT: Lung Screening by Meaningful Function Liver and Their Relevance to Tumourigenesis, 71-0747 TestingPart II, 71-0080 Denis, J.-C. Dixit, V. P. [Prevention of Certain Acute and Chronic Effects of Chronic Cor-Pulmonale. (A Study of 1,000 Cases.), Nicotine With N-Acetylhydroxyproline.] , 71-0727 71-0136 Dennish, G. W. Dixon, G. Advances in Obstetrics and Gynaecology, 7,1-1217 Inhibitory Effect of Smoking on the Lower Esophageal >: Sphincter, 71-0500 Dobisova, M. Denolin, H. [Dependence of the Bronchial Secretion and Cough (Investigation of a White-Collar Population. Relation of Symptoms on the Microbial Flora in the Bronchial Tobacco Habits to Other Parameters.] , 71-1204 Tree of Chronic Lung Disease Patients.), 71-1159 Dc Palma, R. G. Dobrzynski, W. LateOcclusionofAortofemosalBypassGrafts: [Clinical and Statistical Analyses of Chronic Bronchitis Influence of Cigarette Smoking, 71-1213 in Port and Shipyard Workers.] , 71.0081 Derwin ne, R. [Chronic Bronchitis Among the Workmen of a Harbor MuscularExerciseDuring Intoxicationby Carbon Grain Elevator.) , 71-0082 Monoxide, 71-0972 Doctor, L. Deshpande, V. A. Obstructive Airway Disease in Patients With Treated Evaluation of Cancer Risk in Tobacco Chewers and Pulmonary Tuberculosis, 71-0460 Smokers: An Epidemiologic Assessment, 71-0590 Dogon, I. L. De Soldati, L. ObservationsontheDiurnalVariationof Some [Second Infarct.), 71-1039 Inorganic Constituents of Human Parotid Saliva in Desplaces, A. Smokers and Non-Smokers, 71-0369 [Action of the Gas Phase of Cigarette Smoke on the Doihara, Y. LymphoblasticTransformationof Small Human [Composition of Tobacco Smoke. Part XIV. Formation Lymphocytes (Preliminary Observations).), 71-1195 of Pyridines in Pyrolysis of Nicotine.), 71.0823 deTreville, R.T.P. Dolke, A. M. Fibrous Glass Manufacturing and Health. Results of a Smoking, Extraversion, and Neuroticism, 71-0165 Comprehensive Physiological Study: Part II, 71-0618 Doll, R. Deuber, A. Cancer andAging: The Epidemiological Evidence, The Effect of Filtered Cigarette Smoke on the Carbon 71-0056 MonoxideHemoglobin Level and the Respiration [IncidenceofCancerasaFunctionofAge: Frequency in Rats.) , 71-1114 Epidemiological Elements.), 71-0057 Diamond, E. L. Dietary Sugar Intake in Men With Myocardial Infarction. EpidemiologicStudiesofParkinson'sDisease.1. ReporttotheMedical Research Council by Its Smoking and Parkinson's Disease: A Survey and Working-Party on the Relationship Between Dietary Explanatory Hypothesis, 71-0682 Sugar Intake and Arterial Disease, 71-0133 Diamond, L. Cancers of the Lung and Nasal Sinuses in Nickel Acute Pulmonary Effects of Smoking a Reference Workers, 71-0427 Cigarette, 71-0437 Practicat Steps Towards the Prevention of Bronchial Diaz, G. S. Carcinoma, 71-0750 [Symposium onMedicalProblemsOriginatingin Dolovich, M. Tobaccoism.I.AlterationsoftheRespiratory Regional Aerosol. Clearance in Smokers and System.), 71-0879 Nonsmokers, 71-0607 Dickens, G. Domanski, I.J. Cravings and Aversions During Pregnancy, 71-1066 Systematic Studies on the Breakdown of p,p'-DDT in Dieter, M. P. Tobacco Smokes, 71-0365 Effects of Smoke on Tolerance of Rats to Hypoxia, Donoghue, J. R. 71-0185 Hypnosis and Smoking: A Review of the Literature, Dp1eY, 3.V. 71-0532 Cocarcinogenic Studies in Pulmonary Carcinogenesis, Donovan, L. P. 71-0999 Cognitive Dissonance and the Smoking Behavior of DiIIey, 3.W. Researchers on Smoking, 71-0934 Smoking on Campus, 714)323 Donovan, P.J. Dingman, J. F. Characteristicsof Primary Tumors by Carcinogenic Hypersecretion of Arginine Vasopressin in Acromegaly, Polycyclic Hydrocarbons in Syrian Hamsters, 71-0241 71-1067 Dontenwill, W. Dinman, B. D. [Experimental Studies on Intake and Deposition of Effects of Carbon Monoxide on DPG Concentrations in Smoke Particles in Golden Hamsters When Exposed to the Erythrocyte, 71-0368 Cigarette Smoke.] , 71-0193 rs *Dinman, B. D. (Experimental Animals,Their Maintenanceand Effects of Chronic Exposure to Low Levels of Carbon Testing.] , 71-0404 MonoxideonHumanHealth,Behavior,and Experimental Studies on the Intake and Deposition of Performance, 71-0399 Smoke Particles in the Passive Smoking of Cigarette

Individual has contributed to this reference but is not listed as part of the main citation. 253 255 CUMULATIVE AUTHOR AND ORGANIZATIONALINDEX

Smoke by Golden Hamsters, 71-0960 The Effect of Filtrate Fractions of TobaccoSmoke on Donzelli, F. the Avoidance Behavior of Rats Under Extinction Effect of Tobacco Smoke Poisoning on Agglutinins, Procedure, 71-0700 71-0370 (The Effect of Filtered Cigarette Smoke Doorenbos, 11. on the Carbon MonoxideHemoglobin Levelandthe Respiration (Coronary Disease Risk Factors in Young Managers", Frequency in Rats.', 71-1 I 14 71-0900 DuBois, A. B. Dorton, G. Establishment of "Threshold" CO Exposure Levels, Carbon Monoxide Uptake by Inspectors ata United 71-0371 StatesMexico Border Station, 71-0116 *DuBois, A. B. Douglas, F. G. Effects of Chronic Exposure to Low Levels of Carbon Foreign Particle Embolism in Drug Addicts: Respiratory Monoxideon Human Health,Behavior,and Pathophysiology, 71-10 I 1 Performance, 71-0399 Dowell, A. R. Duck, K.-D. Short-Term Exposure to Nitrogen Dioxide. Effecton (Directed Prevention of lschemic Heart Disease in the PulmonaryUltrastructure, Compliance,andthe Frameworkof anExperimentalEpidemiological Surfactant System, 71-1160 Study.(, 71-0780 Doyle, M. J. Duclaux, C. Hypersecretion of Arginine Vasopressin in Acromegaly, DermatitisinTobacco Workers (Remarks on9 71-1067 Observations), 71-0498 Drac, P. Dufour, G. (SterilityinSmoking and Nonsmoking Women", Incidence of Pulmonary Ferruginous Bodies in France, 71-0144 71-0424 Drachev, T. Dugan, F. A. (Effect of Moisture and Temperature on the Change of The Detection of Individuals Prone to Coronary Artery Some Chemical Components in the Virginia Tobacco Disease A Screening Program Conducted on Medical Type During Fermentation.(, 71-0014 Students, 71-0642 Dragiev, M. Duggan, J. J. (Changes in the Activity of Adenosine Triphosphatase Unheeded Signals of Fatal Coronary Artery Disease, and Succinic Dehydrogenase of the Liver, Kidneys, 71-1196 Heart and Brain of Rabbits Under the Influence of Dujardin, J. Toxic Substances Formed in the Fermentationof MuscularExercise DuringIntoxication by Carbon Tobacco.( , 71-0550 Monoxide, 71-0972 Experimental Investigations on the Microclimateof Dugan, L. A. Tobacco Fermentation Chambers. IV. Histochemical (CurrentPhysico-Chemical Methods ofAnalyzing Changes in the Catecholamines of the Medullar Part of Tobacco and Tobacco Smoke. I, 71-0829 the Suprarenals in Rabbits, 71-0724 Dumas, C. Drdkova, S. ( Determination of Nicotine by Gas-Phase (Influence of Chronic Effect of Carbon Monoxideon Chromatography. 11. Applications", 71-0362 Clinical State and Biological Changes in the Serumof Dumitriu, M. ExposedPersonsWithRespecttoPrecocious (Epidemiological Studies on Chronic Bronchitis ina Development of Atherosclerosis", 71-0903 Sample of the General Population of Bucharest", Dreifus, L. S. 71-0451 Dummett, C. 0. TheFateofWomenWithNormalCoronary Arteriograms and Chest Pain Resembling Angina Systemic Significance of Oral Pigmentation, 71-0145 Pectoris, 71-0671 Duncan, K. A. Drews, C. J. The Association of Cigarette Smoking With Respiratory (Cigarette Smoke Condensate for AnimalTests.3. Symptoms and Pulmonary Function ina Group of Investigations of the Volatile Components of Solutions High School Students, 71-0074 of Smoke Condensates", 71-0380 Duncan, M. E. (Appearance of Norbomene Derivatives in Tobacco The Relation of Metabolism to Macromolecular Binding Smoke Condensates", 71-0558 of the Carcinogen Benzo(a)pyrene by Mouse Embryo Cells in Culture, 71-0015 (Analytical Investigation of Gas Phase Condensate", 71-1125 Carcinogenic Hydrocarbons and Human Cells inCulture, 71-0958 Drexler, J. Dunger, M. Asymptomatic Polyps of the Colon and Rectum.Ill. (Investigation of the "Semi-Volatiles" of Cigarette Proximal and Distal Polyp Relationships, 71-0310 Smoke.( , 71-1123 Dringoli, R. Dunnill, M. S. (Action of Cigarette Smoking on Several Parametersof A Quantitative Study of the Relationship Between Lipid Metabolism", 71-1194 Chronic Bronchitis,EmphysemaandSmoking, Drion, E. F. 71-0438 Serum Lipids and Energy Expenditure in Old Men, 71-0787 A Quantitative Study of Bronchial Mucous Gland Volume, Emphysema and Smoking ina Necropsy Driscoll, P. Population, 71-0876 The Effect of Nicotine and Total Alkaloids Extracted Dupin-Girod, S. From Cigarette Smoke on Avoidance Behavior in Rats Precipitation Reaction Between Certain Human Sera and Under Extinction Procedure, 71-0324 Soluble Tobacco Extracts, 71 -0505

Individual has contributed to this referencebut is not listed as part of the main citation. 2,56c. 254 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Durand Ochamendi, R. Elebutc, E. A. [Analysis of the Smoking Habit in Discharged Patients. VentilatoryFunctioninHealthy AdultNigerians, Study of 453 Cases.), 71-0064 71-0862 Durda, M. Elmenhorst, H. [ChronicNon-specificLungDiseaseAmong the [MeasurementofFluoresceneinCig .rette Smoke Workmen of the Electro-Machine Works "EDA" at Condensate.] , 71-0372 Poniatowa.) , 71-0083 (The A lkylating Effect of Cigarette Smoke.), 71-0373 [Chronic Non-specific Diseases of the Lung Among the (Cigarette Smoke Condensates for Animal Tests.1. Rural Population of the Lublin Province.] , 71-1012 Preparation and Routine Control.), 71-0374 Durusoy, F. (Cigarette Smoke Condensates for Animal Tests. 2. A (Smoking Habits Among Lycee Students.] , 71-1232 New Practical Method of Preparation to Preserve the Dusek, J. Volatile Components of the Smoke in the Solution.), [Etiopathogenesisand ProphylaxisofCoronary 71-0375 Atherosclerosis (11).1,71-1046 [Detection of Maltol in Cigarette Smoke.] , 71-1115 Dzierzylcray-Rogahki, T. Elmes, P. C. (Clinical and Metabolic Studies in Men With Myocardial Insulation Workers in Belfast. 3. Mortality 1940-66, Infarction at Young Age.) , 71-0885 71-0848 Elmfeldt, D. [Smoking and Coronary Disease (8): Smoking Habits of Patients with Heart Infarctions.(, 71-0120 Smoking and Coronary Disease (8): Smoking Habits of Eastwood, M. R. Heart Infarct Patients, 71-0473 Smoking and Neurotic Illness, 71-0325 El-Sewefy, A. Z. Stress and Coronary Heart Disease, 71-1197 Chest Symptomatology in an Egyptian Cement-Asbestos Eaton, J. W. Pipe Factory (A Field Survey), 71-0084 Effects of Carbon Monoxide on DPG Concentrations in Spirometric Measurements in an Egyptian Portland the Erythrocyte, 71-0368 Cement Factory, 71-0270 Cigarette Smoking as a Cause of Hypoxemia in Man at Elwoort, P. C. Altitude, 71-0470 Ascorbic Acid and Serum-Cholesterol. (Letter), 71-0474 Eddy, T. P. Emmelot, P. A Survey of 216 Elderly Men and Women in General Studies on Lung Tumours. II. Morphological Alterations Practice, 71-0693 Induced by Dimethylnitrosamine in Mouse Lung and Eder, H. Liver and Their Relevance to Tumourigenesis, 71-0747 Risk Factors in Occlusive Diseases of the Peripheral Endoh, M. Arteries of Varying Severity, 71-1055 Pharmacological Features of the Gall Bladder and its Ederer, F. Vascular Bed of the Dog In Situ, 71-0841 Cancer Among Men on Cholesterol-Lowering Diets. Engelmann, L. Experience From Five Clinical Trials, 71-1137 [Myocardial Infarct in Young People.), 71-1060 Edwards, C. N. Enslein, K. Smoking and Youth: Contributions to the Study of Computer Based Data Analysis in Longevity Research, Smoking Behavior in High School Students, 71-0164 71-0230 Edwards, W. S. PersonalityCharacteristicsof MedicalStudentsas Peripheral Arterial Disease in Ceylon, 71-0298 Reflected by the Strong Vocational Interest Test With Eggen, D. A. Special Reference to Smoking Habits, 71-0338 Risk Factors and Atheroscloero tic Lesions, 71-0490 Environmental Protection Agency. Air Pollution Control Egle, J. L. (Jr.) Office. Single-BreathRetentionof AcetaldehydeinMan, Air Quality Criteria for Nitrogen Oxides, 71-0551 71-1013 Enzell, C. R. Egsmore, T. TobaccoChemistry.3:UnsaturatedHydrocarbon (Social Communication and Public Health.) , 71-0160 Constituents of Greek Tobacco, 71-0354 Egsmore, R. Tobacco Chemistry. 4: Chemical and Cilio toxic Studies (The Attitude of Danish Doctors Toward a Tobacco of Smoke Fiom Freeze-Dried Tobacco, 71-1116 Smoking Control Program.) , 71-0711 Epstein, F. H. (Editor) (Awareness of Health Hazards of Tobacco Smoking Twin Registries in the Study of Chronic Disease With Among Danish Doctors.) , 71-0926 Particular Reference to the Relation of Smoking to Egamose, T. Cardiovascular and Pulmonary Diseases, 71-1193 [Priority Problems and Tobacco Smoking.] , 11-0342 Erbstosser, H. Socioeconomic Consequences of Smoking. An Attempt [Directed Prevention of lschemic Heart Disease in the at SystemsAnalysis ofthe Socioeconomic FrameworkofanExperimentalEpidemiological Consequences of Smoking, 71-0537 Study.) , 71-0780 (The Attitude of Danish Doctors Toward a Tobacco Erecinska, M. Smoking Control Program.) , 71-0711 Mitochondria) Responses to Carbon Monoxide Toxicity, [Awareness of Health Hazards of Tobacco Smoking 71-0548 Among Danish Doctors.] , 71-0926 Erickson, H. H. Eilertsen, E. TheEffectsof CarbonMonoxideonCoronary Smoking and Coronary Disease (3): The Bergen Study, Hemodyruunics and Left Ventricular Function in the 71-0648 Conscious Dog, 71-0806 Eisinger, R. A. Ericsson, P. Nicotine and Addiction to Cigarettes, 71-1077 Importance of Certain Factors for Changes in Physical 255 257 CUMULATIVE AUTHOR AND ORGANIZATIONALINDEX

Work Capacity and Ventilatory Capacity DuringFive Fargo, R. Years' Ageing, 71-0861 Personality Erwin, C. W. CharacteristicsofMedical Studentsas Reflected by the Strong Vocational Interest Test With Cardiac Rate Responses to Cigarette Smoking: A Study Utilizing Radiotelemetry, 71-0475 Special Reference to Smoking Habits, 71-0338 Esparza, A. R. Farhi, L. CarcinoMa In Situ of the Larynx, 71-0594 Effects of Chronic Exposure to Low Levelsof CO on Esquivel Avila, J. Human Health, Behavior, and Performance,71-0399 Flutes Rodriguez, J. M. Myocardial Infarction in the Younger Age Groups.) , (Carcinoma of the Larynx.), 71-0752 71-0777 Fasal, E. Estandla Cano, A. Association of Psychosocial Factors to the Smoking (Myocardial Infarction in the Younger Age Groups.), Practices of High School Students, 71-0939 71-0777 Faure, J. Estes, J. W. (Carboxyhemoglobinemia in the Child Bom toa Mother Relationships Among Medical and Nonmedical Usesof Who Smokes.), 71-0006 Pharmacologically Active Agents, 71 -1238 Estier, C.-J. (Thiocyanaturia of the Smoker.), 71.0040 (Can the Tobacco Origin of Chronic Carbon Monoxide Catecholamine-Independent GlycogenolysisinBrain Poisoning Be Determined?), 71-0041 During Carbon Monoxide Poisoning, 71-0194 Presence of Carbon Monoxide in the Blood ofa Child (Metabolites ofCarbohydrate Metabolism and Bom of a Smoking Mother, 71-0807 High-Energy Phosphates in the Brain of MiceAfter Can the Tobacco Origin of Chronic Carbon Monoxide Repeated Carbon Monoxide Poisoning.), 71-0195 Intoxication Be Determined? 71-0847 Evang, K. Fazekas, L. G. (Smoking as a Health Hazard.) , 71-0181 (Histological Changes in Acute Nicotine Intoxication.), Evans, J. G. 71-0196 Current Developments in the Pacific, 71-0781 Federal Trade Commission. Evans, J. W. Report to Congress. Pursuant to the Public Health Double-Blind Trial of Fenfluramineasan Aid to Cigarette Smoking Act, 71 -0529 Stopping Smoking, 71-0950 Statistical Supplement to Federal Trade Commission Evans, M. J. Report to Congress. Pursuant to the Public Health Ultrastructural Changes in Connective Tissue in Lungs of Cigarette Smoking Act, 71-0530 Rats Exposed to NO2, 714461 Federationof AmericanSocieties for Experimental Extermann, J. C. Biology. Life Sciences Research Office. (Papular Leukokeratosit of the Palate.) , 71-1223 A Review of the Biomedical Effects of Marihuanaon Eye, Ear, Nose, and Throat Monthly. Man in the Military Environment, 71-0197 Tobacco Institute vs. American Cancer Society, 71-0751 Fedrick, J. Eyraud, C. PossibleTeratogenicEffect of Cigarette Smoking, (Survey and Improvement of Efficiency ofCigarette 714674 Filters.) , 71-0181 CertainCausesofNeonatalDeath.IV.Massive Pulmonary Haemorrhage, 71-1068 Feinstein, A. R. Smoking and Cancer Morphology. (Letter), 71-0586 Facchini, G. Feist, J. H. (Influence of Cigarette Smokeonthe "In Vivo" Roentgen Features of Giant Cell Carcinoma of theLung, 71-0587 Sensitivity-to-Heparin Test, Studied by the Thromboelastographic Method.), 71 -0121 Fejfar, Z. lschaemic Influence of Cigarette Smoke on the "In Vivo"Heparin Heart Disease. Prognosis,Treatment, Sensitivity Test Studied by the Thromboelastrographic Rehabilitation, and Prevention, 71-1040 Method, 71-0649 Femi-Pearse, D. Falk, G. A. VentilatoryFunctioninHealthy Adult Nigerians, 71-0862 Alpha i-Antiuypsin Deficiency in ChronicObstructive Pulmonary Disease. (Editorial), 71-0439 Ferez Santander, S. Falk, H. L. (Myocardial Infarction hf the Younger Age Groups.), AnticarcinogenesisAn Alternative, 71 -0990 71-0777 Fallat, R. Ferguson, S. Alphas- Antltrypsin Chronic ObstructivePulmonary Disease With Deficiency: Heterozygosity, Intermediate AlpharAntitrypsin Deficiency, 71-0440 Intermediate Levels, and Pulmonary Disease, 71-0443 ObstructiveLung Disease andAlpha' -Andtrypsin An Epidemiological Approach to Chronic Obstructive Deficiency Gene Heterozygoslty, 71 -1167 Pulmonary Disease and AlpharAntitrypsin in Hospital Fallat, R. J. Patients: A Tri-Racial Study, 71-0616 Prospects for the Prevention of Disabling Pulmonary Ferrara, F. A. Disease, 71-0272 Ecological Analysis of Lung Cancer in the City ofLa Fancher, O. E. Plata, 71.1138 Fate of Aflatoxins in Cigarette Tobacco, 71-0209 Ferrell, R. L. Epidemiological Aspects of Oral Cancer, 71-0991 Fang, H. S. Ferris, B. G. (Jr ).. The Influence of Smoking and Drinking on Binocular Smoking and Chronic Respiratory Disease: Finding in Depth Perception, 71-0501 Surveys Curled Out in 1957 and 1966 in Staveley in *Individual has contributed to this reference but isnot listed as part of the main citation. 253 256 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Derbyshire, England, 71-0444 Flasher, J. W. Cigarette Smoking and Pulmonary Diffusing Capacity, The Possible Role of Reactive Metabolites of Polycyclic 71.0634 Hydrocarbons in Oncogenesis, 71-0243 Adult Mortality in Berlin, NH, From 1961to 1967, Fletcher, C. M. 71 .0981 Cigarettes and Respiratory Disease, 71.0085 Chronic Nonspecific Respiratory Disease, Berlin, New International Studies in Chronic Respiratory Disease, Hampshire,1961-1967: A Cross-SectionalStudy, 71.0233 71 -1161 Flint, G. L. Fiabane, L. Influence of Cigarette Smoke on Guinea Pigs. Effect on [Smoking Habits Among Secondary School Students in PulmonaryCellsand SerumAntitrypsinLevels, Belluno.) , 71-0797 71.0198 Fingerland, A. Fodor, J. Contributiontothe Investigation of the Effect of [Smoking3:.dCoronaryDisease(4): The Prague Cigarette Smoking, 71-1133 Study.) , 7143122 Finklea, J. F. Smoking and Coronary Disease (4): The Prague Study, Cigarette Smoking and Acute Non-I nfluenzal 71.0476 Respiratory Disease in Military Cadets, 71 -0613 Fodor, J. T. CigaretteSmoking and Hemagglutination Inhibition CurriculumDevelopmentand Implementationof Responseto Influenza After Natural Disease and Smoking ResearchA Longitudinal Study, 71.0326 Immunization, 71.0888 Fontan, M.E.C. Finlayson, A. [An Approach for the Fight Against Tobacco Poisoning. Mesothelioma in Scotland, 71.0062 Epidemiologic Data on a Group of Adults of Both Finley, T. N. Sexes.) , 71.0376 The Ultrastructure of Alveolar Macrophages From Food and Cosmetics Toxicology. Human Cigarette Smokers and Nonsmokers, 71-0627 Polybenzoid Hazards, 71-0552 Alveolar Macrophages.StructuralandFunctional Forbes, W. H. Differences Between Nonsmokers and Smokers of Carbon Monoxide Uptake Via the Lungs, 71.0721 Marijuana and Tobacco, 71-0828 Ford, Z. T. Finnegan, A. "Ripening" Tobacco With the Ethylene-Releasing Agent Nutritional and Epidemiologic Factors Related to Heart 2-Chloroethylphosphonic Acid, 71-0409 Disease, 71-0776 Forster, R. E. Finster, M. Carbon Monoxide and the Partial Pressure of Oxygen in Effects of Environmental Chemicals on the Metabolism Tissue, 71.0553 of Drugs, Carcinogens, and Normal Body Constituents Forster, R. E. in Man, 71-0812 Effects of Chronic Exposure to Low Levels of Carbon Fischer, G. MonoxideonHuman Health,Behavior,and [The Causality of Bladder Tumors (As Related to Performance, 71-0399 Cigarette Consumption).), 71-0242 Forster, W. Smoking Habits and Bladder Tumors. A Clinical Study, [Anamnestic Investigation of Gastric and Duodenal 71 -0992 Ulcers.) 971.0680 Fiser, F. Forwerg, W. [Dependence of the Bronchial Secretion and Cough [Determination of Nicotine in the Air of a Working Symptoms on the Microbial Flora in the Bronchial Area.) , 71-0961 Tree of Chronic Lung Disease Patients.) , 71-1159 Foumaud, S. Fisher, A. B. Precipitation Reaction Between Certain Human Sera and Effect of Carbon Monoxide on Function and Structure Soluble Tobacco Extracts, 71-0505 of the Lung, 71.0271 Fournier, E. Fisher, D. E. [Tobaccoism, Bullous Emphysema and Spontaneous Air Pollution in Nurseries: Correlation With a Decrease Idiopathic Pneumothorax.) , 71-0286 in Oxygen-Carrying Capacity of Hemoglobin, 71-0641 [The Lung and Tobacco.) , 71-0441 Fisher, K. D. Lung and Tobacco, 71-1014 Dark Adaptation and Night Vision, 71-0679 Frahm, B. Fisher, K. D. [MeasurementofFluoresceneinCigarette Smoke A Review of the Biomedical Effects of Marihuana on Condensate.), 71 -0372 Man in the Military Environment, 71-0197 Frankenhaeuser, M. Fitzgerald, D. E. Behavior and Circulating Catecholamines, 71-1078 Nutritional and Epidemiologic Factors Related to Heart Behavioural andPhysiologicalEffects of Cigarette Disease, 71-0776 Smoking in a Monotonous Situation, 71-1239 Fleischman, A. I. Frantz, 1. D. (Jr.) The 5-Year Experience of Modified Fat Diets on Cancer Among Men on Cholesterol-Lowering Diets. Younger Men With Coronary Heart Disease, 71 -0110 Experience From Five Clinical Trials, 71-1137 Fleischman, W. A. Frasca, J. M. Smoking Behavior, 71-1075 ElectronMicroscopicObservationsonPulmonary Smoking Behavior. Data Book, 71.1076 Fibrosis and Emphysema in Smoking Dogs, 71-0863 The Potential of Organizational Coordination as an Fraumeni, J. F. (Jr.) InterventionProcess:Applied to the Problem of Certain Mortality Patterns of Esophageal Cancer in the Cigarette Smoking and Health, 71-1083 United States, 1930-67, 71-0051

*Individual has contributed to this reference but is not listed as part of the main citation.

257 CUMULATIVE AUTHOR AND ORGANIZATIONALINDEX

Fredrickson, D. T. of D-Glucose, Sucrose, and Their Degradation Products The Primary PhysicianinOfficeManagement of to the Smoke, 71-0813 Smoking Problems, 71-0344 Tobacco Additives andCigarette Smoke. Part11. Freeman, G. Organic, Gas-Phase Products From Dx.11ucose and Ultrastructural Changes in Connective Tissue in Lungs of Sucrose, 71-0814 Rats Exposed to NO2, 71-0461 Gajaraj, A. French, J. E. Roentgen Features of Giant Cell Carcinoma of the Lung, Atherogenesis and Thrombosis, 71-0889 71-0587 Freour, P. Galante, M. [An Approach for the Fight Against Tobacco Poisoning. Oral Cancer, 71-1152 Epidemiologic Data on a Group of Adults of Both Galy, P. Sexes.] , 71-0376 [ Symposium on Chronic Bronchitis. I. Nosology and [Epidemiologic StudyofChronic Bronchitis and Epidemiology.), 71-0614 Respiratory Insufficiency. Prevalence in a Sample of Gambhir, S. S. Women 30 to 70 Years of Age.), 71-0436 Effects of Acetylcholine and Carbachol on the Blood Epidemiological Research on Chronic Bronchitis and Vessels of the Frog, 71-0016 Respiratory Insufficiency. Study of Prevalence ina Gandevia, B. Sample of Women From 30 to 70 Years, 71-1010 Respiratory Symptoms and Skin Reactivity in Workers Friberg, L. Exposed to Proteolytic Enzymes in the Detergent The Validityof Questionnaire Diagnosis."Angina Industry, 71-0623 Pectoris," 71-1206 Gangadharan, P. Friberg, L T. (Editor). The Problem of Gastro-Intestinal CancerinIndia, Twin Registries in the Study of Chronic Disease With 71-0596 Particular Reference to the Relation of Smoking to Garbe, E. Cardiovascular and Pulmonary Diseases, 71-1193 [Tobacco and Cancer. EpidemiologicalProblems.) , FriedeU,G. H. 71-1139 Smoking and Cancer of the Lower Urinary Tract, Garcia, G. 71-0054 [Cancer of the Larynx.), 71-0588 Friedman, M. Garcia, M. J. The Central Nervous System and Coronary Heart Serum Lipid Precursors of Coronary Heart Disease, Disease, 71-1056 71-0778 Frith, C. D. Garfinkel, L. The Effect of VaryingtheNicotine Content of Thickness of Walls of Myocardial Arterioles in Relation Cigarettes on Human Smoking Behavior, 71-0327 to Smoking and Age, 71-0106 Smoking Behavior and Its Relation to the Smoker's Longevity of Parents and Grandparents in Relation to Immediate Experience, 71-0328 Coronary Heart Disease and Associated Variables. Frost, D. M. 71-0124 The Physician's Role in the South Dakota Drug Scene, Effects of Cigarette Smoking on Dogs. 71-0428 71-0161 Epithelial Changes in Ex-Cigarette Smokers, 71-1155 Fry, J. N. Garofalo, P. PersonalityVariables and Cigarette Brand Choice, [Acute Accidental Poisoning at HomeFrom 71-1240 Vegetables.], 71-0017 Fulghesu, G. Gary, K. On the Incidence of Cardiovascular Disease Among the [Influence of the Locally Different Grade of Pollution Workers of the Mining industry of Sardinia. 2nd in the Township of Duisburg on the Incidence of Communication: Incidence in Relation to Habitual Non-Specific Respiratory Diseases. V Smoking and Consumption of Alcohol, 71-1033 Communication.), 71-0280 Fulginiti, S. Gasinska, T. Effectsof Alpha-Methyl Tyrosine and Adrenergic [The Harmful Effects of Chronic Tobacco Smoking.), Blocking Agents ontheFacilitating Action of 71-0244 Amphetamine and Nicotine on Learning in Rats, Gasthaus, L. 71-0212 The Epidemiology of Bronchopulmonary Symptoms in Effects of Learning, Amphetamine and Nicotine on the Coal Miners, Foundry Workers, Chemical Workers and Level and Synthesis of Brain Noradrenaline in Rats, Bakers, 71-0772 71-0554 Cause, E. M. Reaction of Nitrogen Dioxide With Blood and Lung Components.ElectronSpinResonanceStudies, 71-0571 Gadomska, H. Gauthier, H. [Epidemiological EvaluationoftheIncidence and [Respiratory Insufficiency in Canada.), 71-0615 Mortality Due to Pulmonary Carcinomainthe Gavrilescu, N. Population of the City of Warsaw in the Years [Pulmonary Compliance in Patients With Silicosis and 1963-1967.) , 71-0059 Normal Spirographic Values.], 71-0099 Gaffney, C. Gburek, Z. Determinants of Survival of the Dialysis Cannula, (The Harmful Effects of Chronic Tobacco Smoking.), 71-0128 71-0244 Gager, F. L. (Jr.) Gearty, G. F. Tobacco Additives and Cigarette Smoke. Part I. Transfer Mediscan: A Population Screening Programme for the

258 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX.

Detection of Coronary Heart Disease Risk Factors, Derbyshire, England, 71-0444 71-0653 Gima, A. S. Nutritional and Epidemiologic Factors Related to Heart Characteristics of Longshoremen Related to Fatal Coro- Disease, 71 -0776 nary Heart Disease and Stroke, 71-0659 Geller, 1. Gimpl, M. EffectsofNicotine,Nicotine Monomethiodide, Operant Conditioning and Self-Control of Smoking and Lobe line, Chlordiazepoxide, Meprobamateand Studying, 71-1266 Caffeine on a Discrimination Task in Laboratory Rats, Glass, L. H. 71-0927 Curriculum Development and Implementation of Smok- George, M. E. ing ResearchA Longitudinal Study, 71-0326 Hematological Effects of Long-Term Continuous Animal Glauser, M.-P. Exposure to Carbon Monoxide, 71-0843 [Alphal-Antitrypsin Deficiency Associated With Pulmo- of the George, R. nary Emphysema. A Contribution to the Study Some Effects of Nicotine on Gastric Secretion in Rats, Clinical Types of Patients.), 71-0761 [Alphai-Antitrypsin Deficiency Associated With Pulmo- 71-0512 Study of the Georgiev, S. nary Emphysema. A Contribution to the [Influence of the Density of Cigarettes on the Chemical Clinical Types of Patients. (Conclusion).) , 71-0762 Composition of the Smoke.) , 71-0018 Glauser, S. C. Gerhardt, T. Comments on Glauser Et Al's Article. (Letter), 71-0381 [Toxicityof Carbon MonoxideinMan Breathing Glick, S. D. Mixtures of CO and Air at Elevated Pressure.) , Titration of Oral Nicotine Intake With Smoking Be- 71-0962 havior in Monkeys, 71-0815 Gesztelyi, I. Glucksmann, A. Analysis of the Depolarizing Effect of Nicotine on The Influence of Carcinogenic Dosage and of Sex on the Frog's Skeletal Muscle, 71-0977 induction of Epitheliomas and Sarcomas in the Dorsal Ghise, 0. Skin of Rats, 71-1136 (Epidemiological Studies on Chronic Bronchitis in a Godber, G. Sample of the General Population of Bucharest.) , (The Price of a Pack of Cigarettes: Five Years of Life.) , 71-0451 71-0045 Ghosh, T. N. Goertz, E. A Study of Bronchogenic Carcinoma, 71-0745 [Experimental Studies on Intake and Deposition of Gianunona, S. T. Smoke Particles in Golden Hamsters When Exposed to Effectsof Cigarette Smoke onIncorporation of Cigarette Smoke.) , 71-0193 Radioisotopically Labeled Palau tic AcidInto Experimental Studies on the Intake and Deposition of Pulmonary Surfactant and on Surface Activity of Smoke Particles in the Passive Smoking of Cigarette Canine Lung Extracts, 71-0864 Smoke by Golden Hamsters, 71-0960 Giannelli, S. (Jr.) Gokina, M. S. Myocardial and Systemic Responses to [Myocardial Contractile Function in Workers Exposed Carboxyhemoglobin, 71-0288 to Prolonged Action of Small Concentrationsof Giannini, S. D. Carbon Monoxide.) , 71-1041 [Coronary Risk Factors.) , 71-0650 Goldbarg, A. N. Gibbs, G. W. Effects of Cigarette Smoking on Hemodynamics at Rest Mortality in the Cluysotile Asbestos Mines and Mills of and During Exercise. 1. Normal Subjects, 71-1042 Quebec, 71-0421 Goldenberg, M. M. Gibson, A.A.M. Relationship Between Chronic Vagal Denervation and Mesothelioma in Scotland, 71-0062 the Response of the Isolated Rat Ileum to Nicotine, Gibson, R. W. 71-0963 Cessation of Patterned Behavior: Withdrawal From Goldfarb, I. Action of Nicotine on Reflexes in Spinal Cats, 71-0816 Smoking, 71-1080 on Giese, H. EffectsofNicotine and RecurrentInhibition [12. Personality Characteristics.) , 71-0798 Monosynaptic Reflexes in Acute and Chronic Spinal Gilani, S. H. Cats, 71-0964 Nicotine and Cardiogenesis. An Experimental Study, Goldman, H. M. 71-1198 Carcinogenic Effect of a Dimethyl Sulphoxide Extract Gilder, S.S.B. of Betel Nut on the Mucosa of the Hamster Buccal Cigarettes and Gastric Secretion, 71-1218 Pouch, 71-0435 Gilgen, A. Goldman, M. D. [Toxicological and Physiological Investigation on Acro- Chronic Nonspecific Respiratory Disease, Berlin, New lein Inhalation in the Mouse.) , 71-0034 Hampshire,1961-1967: A Cross-SectionalStudy, [Air Pollution and Health.) , 71-0555 71-1161 Gillis, C. R. Goldschmidt, B. M. Multiphasic Screening Findings in Volunteers Examined Cocarcinogenesis Studies on Mouse Skin and Inhibition at the Chest and 'Heart Association Health Exhibition of Tumor Induction, 71-0415 in Glasgow, 71-0087 Goldsmith, J. R. Gilson, J. C. The New Airborne Disease. Community Air Pollution Smoking and Chronic Respiratory Disease: Finding in 71-0046 Surveys Carried Out in 1957 and 1966 in Staveley in Carbon Monoxide Uptake by Inspectors at a United

259 264 CUMULATIVE AUTHOR AND ORGANIZATIONALINDEX

StatesMexico Border Station, 71-0116 Carbon Monoxide Uptake in [Toxicity of Carbon Monoxide in Man BreathingMix- Cigarette Smoking, tures of CO and Air at Elevated Pressure.], 71-0962 71-0117 Gottlieb, A. J. Prospects for the Prevention of DisablingPulmonary Disease, 71-0272 The Effects of Deoxygenation of Adult andFetal Hemoglobin on the Synthesis of Red Cell2,3-Dephos- Contribution of Motor Vehicle Exhaust, Industry,and phoglycerate and Its In Vivo Consequences, 71-0132 Cigarette Smoking to Community CarbonMonoxide Gough, C. Exposures, 71-0377 Smoking, Drugs and Alcohol in DublinSecondary Carbon Monoxide: Association ofCommunity Air Schools, 71-1086 Pollution With Mortality, 71-0384 Graczyk, J. *Goldsmith, J. R. [Chronic Bronchitis and Assessment of Respiratory Effects of Chronic Exposure to Low Levelsof Carbon F unctioninConvalescentsAfterTuberculosis.], Monoxide on Human Health, Behavior,and Perfor- 71-1162 mance, 71-0399 Graham, J.D.P. Goldstein, H. PossibleTeratogenicEffect of Cigarette Smoking, Response to Acetylcholine and Nicotine of the Perfused 71-0674 Vessels of the Rabbit Ear, 71-0199 Graham, J. F. Factors Influencing the Height of Seven Year Old Cigarette Smoke Analysis by Compu ter GLC, 71-0200 ChildrenResults From the National ChildDevelop- Graham, S. ment Study, 71-1219 V. Smoking Withdrawal in the Reduction of Risk ofLung Cancer, 71-0245 (Epidemiologic Study of Non-specific Bronchopathies.], 71-0442 Cessation of Patterned Behavior: WithdrawalFrom Smoking, 71-1080 [Study of Current Prevalence of ChronicBronchitis in Grandjean, E. an Urban Population.] , 71-0763 (Toxicological and Physiological Investigation Epidemiological Study of Non-specific Bronchopathies, on Acro- lein Inhalation in the Mouse.), 71-0034 71-0865 Grandstaff, N. [Study of the Smoking Habit.], 71.1241 Carbon Monoxide Exposure and CerebralFunction, Golovchiner, 1. Y. 71-0358 [Some Social Factors in the Incidence of Myocardial Behavioral Responses to Small Doses ofCarbon Mon- Infarct.] , 71-1199 oxide, 71-0809 Goni, J. Grannis, G. F. Incidence of Pulmonary Ferruginous Bodies inFrance, Cigarettes and Heart Disease. (Letter), 71-0646 71-0424 Grant, A. K. Gopinath, N. Personality Pattern and Emotional Stress in theGenesis Bronchial CarcinomaAn Analysisof 120 Cases, of Gastric Ulcer, 71-0785 71-0589 Gastric Ulcer in South Australia, 1954-1963.2. Symp- Gordon, T. toma tology and Response to Treatment, 71-1216 Premature Mortality From Coronary Heart Disease.The Green, D. P. Framingham Study, 71-0651 The 5-Year Experience of Modified FatDiets on Section 27. Coronary Heart Disease, A therothrombotic Younger Men With Coronary Heart Disease, 71-0110 Brain Infarction, Intermittent ClaudicationAMulti- Green, G. M. variate Analysis of Some Factors Relatedto Their Investigation on the Effects of Cigarette Smokeon Incidence: Framingham Study, 16-YearFollowup, Rabbit Alveolar Macrophages, 71-1023 71-1043 Greenberg, M. Gordon, W. W. Survey of Workers Exposed to Dusts ContainingDeriva- The Treatment of Alcohol (and Tobacco) Addictionby tives of Bacillis Subtilis, 71-0086 Differential Conditioning. New Manual and Mechanical Greenblatt, M. Methods, 71-0951 Nitrosamine Studies: Induction of Lung Adenomasby Gore, J. Concurrent Administration of Sodium Nitrile andSec- Nutritional and Epidemiologic Factors Relatedto Heart ondary Amines in Swiss Mice, 71-0753 Disease, 71-0776 Greene, D. Gorrod, J. W. Smoking Habits of Physicians and Their Wives,71-0928 The Analysis of Nicotine -1 -N-Oxide inUrine, in the Greene, G. R. Presence of Nicotine and Cotinine, andIts Application Thromboembolism and Oral Contraceptives: An Epi- to the Study of In Vivo Nicotine Metabolism inMan, demiologic Case-Control Study, 71-0664 71-1107 Greenwald, P. Smoking Habits of Physicians and Their Wives, The Effect of Smoking on Nicotine MetabolismIn Vivo 71-0928 in Man, 71-1108 Greer, D. L. Gossett, J. T. A Tobacco Related Epidemic of CongenitalLimb Deformities in Swine, 71-0790 Extent and Prevalence of Illicit Drug Useas Reported by 56,745 Students, 71-1079 Gregory, J. Gothert, M. A Study of 340 Cases of Chronic Bronchitis, 71-0273 Greisen, O. [Effects of Low Carbon Monoxide Concentrationsin Man.] , 71-0321 The Bronchial Epithelium. Nucleic AcidContent in Carbon Monoxide Partial Pressure in Tissue of Different Morphologically Normal, Metaplastic and Neoplasdc Animals, 71-0722 Bronchial Mucosae. A MicrospectrophotometricStudy of Biopsy Material, 71-0754

*Individual has contributed to this referencebut is not listed as parted' the main citation. 260 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Grenier de Rucre, P. Gulcria, J. S. [Food. Drink. Tobacco. Study of a Representative Bronchial CarcinomaAn Analysisof120Cases, Sample of 706 Men, 21to 65 Years of Age, at 71-0589 Saint - Etienne. Chapter VI. Alcohol and Tobacco.] , Gupta, M. 71-0921 Ultrastructure of Human Oral Mucosa After Prolonged Grimwadc, J. Exposure to Tobacco, 71-0789 Smoking and Neuroticism. (Letter), 71-1248 Gupta, P. C. Groenen, P. J. Reverse Smoking in Andhra Pradesh, India: A Study of [Chemical Aspects of Cigarette Smoke.] , 71-0201 Palatal Lesions Among 10,169 Villagers, 71-0690 Flame Photometric Detection of Volatile Sulphur Com- Gupta, R. G. pounds in Smoke From Various Types of Cigarettes, Bronchial CarcinomaAn Analysisof120Cases, 71-0556 71-0589 Croke, M. Gupta, R. S. A Study of Children's Smoking Habitsin Kerry, Effect of Ganglion Blocking Agents on Spontaneous and 71-0171 Adrenaline-Induced Ventricular Ectopic Tachycardia Grosgogeat, Y. Following Coronary Occlusion, 71-0294 [Tobacco and Coronary Disease.( , 71-0895 Gutierrez, M. T. Gross, P. Some Physico-Chemical Characteristics of Acute Myo- Some Aspects of Pneumoconiosis, 71-1015 cardial Infarction Among Manila Residents, 71-0123 Gross, W. Gyselen, A. Changes of the Serum Lipids Due to Smoking, 71-0890 (Etiology of Bronchial Carcinoma.) , 71-0741 Grover, R. F. Cigarette Smoking as a Cause of Hypoxemia in Man at Altitude, 71-0470 Grunwald, C. Cholesterol in Cigarette Smoke Condensate, 71-0019 Haase, E. Gsell, 0. R. [Measurable Effects on the EOG by Cigarette Smok- Epidemiology of Bronchial Carcinoma in a Mountain ing?] , 71-0557 Region, 71-1140 Haddow, A. J. Guarona, P. The Future and Lung Cancer, 71-0047 [Action of Nicotine on Cells Cultured In Vitro. 71-0033 Haebisch, H. Gubinelli, C. The Cigarette as a Source of Carbon Monoxide, 71-0021 (Statistical, Clinical, and Radiotherapeutic Observations Hagerup, L. of 131 Cases of Malignant Bronchogenic Neoplasms.] , [Tobacco Smoking and Respiratory Symptoms in a 71-0993 Danish Population. From a 50-Year Study in Glo- Guenter, C. A. sirup.] , 71-0866 Alphas-Antitrypsin Deficiency: Heterozygosity, Inter- (Tobacco Smoking and the Risks of Coronary Disease. mediate Levels, and Pulmonary Disease, 71-0443 From a 50-Year Study in Glostrup.(, 71-0891 Alphas - Antitrypsin Deficiency and Pulmonary Emphy- [Smoking and Hematocrit and Hemoglobin Levels. sema, 71-0477 From a 50-Year Study in Glostrup.) , 71-0894 An Epidemiological Approach to Chronic Obstructive Relationship Between Cigarette Smoking and High Pulmonary Disease and Alphas- Antitrypsin in Hospital Packed Cell Volume and Haemoglobin Levels, 71-1047 Patients: A Tri-Racial Study, 71-0616 Haglund, S. Guerin, M. (The Role of Attitude Theories in Measuring the Effect (Inhibiting Action of Chemical Carcinogens on the of Information.] , 71-1242 Mitosis in the Cultures of Pulmonary Cells of Rats. I. Hakama, M. Study of 3,4-Benz opyrene.I , 71-0020 Age-Adjustment of Incidence Rates in Cancer Epidemio- Guerin, M. R. logy, 71-0048 Tobacco Smoke Analysis Program Progress Report for Hall, G. H. the Period January 1, 1970, to September 1, 1970, Hypothermia Produced by Nicotine Perfused Through 71-0202 the Cerebral Ventricles of the Unanaesthetized Mon- Guerre, J. key, 71-0818 (Delayed After - Effects of Gastrectomy4 , 71-1069 Halliwell, J. V. Guertzenstein, P. G. Uptake of Nicotine and Extracellular Space Markers by Stimulation by Nicotine of a Vasodilator Area on the Isolated Rat Ganglia in Relation to Receptor Activa- Floor of the Fourth Ventricle, 71-0378 tion, 71-0359 Guilfoyle, P. Hames, C. G. Pulmonary Tuberculosis, lsoniazid and Cancer, 71-0052 Occupation and Physical Activity and Coronary Heart Guillerm, R. Disease, 71-1034 (Composition andBiologicalEffectsof Tobacco Body Weight and Cigarette Smoking as Risk Factors, Smoke.(, 71-0817 71-1044 Guillerme, R. Hammarsten, J. F. (Determination of Nicotine by Gas-Phase Chromatog- Alphas- Antitrypsin Deficiency: Heterozygosity, Inter- raphy.11. Applications.( , 71-0362 mediate Levels, and Pulmonary Disease, 71-0443 Guira, A. C. Alphas Antitrypsin Deficiency and Pulmonary Emphy- Bladder Carcinoma in Rubber Workers, 71-1141 sema, 71-0477 Gulati, J. An Epidemiological Approach to Chronic Obstructive ainico-Pathological Study of Cancer of the Larynx, Pulmonary Disease and Alpha' Antitrypsin in Hospital 71-0994 Patients: A Tri-Racial Study, 71-0616

261 ?MR CUMULATIVE AUTHOR ANDORGANIZATIONAL INDEX

Hammen, C. L. Harris, H. Motivation, Structure, and Self-Monitoring: Role of Pulmonary Emphysema and Alphal-Antitrypsin Nonspecific Factors in Smoking Reduction,71-0935 Defi- Hammer, D. I. ciency, 71-0275 Harris, J. O. Cigarette Smoking and Acute Non-Influenza!Respira- tory Disease in Military Cadets, 71-0613 Human Alveolar Macrophages: Comparisonof Phago- Cigarette Smoking and Hemagglutination cytic Ability, Glucose Utilization, andUltrastructure Inhibition Re- in Smokers and Nonsmokers, 71-0146 sponse to Influenza After Natural Disease and Im- Harrison, R. C. munization, 71-0888 Hammond, E. C. Effect of Nausea on Human GastricSecretory Re- sponses, 71-0309 Thickness of Walls of Myocardial Arterioles inRelation to Smoking and Age, 71-0106 Effect of Cigarette Smoking on Human GastricSecre- tory Responses, 71-0367 Longevity of Parents and Grandparents in Relationto Hartman, L. A. Coronary Heart Disease and AssociatedVariables, 71-0124 [Coronary Disease Risk Factors in YoungManagers.] , 71-0900 Effects of Cigarette Smoking un Dogs, 71-0428 Hartmann, R. Inorganic Particles in Cigars and Cigar Smoke, 71-0966 Effects of Nicotine, Nicotine Monomethiodide, Epithelial Changes in Ex-Cigarette Smokers,71-1155 Lobe- Hamner, J. E. line, Chlordiazepoxide, Meprobamate andCaffeine on An Epidemiologic and Histopathologic a Discrimination Task in Laboratory Rats, 71-0927 Study of Leuko- Hasenfus, J. L. edema Among 50,915 Rural IndianVillagers, 71-0681 Hamza, J. Cigarettes and Health Education Among YoungPeople, 71-0929 [Chemical Investigation on Domestic Cigarettes, Espe- Hashimoto, K. cially the Newest Products of the Past Year.], 71-0022 Hancock, J.C. Nicotinic Acetylcholine Receptors SubservingNoci- ception in the Dog Hindlimb, 71-0222 Nicotine-Induced Depolarization andStimulation of Potassium Efflux in Striated Muscle, 71-0382 Pharmacological Features of the Gall Bladder andIts Vascular Bed of the Dog In Situ, 71-0841 Haning, H. Hasleton, S. Smoking and Cancer of the LowerUrinary Tract, The Incidence and Correlates of Marihuana Usein an 71-0054 Australian Undergraduate Population, 71-1081 Hanks, T. G. Hasselblad, V. Human Performance of a Psychomotor Test as a Func- Cigarette Smoking and Acute Non-InfluenzalRespira- tion of Exposure to Carbon Monoxide,71-0379 tory Disease in Military Cadets, 71.0613 Hanna, M. G. (Jr.) (Editor). Cigarette Smoking and Hemagglutination InhibitionRe- M orphology of ExperimentalRespiratory Carcino- sponse to Influenza After Natural Disease and Im- genesis, 71-1148 munization, 71-0888 Hanninen, .1. Hattori, K. The Smoking Habits of Finnish Physicians,71-1257 Hardinge, M. The Relationship Between External CalciumConcentra- tion and the Recovery Rate of Aortic Effects of Smoking on Body Mechanisms,71-0617 Strips From Harefuah. Nicotine Tachyphylaxis, 71-0975 Haun, C.C. [An Investigation of the SmokingHabits Among Israeli Physicians and Its Implications.] Hematological Effects of Long-TermContinuous Ani- , 71-1243 mal Exposure to Carbon Monoxide, 71-0843 Harke, H.-P. Hauser, G. A. The Problem of "Passive Smoking",71-0023 [Voluptuaries in Pregnancy.], 71-0910 [Experimental Studies on Intake andDeposition of Haust, M. D. Smoke Particles in Golden HamstersWhen Exposed to Spontaneous Lesions of the Aorta inthe Rabbit, Cigarette Smoke.], 71-0193 71-0295 [The Alkylating Effect of Cigarette Smoke.), 71-0373 Hawthorne, V. M. [Cigarette Smoke Condensates for AnimalTests. 2. A Multiphasic Screening Findings in VolunteersExamined New Practical Method of Preparationto Preserve the at the Chest and Heart Association HealthExhibition Volatile Components of theSmoke in the Solution.), in Glasgow, 71-0087 71-0375 Hay, D. R. [Cigarette Smoke Condensate for Animal Tests. 3. In- Changes in Smoking Habits in Men vestigations of the Volatile Componentsof Solutions Under 65 Years of Smoke Condensates.) After Myocardial Infarction andCoronary Insuffi- , 71-0380 ciency, 71-0125 [Appearance of Norbornene Derivativesin Tobacco Haynes, J. L. Smoke Condensates.], 71-0558 Contribution tothe Problem of Passive Smoking, Comments on Glauser Et Al's Article.(Letter), 71-0381 71-0819 Hayton, T. The 5-Year Experience of Modified Experimental Studies on the Intakeand Deposition of Fat Diets on Smoke Particles in the Passive Younger Men With Coronary HeartDisease, 71-0110 Smoking of Cigarette Hazra, D. K. Smoke by Golden Hamsters, 71-0960 Primary Carcinoma of Lung: [Analytical Investigation of GasPhase Condensate.), Clinico-Pathological Study 71-1125 of 35 Cases, 71-0432 Harland, W. A. Hedrick, J. L. The Problems of Atherosclerosis, 71-0478 Cigarettes and the Economy, 71-0177 The Economic Costs of CigaretteSmoking, 71-0231

262 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Heermann, H. Hampshire, 1961 -1967: A Cross-Sectional Study, [Epidemiology, Pathogenesis, Sex Distribution, Radia- 71-1161 tion Therapy and Statistics of Laryngeal and Higgins, M. W. Hypopharyngeal Carcinomas. Experiences With 1121 Smoking and Chronic Respiratory Disease: Finding in Cases (1946-1969).] , 71.0058 Surveys Carried Out in 1957 and 1966 in Staveley in Heffernan-Fox, F. C. Derbyshire. England, 71-0444 Nutritional and Epidemiologic Factors Related to Heart Electrocardiographic Patterns in Persons With Bronchitis Disease, 71-0776 and Without Bronchitis in Tecumseh, 71-0872 Hegsted, D. M. Chronic Nonspecific Respiratory Disease, Berlin, New Nutritional and Epidemiologic Factors Related to Heart Hampshire, 1961-1967: A Cross-Sectional Study Disease, 71-0776 71-1161 Heim, F. Hilfinger, M. F. (Jr.) Ca techolainine-Independent Glycogenolysis inBrain Unheeded Signals of Fatal Coronary Artery Disease, During Carbon Moroxite Poisoning, 71-0194 71-1196 (Metabolites of Carbohydrate Metabolism and High- Hill, D. Energy Phosphates in the Brain of Mice After Re- Peer Group Conformity in Adolescent Smoking and Its peated Carbon Monoxide Poisoning.) , 71-0195 Relationship to Affiliation and Autonomy Needs, Heinig, P. 71-1244 The Effect of Carbon Monoxide on Human Perfor- Hill, M. mance, 71-0398 Nutritional and Epidemiologic Factors Related to Heart Low Level Carbon Monoxide Exposure and Human Disease, 71-0776 Psychomotor Performance, 71-0400 Hilton, D. D. Henderson, E. G. Access and Attitudes to Smoking. (Letter), 71-0930 Nicotine-Induced Depolarization and Stimulation of Himanen, P. Potassium Efflux in Striated Muscle, 71-0382 The Smoking Habits of Finnish Physicians, 71-1257 Henderson, L. Hinkle, L. E. (Jr.) Alphas-Antitrypsin Deficiency: Heterozygosity, Inter- The Antecedents of Myocardial Infarction and Sudden mediate Levels, and Pulmonary Disease, 71-0443 Death ina Cohort of Actively Employed Men, An Epidemiological Approach to Chronic Obstructive 71-1045 Pulmonary Disease and Alphas Antitrypsin in Hospital Hirayama, T. Patients: A Tri-Racial Study, 71-0616 A Prospective Study on the Influence of Cigarette Hengy, H. Smoking and Alcohol Drinking on the Death Rates for The Determination of Malathion Residues in Tobacco Total and Selected Causes of Death in Japan, 71-0982 and Tobacco Smoke Condensate, 71-0383 Hirvonen, L. The Determination of Thiodan and Thiodan Sulphate Smoking Among the Female Workers of a Cotton Mill, on Tobacco and in Smoke Condensate, 71-1117 71-0517 Henry, H. B. (The Child, Tobacco, and the Pediatrician.) , 71-0931 Eustachian Tube Blocking: A Method of Treatment, Hislop, I. G. 71-0911 Gastric Ulcer in South Australia, 1954-1963. 2. Sympto- Hess, H. matology and Response to Treatment, 71-1216 On "Passive Smoking", 71-0024 Hloucal, L. Smoking and Arterial Circulatory Disturbances of Extre- [Etiopadiogenesb and Prophylaxis of Coronary Athero- mities, 71-0479 sclerosis (II).] , 71-1046 New Considerations on the Phydopathology of Obli- Hnilica, V. S. terating Anglopathies. Part2. Pathogenesis and Padiophysiology of Hereditary Emphysema, 71-1184 Therapy, 71-0652 Hoffman, D. A Contribution to the Problem of "Passive Smoking", Facilitating Effects of Daily Contact Between Partners 71-0723 Who Make a Decision to Cut Down on Smoking, Heater, A. C. 71-0345 Carbon Monoxide: Association of Community Air Pol- Hoffmann, D. lution With Mortality, 71-0384 A Study of Tobacco Carcinogenesis. XI. Tumor Initia- Heyden, S. tors, Tumor Accelerators, and Tumor Promoting Acti- Occupation and Physical Activity and Coronary Heart vity of Condensate Fractions, 71-0203 Disease, 71-1034 Chemical Studies on Tobacco Smoke. XI. Dibenzo- Body Weight and Cigarette Smoking as Risk Factors, furans in Cigarette Smoke, 71-0385 71-1044 Chemical Studies on Tobacco Smoke. X111. Inhibition Hickey, N. of the Pyrosyntheses of Several Selective Smoke Con- Mediscan: A Population Screening Programme for the stituents, 71-0402 Detection of Coronary Heart Disease Risk Factors, Holland, R A.B. 71.0653 Reaction Rates of Carbon Monoxide and Hemoglobin, Higgins, A. 71-0386 A Studyfin Human Antepartum Nutrition, 71-1 230 Holle, W. Higgins, I.T.T. [Cigarette Smoke Condensates for Animal Tests. 1. Pre- Smoking and Chronic Respiratory Disease: Finding in paration and Routine Control.] , 71-0374 Surveys Carried Out in 1957 and 1966 in Staveley in Holly, R. G. Derbyshire, England, 71-0444 Maternal Nutrition andthe Course of Pregnancy, Chronic Nonspecific Respiratory Disease, Berlin, New 71-0508

Individud has contributed to this reference but is not listed as part of the main citation.

263 2,435 CUMULATIVE AUTHOR AND JRGANIZATIONALINDEX

Holubitsky, I. B. Hubay, C. H. Effect of Nausea on Human Gastric SecretoryRe- sponses, 71-0309 Late Occlusion of Aortofemoral Bypass Grafts:Influ- ence of Cigarette Smoking, 71-1213 Effect of Cigarette Smoking on Human GastricSecre- Huber, T. E. tory Responses, 71-0367 Dark Adaptation and Night Vision, 71-0679 Homburger, F. Huckauf, H. Mechanical Irritation, Polycyclic Hydrocarbons, and (Changes in Pulmonary Function of Young People Snuff. Effects on Facial Skin, Cheek Pouch, and Oral as a Result of Cigarette Smoking Over ManyYears.) , Mucosa in Syrian Hamsters, 71-1142 71-1163 Hook, H. L. Hueper, W. C. Fibrous Glass Manufacturing and Health. Results ofa Public Health Hazards From EnvironmentalChemical Comprehensive Physiological Study: Part II, 71-0618 Carcinogens, Mu tagens and Teratogens, 71-1144 Hooper, P. A. Huff, J. E. The Effects of "Autonomic Drugs" on Villous Move- Dark Adaptation and Night Vision, 71-0679 ment in the Small Intestine of the Pigeon, 71-0025 Huffman, W. J. Hoover, R. Antismoking Education Study at the Universityof Population Trends in Cigarette Smoking andBladder Illinois, 71.1236 Cancer, 71-1143 Hugh-Jones, P. Horiguchi, T. Pulmonary Emphysema and Alpha' -Antitrypsin Defi- Pharmacologic Effects of Nicotine Upon the Fetus and ciency, 71-0275 Mother in the Rhesus Monkey, 71-1130 Horn, D. Hughes, M. J. Factors Affecting the Cessation of Cigarette Smoking:A Effect of Cigarette Smoke on the Cardiovascular System Prospective Study, 71-0162 in Dogs, 71-0883 Epidemiology and Psychology of Cigarette Smoking, Hughes, R. E. 71-0516 Ascorbic Acid and Serum-Cholesterol. (Letter), 71-0474 The Smoking Problem in 1971. (Unpublished),71-1100 Humperdinck, C. Horvath, S. M. [Lungs and Occupational Cancers.], 71-0852 Carbon Monoxide and Human Vigilance. A Deleterious Hunscher, H. A. Effect of Present Urban Concentrations, 71-0965 Maternal Nutrition and the Course of Pregnancy, Horwitz, 0. 71-0508 Results of Screening Patients for Peripheral Vascular Hunt, W. A. Disease by Paramedical Personnel, 71-0892 Relapse Rates in Addiction Programs, 71-1099 Hosko, M. J. Huriburt, J. F. The Effect of Carbon Monoxide on the Visual Evoked Study of Asbestos Workers inBritish Columbia, Response in Man. And the Spontaneous Electroen- 71-0429 cephalogram, 71-1220 Hurley, R. J. Houdaille, J. Ascorbic Acid and Serum-Cholesterol. (Letter), 71-0474 [Epidemiology of Tobacco inFrance andinthe Husak, T. World.] , 71-0954 Contribution to the Investigation of the Effect of Ciga- Howard, E. B. rette Smoking, 71-1133 Studies of Inhaled Radon Daughters, UraniumOr Dust, Hutchison, D.C.S. Diesel Exhaust, and Cigarette Smoke in Dogsand Pulmonary Emphysema and AlpharAntitrypsinDefi- Hamsters, 71-0599 ciency, 71-0275 Cocarcinogenic Studies in Pulmonary Carcinogenesis, Huttemann, U. 71-0999 [Changes in Pulmonary Function of Young Peopleas a Howard, P. Result of Cigarette Smoking Over Many Years.], A Long-Term Follow-up of Respiratory Symptomsand 71-1163 Ventilatory Function in a Group of WorkingMen, Huttner, H. 71-0274 Howell, B. [Motivation in Health Behavior. Part I.], 71-0049 Routine Pre- and Post-Operative Physiotherapy. [Motivation to Stay Healthy. Part 3.], 71-0163 Results [Motivation in Health Behavior. Part 4.], 71-1245 of a Trial, 71-0715 Huttner, I. Howes, C. D. [Motivation in Health Behavior. Part I.] Accumulation of Lycopene and Inhibition of Cyclic , 71-0049 [Motivation to Stay Healthy. Part 3.], 71-0163 Carotenoids in Mycobacterium in the Presenceof [Motivation in Health Behavior. Part 4.1, 71-1245 Nicotine, 71-0820 Hyatt, R. E. Hrubec, Z. (Editor) Maximal Static Respiratory Pressures in Generalized Twin Registries in the Study of Chronic DiseaseWith Neuromuscular Disease, 71-0610 Particular Reference to the Relation of Smokingto Pulmonary Function in Coal Workers' Pneumoconiosis, Cardiovascular and Pulmonary Diseases, 71-1193 71-0764 Hrubes, V. Hyde, R. W. The Effect of Filtrate Fractions of Tobacco Smoke on Effect of Carbon Monoxide on Function andStructure Swimming Endurance in the Rat, 71-0675 of the Lung, 71-0271 Hsu, IN. Hytten, F. E. The Effects of Smoking Withdrawalon Quantitatively Maternal Nutrition and the Course of Pregnancy, Analyzed EEG, 71-0502 71-0508

Individual has contributed to this referencebut is not listed as part of the main citation. 264 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Ibrahim, A. B. lsrael-Asselain, R. Nicotine Effects on Alveolar Macrophage Respiration (Symposium on Chronic Bronchitis. :. Nosology and and Adenosine Triphosphatase Activity, 71-0211 Epidemiology.' , 71.0614 Igiene e Sanita Pubblica ltil, T. M. (Educational Health Campaign Against Smoking in the The Effects of Smoking Withdrawal on Quantitatively Town of Bologna.] , 71.0805 Analyzed EEG, 71-0502 Iglesias Leal, R. lvakhno, G. I. (Silent and Atypical Myocardial Infarct.], 71-0893 (Some Problems of the Etiological Community of Can- lida, T. cer of the Larynx and Lungs.' , 71-0246 Studies on the Antidotal Action of Drugs. Part I. Vita- (Role of Smoking in the Incideice of Lung Cancer.], min C and Its Antidotal Effect Against Alcoholic and 71-1147 Nicotine Poisoning, 71-0411 lvancev, V. lkonomides, S. Z. (Experimental Research on the Microclimate of To- (Influence of Smoking Habits on the Incidence of Non- bacco Fermentation Chambers.I.Morphological specific Respiratory Diseases. III. Communication.], Changes in the Internal Organs and Nervous System of 71-0096 Rabbits.] , 71-0357 Influence of Smoking Habits on the Incidence of Non- (Changes in the Activity of Adenosine Triphosphatase specific RespiratoryDiseases.Ill. Communication, and Succinic Dehydrogenase of the Liver, Kidneys, 71-0873 Heart and Brain of Rabbits Under the Influence of ll'in, G. S. Toxic Substances Formed in the Fermentation of To- Role of Aspartic Acid in the Biosynthesis of Nicotine bacco.], 71-0550 and Anabasine, 71-0561 Experimental Investigations on the Microclimate of To- lncukt, 1.1. bacco Fermentation Chambers.IV. Histochemical Particulates in Domestic Premises. I. Ambient Levels Changes in the Catecholamines of the Medullar Part of and Central Air Filtration, 71-0150 the Suprarenals in Rabbits, 71-0724 Ingenito, A. J. lvanov, N. G. An Analysis of the Effects of Nicotine on the Cerebral Volatile Fatty Acids 'n Tobacco, 71 -0725 Circulation of an Isolated, Perfused, In Sint Cat Brain Predecessors of Organic Acidin Tobacco Smoke, Preparation, 71-0204 71-0821 Inglis, W. (Influence of Porosity of Cigarette Paper on the Smoke Clinical Aspects of the Dyspneic Miner, 71-0760 Condensate and Its Composition.] , 71 -1118 Inoki, R. Ivanov, N. Y. Effects of Nicotine on Salivary Amylase Secretion From (Influence of Porosity of Cigarette Paper on the Smoke Rabbit Parotid Gland, 71 -0205 Condensate and Its Composition.] , 71-1118 Action of Tyramine on the Salivary Amylase Secretion Izard, C. From Rabbit Parotid Gland in Reference to That of (Mitoclastic Activity and Chromosomal Aberrations In- Nicotine, 71-0740 duced by Alpha and Beta Naphthonitrile Identified in Inoue, H. a Cigarette Smoke Tar Fraction.], 71-0725 Studies on the Antidotal Action of Drugs. Part I. Vita- (Action of the Gas Phase of Cigarette Smoke on the min C and Its Antidotal Effect Against Alcoholic and Ly mph oblastic Transformationof Small Human Nicotine Poisoning, 71-0411 Lymphocytes (Preliminary Observations).], 71-1195 Inui, N. Acceleration of Proliferation and Tumor Production Rate of L-Strain Cells by Treatment With Cigarette Jack, D. Tar, 71-1145 Investigation of Central Cholinergic Mechanisms in the Effect of Cigarette Tar Upon Tissue Cultuf Neo- Conscious Mouse, 71-0353 plastic Transformation of Hamster Lung Cells by To- Jackson, A. F. bacco Tar in Tissue f:ulture, 71-1 i46 Pressor Action of Nicotine Following 'Reversal' During lonescu, S. Alpha Adrenergic Blockade, 71-0213 (EpidemiologicalInvestigations on Ischemic Cardio- Jackson, G. C. pathy in Industry. Study of a Group Involving Mini- The Determination of Nicotine in Human Bldod by mal Physical Work (Engineers, Technicians, De- Gas-Liquid Chromatography, 71.0644 signers).] , 71-0897 Jackson, T. A. Irgens-Jensen, 0. Distribution of Inhaled Metal Oxide Particles in Pul- Drugs in NorwayAttitudes and Use, 71-0799 monary Alveoli, 71-0458 Irwin, R. P. Jacobs, D. Adolescent Cigarette Smoking, 71-0169 The Aetiology and Possible Prevention of Myocardial Adolescent Cigarette Smoking in Two Societies, Infarction, 71-0480 71-1250 Jacobs, L. Inger, H. Carotid Sinus Versus Carotid Body Origin of Nicotine (Smoking and Hematocrit and Hemoglobin Levels. and Cyanide Bradycardia in the Dog, 71 -0206 From a 50-Year Study in Glostrup.i , 71-0894 Jacobs, M. A. Relationship 9etween Cigarette Smoking and High Personality Patterns Associated With Heavy Cigarette Packed Cell Volume and Haemoglobin Levels, 71-1047 Smoking in Male College Students, 71-1246 Islam, M. S. Interaction of Personality and Treatment Conditions Changes of Ventilatory Function Amongst Smokers and Associated With Success in a Smoking Control Pro- Non-S:nokers, 71-0445 gram, 71.1262

26S CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Jacobson, E. D. Jaques, W. E. Effects of Nicotine on Gastrointestinal Secretions, Comparison of the Incidence and Site of Malignancies in 71-0683 Taipei, Taiwan and Little Rock, Arkansas. 71-0050 Effects of Nicotine on Gastric Secretion and Ulcer For- Larvik, M. E. mation in Cats, 71-1221 Titration of Oral Nicotine Intake With Smoking Be- Jacobson, H. N. havior in Monkeys, 71-0815 Maternal Nutrition and the Course of Pregnancy, Jaivinen, M. 71-0508 The Smoking Habits of Finnish Physicians, 71-1257 Jacobson, M. Jaurand, M. C. Effects of Environmental Chemicals on the Metabolism Incidence of Pulmonary Ferruginous Bodies in France, of Drugs, Carcinogens, and Normal Body Constituents 71-0424 in Man, 71-0812 Jelonkiewicz, J. Jacotot, B. [Chronic Bronchitis in Textile Industry Workmen.), [Prevention of Certain Acute and Chronic Effects of 71-0079 Nicotine With N-Acetyl-hydroxyproline.1, 71-0727 Jeney, E. Jaeger, I [Data on the Effect of Low Carbon Monoxide Content Effect of lodoacetate on the Carbon Monoxide Toler- of the Air on People.), ?1-0668 ance of the Chick, 71-0396 Jenkins, C. D. Jaffe, L. S. Psychologic and Social Precursors of Coronary Disease, Sources, Characteristics, and Fate of Atmospheric Car- 71-1202 bon Monoxide, 71-0728 Jahnecke, J. Jenkins, H. J. (Prophylaxis of Cardiovascular Diseases by Elimination Classification of Nicotine Block at Neuromuscular Junc- tion, 71-1113 of Risk Factors in Medical Practice.), 71-1048 Jain, D. K. Jenkins, R. W. (Jr.) Cancer in Chiang Mai, North Thailand. A Relative Fre- Cigarette Smoke Formation Studies. 1. Distribution grid quency Study, 71-0998 Mainstream Products From Added 1 C- Jain, S. K. Dotriacontane-16,17, 71-0387 Chronic Obstructive Lung Disease in Delhi. A Compara- Cigarette Smoke Formation Studies. II. Smoke Distri- tive Study, 71-0457 bution and Mainstream Pyrolytic Composition of Jain, S. R. Added 114C-Menthol (U), 71-0388 Chronic Cor-Pulmonale. (A Study of 1,000 Cases.), Analysis of Tobacco and Tobacco Smoke by Neutron 71-0136 Activation, 71-0846 James, B. The Quantitative Recovery of Smoke From Radio- Drug and Nutritional Factors in Optic Neuropathy, actively Labeled Cigarettes, 71-1269 71-0677 Jenner, P. Jamieson, J. D. The Analysis of Nicotine-e-N-Oxide in Urine, in the Electron Microscopic Observations on Pulmonary Fibro- Presence of Nicotine and Cotinine, and Its Application sis and Emphysema in Smoking Dogs, 71-0863 to the Study of In Vivo Nicotine Metabolism in Man, Jamison, K. 71-1107 Marijuana and the Use of Other Drugs, 71-0151 The Effect of Smoking on Nicotine Metabolism In Vivo Jan, F. in Man, 71-1108 [Tobacco and Coronary Disease.), 71-0895 Jessop, W.J.E. Jana, H. Nutritional and Epidemiologic Factors Related to Heart Cardiovascular and Respiratory Changes in Suggested Disease, 71-0776 Smoking, 71-0800 Johansson, C. R. Jancik, E. Acute Irritation Effects of Tobacco Smoke in Room [Some Facts and Correlations From an Epidemiologic Air, 71-0147 Study on the Incidence of Symptoms Characteristicto Johansson, G. Chronic Non-specific Lung Diseases.), 71-0446 Behavioural and PhysiologicalEffects of Cigarette Janczy, S. Smoking in a Monotonous Situation, 71-1239 [Pulmonary Tuberculosis and Cough and Expectoration Johnson, J. E. (III) in Inhabitants of Krakow.), 71-1021 Human Alveolar Macrophages: Comparison of Phago- Janis, I. L. cytic Ability, Glucose Utilization, and Ultrastructure Facilitating Effects of Daily Contact Between Partners in Smokers and Nonsmokers, 71-0146 Who Make a Decision to Cut Downon Smoking, Johnson, L. C. 71-0345 Spirometric Standards for Healthy Nonsmoking Adults, Jannon, P. 71-0090 [Delayed After-Effects of Gastrectomy.], 71-1069 Johnson, L. R. Janus, T. Effects of Nicotineon Gastrointestinal Secretions, [Occurrence of Chronic Unspecific Diseases of theRe- 71-0683 spiratory System Among Workers in the Plaster Works Johnson, M. at "Dolina Nidy" in Gacki.), 71-1176 Relationships Among Medical and Nonmedical Uses of Januszewicz, W. Pharmacologically Active Agents, 71-1238 [Clinical and Metabolic Studies in Men With Myocardial Johnson, P. C. Infarction at Young Age.), 71-0885 Pathophysiology of Hereditary Emphysema, 71-1184

Individual has contributed to this reference but is not listed as part of the main citation.

266 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX.

Johnson, R. cinoma Patients in Rotterdam] , 71-0261 Acute Pulmonary Effects of Smoking a Reference Ciga- Kaatzsch, H. rette, 71-0437 The Influence of Smoking on the Ventilatory Dis- Johnson, T. H. (Jr.) turbance in Bronchitis, 71-0447 Roentgen Features of Giant Cell Carcinoma of the Kaburaki, Y. Lung, 71-0587 (Studies on Composition of Tobacco Smoke. VII. Johnson, W. H. Composition of Volatile Phenol Fraction of Tobacco Tobacco Chemistry. 4: Chemical and Ciliotoxic Studies Smoke] , 71-0822 of Smoke From Freeze-Dried Tobacco, 71-1116 (Composition of Tobacco Smoke. Pan }UV. Formation Johnston, D. of Pyridines in Pyrolysis of Nicotine.' , 71-0823 Inhibitory Effect of Cigarette Smoking on Gastric Secre- Kafilmout, tion Stimulated by Pentagastrin in Man, 71-0918 Foreign Particle Embolism in Drug Addicts: Respiratory Johnston, E. Pathophysiology, 71-1011 Hypnosis and Smoking: A Review of the Literature, Kahan, S. A. 71-0532 Drug Usage and Related Patterns of Behavior in Uni- Jones, J. A. versity Students:I. General Survey and Marihuana The Saskatoon Smoking ProjectThe Model, 71-0172 Use, 71-0697 The Saskatoon Smoking StudyResults of the First 'Cahn, E. B. Year, 71-1253 Smoking and Youth: Contributions to the Study of Jones, J. B. Smoking Behavior in High School Students, 71-0164 The Smoking Disease. (Letter), 71-0712 Kahn, H. A. Jones, L. W. Distribution and Multiple Regression Analysis of Blood Studies on Figure Drawings: Biological Implications of Pressure in 10,000 Israeli Men, 71-0666 Structural and Graphic Characteristics, 71-0706 Prevalence and Incidence of Coronary Disease in a Pop- Jones, M. C. ulation Study. The Yugoslavia Cardiovascular Disease Alphas-Antitrypsin Deficiency and Pulmonary Emphy- Study, 71-1205 sema, 71-1164 Kallen, B. Jones, R. A Prospective Study of Smoking and Pregnancy, Smoking Risks of Different Tobaccos, 71-0870 71-0686 Jones, R. A. Kallqvist, I. Effects on Experimental Animals of Long-Term In- Peak Expiratory Flow in Healthy Persons Aged 45-65 halation Exposure to Carbon Monoxide, 71-0654 Years, 71-0448 Jones, R. J. (Editor) Kamenshchikova, S. V. Atherosclerosis. Proceedings of the Second International (Current Physicochemical Methods of Analyzing Symposium, 71-0481 Tobacco and Tobacco Smoke.1, 71-0829 Jordeczka, S. Kameswari, V. R. (The Prevalence of Chronic Non-specific Broncho- Carcinoma of thePalateinVisakhapatnam Area, pulmonary Disease in Wool Industry Workmen.] , 71-0857 71-0088 Histopathological Studi, of StomatitisNicotina Joseph, J. 71-1150 Dermatitis in Tobacco Workers (Remarks on 9 Observa- Kaminski, E. J. tions), 71-0498 Fate of Aflatoxins in Cigarette Tobacco, 71-0209 Journal of School Health. Kartarek, D. AAHPER Position Statement. Smoking Education : The The Incidence of Fungi in the Throat, 71-1171 Schools Responsibility, 71-0932 Kandaswamy, S. Journal of the American Osteopathic Association. An Analysis of Coronary Disease in 150 Cases of Chest The Relationship Between Smoking and Health: A Pain, 71-0296 Review, 71-0420 Kanekar, S. Joyet, G. Smoking, Extraversion, and Neuroticism, 71-0165 The Thorium-Series in Cigarettes and in Lungs of Kanevcheva, I. S. Smokers, 71-0207 [Current Physicochemical Methods of Analyzing To- Juchau, M. R. bacco and Tobacco Smoke.] , 71-0829 Human Placental Hydroxylation of 3,4-Benzpyrene (Investigation of the Composition of Tobacco Smoke. I. During Early Gestation and at Term, 71-0503 Qualitative Composition of Tobacco Smoke Ambles] , Juchems, R. 71-1121 Changes of the Strum Lipids Due to Smoking, 71-0890 Kanfer, F. H. Judd, H. J. Self-Monitoring: Methodological Limitations and Levels of Carbon Monoxide Recorded on Aircraft Flight Clinical Applications, 71-0166 Decks, 71-0208 Kannel, W. B. Jussawalla, D. J. The Framingham Study and Chronic Disease Prevention, The Epidemiology of Oral and Oropharyngeal Cancer, 71-0297 India, 71-0247 Premature Mortality From Coronary Heart Disease. The Evaluation of Cancer Risk in Tobacco Chewers and Framingham Study, 71-0651 Smokers: An Epidemiologic Assessment, 71-0590 Current Status of the Epidemiology of Brain Infarction Association With Occlusive Arterial Disease, 71-0655 Serum Lipid Precursors of Coronary Heart Disease, 71-0778 Kaalen, J.G.A.H. Section 27. Coronary Heart Disease, Atherothrombotic [Occupations and Smoking Habits of Bladder Car- Brain Infarction, Intermittent ClaudicationA Multi-

267 CUMULATIVE AUTHOR AND ORGANIZATIONALINDEX

variate Analysis of Some Factors Relatedto Their Kemp, R. Incidence: Framingham Study, I6-YearFollowup, Patients and Cigarettes, 71-0995 71-1043 Kempe, G. Kannerstein, M. (Doctors and Smoking. Results of an Investigation of Occupational Exposure and Its Relation to Typeof the Smoking Habits and of the Attitudes Lung Cancer, 71 -0988. on Smoking Detoxification of Doctors in the Magdeburg District.), Kaplan, B. H. 71-0337 Occupation and Physical Activity and CoronaryHeart (Cytisine(Taber) as a Drug Aid in Breaking the Disease, 71-1034 Smoking Habit.], 71-0535 Karewicz, Z. Kempski, H. W. (Epidemiological Evaluation of the Incidence and Mor- (New Endocrinous Aspects in Pulmonary Cancer.], tality Due to Pulmonary Carcinoma in the Population 71-0248 of the City of Warsaw in the Years 1963-1967.1, Kennedy, J. 71-0059 Nutritional and Epidemiologic Factors Relatedto Heart Kari- Koskinen, 0. Disease, 71-0776 Smoking Among the Female Workers ofa Cotton Mill, Kessler, I. 1. 71-0517 Karna, T. Epidemiologic Studies of Parkinson's Disease. I. Smok- ing and Parkinson's Disease: A Survey and Explana- (Incidence of Tobacco Allergy in Patients WithBron- tory Hypothesis, 71-0682 chial Asthma.1, 71-1157 Kashinskas, R. Y. Keys, A. Chronic Pharyngitis and Allergy, 71-0504 Mortality and Coronary Heart Disease Among Men }Catkin, J. M. (Jr.) Studied for 23 Years, 71-0779 Limitation of Smoking by Sons and Daughters Who Sucroseinthe Diet and Coronary Heart Disease, Smoke and Smoking Behavior of Parents, 71-0698 71-1203 Katz, C. Khanna, S. K. Cocarcinogenesis Studies on Mouse Skin and Inhibition Action of Cholinergic Drugs on Motility ofSperma- of Tumor Induction, 71-0415 tozoa, 71-0835 Khesina, A. Y. Cigarette Smoke Carcinogenesis: Importance ofTumor Promoters, 71.0602 (Toxic Effect and Metabolism of CarcinogenicAromatic Structure and Tumor-Promoting Activity of Anthralin Hydrocarbons in Cultures of Normal and TumorCells (1,8-Dthydroxy-9-anthrone) and Related Compounds, in Golden Hamsters.], 71-0980 71-1127 Khosla, T. Kearns, F. Obesity and Smoking Habits, 71-0912 Indices of Ventilatory Measurements, 71-1165 The Mechanism of Carcinogenesis by the NeutralFrac- tion of Cigarette Smoke Condensate, 71-0258 Kilburn, K. D. Keble, D. L. Reduction in the Concentration of Aromatic Polycyclic The Prevalence of Chronic Bronchitis, ChronicAirway Hydrocarbons in Cigarette Smoke, 71-0547 Obstruction, and Respiratory Symptoms ina Colorado Kilburn, K. H. City, 71-0278 Short-Term Exposure to Nitrogen Dioxide. Effecton Keen, P. Pulmonary Ultrastructure, Compliance, and the Sur- Carcinoma of the Maxillary Antrum and Its Relation- factant System, 71-1160 ship to Trace Metal Content of Snuff, 71-0583 Killip, T. (111) Keeti-Szanto, M. Shock After Acute Myocardial Infarction. A Clinical Atmospheric Pollution and Pentazocine Metabolism, and Hemodynamic Profile, 71-0135 71-0389 Kilpatrick, G. S. Keighley, G. D. Advances in the Treatment of Respiratory Disorders, Vibration Syndrome in Forestry CommissionChain Saw 71-1166 Operators, 71-0694 1Cimbiris, D. Kell, R. L. The Fate of Women With Normal Coronary Arterio- Vibration Syndrome in Forestry CommissionChain Saw grams and Chest Pain Resembling Angina Pectoris, Operators, 71-0694 71-0671 Keller, G.H.M. Kimland, B. Sugar Consumption, Physical Activity, Smoking, and Tobacco Chemistry. 3: Unsaturated HydrocarbonCon- Serum Composition in Man, 71-0292 stituents of Greek Tobacco, 71-0354 Serum Lipids and Energy Expenditure inOld Men, King, A. J. 71-0787 Keller, J. B. Stress, Cigarette Smoking and SnackingBehaviour in Adolescent Males, 71-0933 Electrocardiographic Patterns in Persons With Bronchitis 1Cirnian, D. and Without Bronchitis in Tecumseh, 71-0872 Thickness of Walls of Myocardial Arterioles in Kelly, D. F. Relation to Smoking and Age, 71-0106 Effect of Carbon Monoxide on Function andStructure Effects of Cigarette Smoking on Dogs, 71-0428 of the Lung, 71-0271 Kisbenedek, L. Kelly, M. L. (The Role of Smoking in the Developmentof Tumors Chronic Maternal Cigaret Smoking and InfantRetro- of the Bladder.], 71-0426 lental Fibroplasia: Negative Results, 71-0792 Kishore, B. Kelvin, A. S. Primary Carcinoma of Lung: Clinico-PathologicalStudy Cigarette Dependence. (Letter), 71-0976 of 35 Cases, 71-0432

268 CUMULATIVE AUTHCR AND ORGANIZATIONAL INDEX

Kisielewicz, J. (Chronic Bronchitis Among the Workmen of a Harbor (Clinical and Statistical Analyses of Chronic Bronchitis Grain Elevator.] , 71-0082 in Port and Shipyard Workers.) , 71-0081 Kohler, H. (Chronic Bronchitis Among the Workmen of a Harbor (Myocardial Infarct in Young People.) , 71-1060 Grain Elevator.) , 71-0082 Koidakis, A. Kitabchi, A. E. (Tobacco Smoking and Atherosclerotic Vascular Dis- Management of Fluctuant Hearing Loss, 71-1072 ease.) , 71-0896 Kjeldsen, K. Kojima, S. Effects of Carbon Monoxide Exposure on the Arterial Effects of Nicotine on Salivary Amylase Secretion From Walls, 71 -0355 Rabbit Parotid Gland, 7 I -0205 The Effects of Exposure to Carbon Monoxide, Hypoxia Action of Tyramine on the Salivary Amylase Secretion and Hyperoxia on the Development of Experimental From Rabbit Parotid Gland in Reference to That of Atheromatosis in Rabbits, 7I-0468 Nicotine, 71 -0740 Carboxyhemoglobin and Serum Cholesterol Levels in Konturek, S. J. Smokers Correlatedto the Incidence of Occlusive Effects of Nicotine on Gastrointestinal Secretions, Arterial Disease, 71-0482 71-0683 Smoking and Coronary Disease (12): Carbon Monoxide Effects of Nicotine on Gastric Secretion and Ulcer Exposure and Frequency of Atherosclerosis, 71-0483 Formation in Cats, 71-1221 Carbon-Monoxide-Induced Mountain Sickness Provoked Koomhof, H. J. by Tobacco Smoking, 7I-0775 The Incidence of Fungi in the Throat, 71-1171 Reversal of Rabbit Atheromatosis by Hyperoxia, Kopecny, J. 71-1 201 [Sterilityin Smoking and Nonsmoking Women.) , Klein, M. G. 71-0144 Histologic Types of Lung Cancer Among Uranium Korb, J. Miners, 71-0259 (Tobacco Mosaic Virus, Polyphenols and the Carcino- Klimek, M. F. genicity of the Tobacco Habit.) , 71-0240 Deposition and Clearance of 2-Micron Particles in the Kordecka, J. Tracheobronchial Tree of Normal Subjects-Smokers (The Effect of Occupational Dust Exposure on the and Nonsmokers, 71-0620 Prevalence of Chronic Bronchitis Among Workmen of Klimen t'eva, N. 1. Sierzan's Wool Industry at Bialystok.) , 71-0078 Role of Aspartic Acid in the Biosynthesis of Nicotine [Chronic Bronchitis Among Textile Workers. Clinical and Anabasine, 71-0561 and Radiological Detection.) , 71-0455 Klingenberg, H. Komitzer, M. The Effects of Smoking Withdrawal on Quantitatively (Respiratory Symptomatology in Epidemiology. Results Analyzed EEG, 71-0502 From a Survey Effected in a Bank in Brussels.), 71-0449 Klonglan, G. E. (Investigation of a White -Collar Population. Relation of Coordinating Health Organizations: The Problem of Tobacco Habits to Other Parameters.] , 71-1204 Cigarette Smoking, 71-1082 Kosa, F. The Potential of Organizational Coordination as an (Histological Changes in Acute Nicotine Intoxication.) , Intervention Process: Applied to the Problem of Ciga- 71-0196 rette Smoking and Health, 71-1083 Koschorreck, B. Knapp, P. H. Incidence of Risk Factors of Coronary Heart Disease in Interaction of Personality and Treatment Conditions Different Age Groups and Social Classes in Men, Associated With Success in a Smoking Control Pro- 71-0643 gram, 71 -1262 Kosciolko, L. Knappe, G. (Chronic Non-specific Lung Disease Among the Work- (Directed Prevention of lschemic Heart Disease in the men of the Electro-Machine Works "EDA" at Ponia- Framework of an Experimental Epidemiological towel , 71-0083 Study.] , 71-0780 Koskela, A. Knappe, J. Association of Certain Social Habits and Attitudes With [Directed Prevention of Ischemic Heart Disease in the Risk Factors of Coronary Heart Disease, 71-0909 Frame work of an Experimental Epidemiological Koski, A. Study.] , 71-0780 Spirometric Standards for Healthy Nonsmoking Adults, 71-0090 Knorre, G. v. Kos.arowski, T. [Results of a Screening Test for Asthma, Chronic Bron- Epidemiological Evaluation of theIncidence and chitis and Emphysema.] , 71-0867 Mortality Due to Pulmonary Carcinoma in the Popula- Kobashi, U. tion of the City of Warsaw in the Years 1963-1967.] , (Composition of Tobacco Smoke. Part XIV. Formation 71-0059 of Pyridines in Pyrolysis of Nicotine.], 71-0823 Kovacs, L. Kocaturk, E. Analysis of the Depolarizing Effect of Nicotine on [Smoking Habits Among Lycee Students.] , 71-1232 Frog's Skeletal Muscle, 71-0977 Koch, R. Kovtunov, V. S. [Acrolein and Hydrocyanic Acid Content in Cigarette (Current Physico-chemical Methods of Analyzing To- Smoke.] , 71-0004 bacco and Tobacco Smoke.] , 71-0829 Kociecka, I. Kowalski, C. J. [Clinical and Statistical Analyses of Chronic Bronchitis Relationship Between Smoking and Calculus Deposi- in Port and Shipyard Workers.) :71-0081 tion, 71-0311

269 2,71 CUMULATIVE AUTHOR AND ORGANIZATIONALINDEX

Kozarevic, D. of Drugs, Carcinogens, and Normal Body Constituents Prevalence and Incidence of Coronary Disease in a Pop- in Man, 71-0812 ulation Study. The Yugoslavia Cardiovascular Disease Kusalcabe, H. Study, 71-1205 [Studies on Composition of Tobacco Smoke. VII. ICradjian, R. Composition of Volatile Phenol Fraction of Tobacco Peripheral Arterial Disease in Ceylon, 71-0298 Smoke.] , 71-0822 Krain, L. S. Kuschner, M. The Rising Incidence of Carcinoma of the Pancreas, Histologic Types of Lung Cancer Among Uranium 71-0249 Miners, 71-0259 Krasnyanskaya, P. N. Experimental Models inEnvironmental Carcinogenesis, [Experimental Investigation on the Role of Smoking in 71-0853 'the Development of Lung Cancer.], 71-0250 Kustermann, 1. Kreis, B. [Investigation of the"Semi-Volatiles" of Cigarette Precipitation Reaction Between Certain Human Sera Smoke", 71-1123 and Soluble Tobacco Extracts, 71-0505 Kyriadkides, E. C. Krishna, K. P. Lecithin BiosynthesisinCigarette Smoking Dogs, A Smoking Problem Check-List for College Students, 71-0186 71-0705 Krivanek,J. Screening for Lung Cancer High-Risk Groups, 71-0252 Krivinka, R. Lacassagne, A. [Cigarette Smoking and the Hazard of Lung Cancer.], Alcohol and Cancer, 71-0996 71-0251 Lachman, A. J. Screening for Lung Cancer High-Risk Groups, 71-0252 The Ultrastructure of Alveolar Macrophages From Kroller, E. Human Cigarette Smokers and Nonsmokers, 71-0627 (Results of Smoking Tests With Filter Cigarettes. Alveolar Macrophages. Structural and Functional Differ- Second Communication, 71-0559 ences Between Nonsmokers and Smokers of Marijuana [Results of Smoking Tests With Filter Cigarettes. Third and Tobacco, 71-0828 Communication.], 71-0560 Lafarge, J.-P. Krone, R. J. [Research and Measurement of Nicotine in the Urine by Effects of Cigarette Smoking on Hemodynamics at Rest Gas Chromatography.], 71-0148 and During Exercise. I. Normal Subjects, 71-1042 Lagarde, J.-P. Krosch, H. ("The Five-Day Plan" or ". Controlled Tobacco Detox- [Prophylaxis of Myocardial Infarct.], 71-0656 ification."', 71-1097 Kubik, A. Lahiri, B. [Cigarette Smoking and the Hazard of Lung Cancer.], Primary Carcinoma of Lung: Clinico-Pathological Study 71-0251 of 35 Cases, 71-0432 Screening for Lung Cancer High-Risk Groups, 71 -0252 Lambert, H. Kucewicz, J. [Functional Picture of Radiologically Destructive Chronic Nonspecific Respiratory Diseases in the City of Emphysema.] 971-0097 Cracow. VIII. Fisher's Discriminant Function in the Lancaster, M. C. Analysis of the Influence of Smoking on Prevalence of [Silent and Atypical Myocardial Infarct.], 71-0893 Symptoms, 71-0450 Lancet. Tobacco and Snuff Bill, 71-0178 Kuenssberg, E. V. Counterblaste to Tobacco, 71 -0232 [Therapeutic Tests in General Practice.], 71-0684 Smoking and Cancers of the Bladder and Kidney. (Ed- Kueppen, F. itorial), 71.0430 Chronic Obstructive Pulmonary Disease- With Inter- Words of Warning. (Editorial), 7 1-095 2 mediate Alpha' -Antitrypsin Deficiency, 71-0440 Landiss, C. W. AlpharAntitrypsin: Physiology, Genetics and Path- Some Immediate Effects of a Smoking Environment on ology, 71-0685 Children of Elementary School Age, 71-0129 Pulmonary Emphysema and AlpharAntitrypsin Defi- Lane, E. ciency, 71-07 7 1 Clinical Aspects of the Dyspneic Miner, 71-0760 Obstructive Lung Disease and AlpharAntitrypsin Defi- Lanfranco, A. ciency Gene Heterozygosity, 71-1167 Smoking and Disease, 714581 Identification of the Heterozygous State for the Alphar Lange, U. Antittypsin Deficiency Gene in Man, 71-1222 [Results of a Screening Test for Asthma, Chronic Bron- Kulayskly, V. A. chitis and Emphysema.], 71-08 6 7 (Smoking and Pregnancy (Review of the Literature)", Langer, A. M. 71-0788 Inorganic Particles in Cigars and Cigar Smoke, 71-0966 Kullander, S. Lam/lands, J.H.M. A Prospective Study of Smoking and Pregnancy, Insulation Workers in Belfast. 2. Morbidity in Men Still 71-0686 at Work, 71-1016 Kumar, R. Insulation Workers in Belfast. 1. Comparison of a Ran- Primary Carcinoma of Lung: Clinico-Pathological Study dom Sample With a Control Population, 71-1029 of 35 Cases, 71-0432 Langvad, E. Kuntzman, R. Lactate Dehydrogenase Isoenzyme Patterns in Leuko- Effects of Environmental Chemicals on the Metabolism pblcia, Submucous Fibrosis and Carcinoma of the Oral CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Mucosa in South Indians, 71-0060 Lauvergeat, J.-A. Lappicirella, V. [Oral Protozoa. Epidemiologic Study.) , 71-0915 [Homeostasis andIts Probable Alterations by Ali- Laval, P. P. mentary and Voluptuary Limitations in the Light of [Discussions on Chronic Bronchitis. 11. Prophylaxis and Clinical Psychosomatic Judgment.] 71-0801 Treatment of Chronic Bronchitis.] 71-0276 Laplace, M. Lawrence, J. S. [Research and Measurement .if Nicotine in the Urine by Rheumatoid Serum Factor in Populations in the U.K. 1. Gas Chromatography.] 71-0148 Lung Disease and Rheumatoid Serum Factor, 71-0619 Lapp, N. L. Lawrence, W. W. Hyperinflation of the Lungs in Coal Miners, 71-1174 An Automated Method for the Determination of Total Serum Trypsin Inhibitor Concentrations in Coal Miners Aldehydes in Gas Phase of Cigarette Smoke, 71-0012 With Respiratory Symptoms, 714179 Lawther, P. J. La Rocca, M. Cigarette Smoking and Exposure to Carbon Monoxide, [Age and Value of Several Indices for Discrimination in 71-0390 Normal and lschemic Subjects.] 71-0774 Laxenaire, M. C. Larsen, E. E. [ Func tiunalPictureof RadiologicallyDestructive Some Factors Influencing the Spontaneous Course of Emphysema.] , 71-0097 Arterial Vascular Insufficiency, 71-0130 Lay den, T. A. Arterial Insufficiency in the Legs. 1. A Clinical Statisti- Elimination of Cigarette Smoking by Puniblunent and cal Analysis, 71-0898 Self-Management Training, 71-0948 Larsen, K. A. Lazanas, J. C. Smoking and Pulmonary Disease(1):Pathological Fate of Aflatoxins in Cigarette Tobacco, 71-0209 Anatomy and Pathogenic Factors, 71-0591 Lazar, P. Larsen, M. [Inhibiting Action of Chemical Carcinogens on the [Tobacco Smoking and Respiratory Symptoms in a Mitosis in the Cultures of Pulmonary Cells of Rats. 1. Danish Population. From a 50-Year Study in Glos- Study of 3,4-Benzopyrene.] 71-0020 trup.] 71-0866 Larsen, V. Lazzarini, L. Intolerance of Tobacco in Patients With Gastric Cancer, Medical-Legal Aspects of Smoking in a Closed Environ- 71-0605 ment, 71-0824 Smoking Habitsof Patients With Gastric Cancer, Leander, K. 71-0860, Stability, Transfer and Absorption of Cannabinoid Con- Smoking Habits of Patients With Pemicious Anaemia in stituents of Cannabis (Hashish)During Smoking, Whom Gastric Cancer Has Not Been Demonstrated, 71-1106 71-1215 Lebbe, J. Larson, M. [Research and Measurement of Nicotine in the Urine by A Household Survey of Chronic Methodological Prob- Gas Chromatography.] 71-0148 lems and Results of Pilot Survey, 71-0092 Lebedun, M. Larson, R. K. Cognitive Dissonance and the Smoking Behavior of Re- Obstructive Lung Disease and AlpharAntitrypsin Defi- searchers on Smoking, 71-0934 ciency Gene Heterozygosity, 71-1167 Lebovits, B. Laskin, S. Smoking and Personality: A Methodological Analysis, Experimental Models in Environmental Carcinogenesis, 71-0518 Lebras, M. 71-0853 Lateyeva, D. N. [Some Aspects of Coronary Disease in Black Africans [Current Physico-Chemical Methods of Analyzing Observed in Abidijan.] 71-0109 Tobacco and Tobacco Smoke.] 71-0829 Lebrun-Brais, L. Latham, M. C. [Pulmonary Emphysema Caused by Alpha-1 Antitrypsin Nutritional and Epidemiologic Factors Related to Heart Deficiency: A Family Study.] 71-1168 Disease, 71-0776 Leclercq, A. Lades, V. G. [Poisoning by Carbon Monoxide.] 71-0126 Effects of Chronic Exposure to Low Levels of Carbon Lee, D.H.K. Monoxide on Human Health, Behavior, and Perfor- Coal Workers' Pneumoconiosis-State of Knowledge and mance, 71-0776 Research Needs, 71-0868 Laughlin, M. E. Lee, K. W. Cha-acteristics of Longshoremen Related to Fatal Coro- The Effects of Betel-Nut Chewing on the Buccal Mucosa nary Heart Disease and Stroke, 71-0659 of 296 Indians and Malays in West Malaysia. A Clinical Laugher, P. Study, 71-0143 [Papular Leukokeratosis of the Palate.] 71-1223 The Effects of Betel-Nut Chewing on the Buccal Laurel', C.-B. Mucosa: A Histological Study, 71-0149 Is Emphysema inAlphas- AntitrypsinDeficiency a Lee, P. N. Result of Autodigestion? 71-1017 The Effect of the Age of Mice on the Incidence of Skin Laurie, W. Cancer, 71-0253 Sputum Cytology in the Diagnosis of Bronchial Carci- Lefcoe, N. M. noma, 71-0592 Particulates in Domestic Premises. I. Ambient Levels Lather, J. and Central Air Filtration, 71-0150 [Statistical Relationship Between Epidemiological LeUouch, J. Data.] 71-0582 [Lipidemia, Tobacco Consumption and Corpulence.

Individual has contributed to this reference but is not listed as part of the main chap.', d 1... 271 CUMULATIVE AUTHOR AND ORGANIZATIONALINDEX

Study of an Active Male Population of 7,972 Sub- the Gas Phase of Cell Metabolism of Alveolar Macro- jects.) , 71-0405 phases. 71-0825 Smoking and Leucocyte-Counts. Results ofan Epi- Effects Chronic Inhalation of Whole Fresh Cigarette demiological Survey, 71-0887 Smoke and of Its Gas Phase on Pulmonary Tumori- Serum Lipids, Smoking and Body Build. Study of 7,972 genesis in Snell's Mice, 71-0997 Actively Employed Males, 71-0907 . [Influence of Fresh Cigarette Smoke on the Develop. Lemanceau, B. ment of Lung Tumors and on Lung Cultures in Snell's (Study by Nuclear Magnetic Resonance of Carcinogenic Mice.) , 71-1018 and Non-Carcinogenic Isomers (Dibenzacridines and Morphological and Cytochemical Effects of Marijuana Dibenzanthracenes).), 71-0011 Cigarette Smoke on Epithelioid Cells of Lung Explants Le Melletier, J. From Mice, 71-1019 (Symposium on Chronic Bronchitis. I. Nosology and Leuner, H. Epidemiology.) , 71-0614 [Toxic Ecstasy.), 71-0027 Lende, R. van der. Leuschner, A. [Chronic Non-specific Lung Disease, Smoking and Lung [Influence of the Locally Different Grade of Pollution Cancer.), 71-0260 in the Township of Duisburg on the Incidence of Non- Lenfant,C.J.M. specific Respiratory Diseases. V. Communication.). Acute Change in Hemoglobin Affinity for Oxygen 71 -0280 During Angina Pectoris, 71-0783 Levin, M. L. Lengyel, 1. Smoking Withdrawal in the Reduction of Risk of Lung [Chemical Components of Domestic Tobaccos.), Cancer, 71-0245 71-0026 Levinson, B. L. Leon Montanez, E. Smoking Elimination by Gradual Reduction, 71-1263 [Myocardial Infarction in the Younger Age Groups.), Levitt, E. E. 71-0777 Reasons for Smoking and Not Smoking Given by School Leren, P. ChUdren, 71-0329 Cancer Among Men on Cholesterol-Lowering Diets. Lewine, H. Experience From Five Clinical Trials, 71-1137 Good-bye to AU That, 71.0538 Leger, T. Lewis, G. P. [A Survey of Smoking Habits Among Physicians in Association Between Elevated Hepatic Water-Soluble Israel.) , 71-1259 Protein-Bound Cadmium Levels and Chronic Bron- Lesko, S. A. (Jr.) chitis and/or Emphysema, 71-1169 Mutagenic Action, Lou of Transforming Activity, and Lewis, J. M. Inhibition of Deoxyribonucleic Acid Template Activ- Extent and Prevalence of Illicit Drug Use as Reported ity In Vitro Caused by Chemical Linkage of Carcino- by 56,745 Students, 71.1079 genic Polycyclic Hydrocarbons to Deoxyribonucleic Lichtenstein, E. Acid, 71-0967 How to Quit Smoking, 71.0346 Leszczynski, B. Modification of Smoking Behavior: Good Designs (The Effect of Occupational Dust Exposureon the Prev- Ineffective Treatments, 71-0519 alence of Chronic Bronchitis Among Workmen of Lieberman, J. Sierzan's Wool Industry at Bialystok.] , 71-0078 Smoking and Chronic Obstructive Lung Diseasein (Chronic Bronchitis Among Textile Workers. Clinical Alphas-Antitrypsin Deficiency, 71-0869 and Radiological Detection.), 71-0455 Heterozygous and Homozygous Alpha' -Antitrypsin Leuchtenberger, C. Deficiency in Patients With Pulmonary Emphysema, Influence of Chronic Inhalation of FreshCigarette 71-1170 Smoke and Its Gas Phase on the Development of Lung Lilienfeld, A. M. (Chairman) Tumors in Snell's Mice, 71-0593 Primary Prevention of the #,C.Irosclerotic Diseases, The Behavior of Macrophages in Lung CulturesAfter 71 -0137 Exposure to Cigarette Smoke. Evidence for Selective Lilis, R. Inhibition by Particulate Matter and Stimulation by (Epidemiological Investigations on IschemicCardi- the Gas Phase of Cell Metabolism of Alveolar Macro- opathy in Industry. Study of a Group Involving Mini- phases, 71-0825 mal Physical Work (Engineers, Technicians, De- Effects of Chronic Inhalation of Whole Fresh Cigarette signers).) , 71-0897 Smoke and Its Gas Phase on Pulmonary Tumorigenesis Liljefors, I. in Snell's Mice, 71-0997 (Smoking and Coronary Disease (7): Smoking Habits (Influence of Fresh Cigarette Smoke on the Develop- and Coronary Disease in Sets of Twins.), 71-0127 ment of Lung Tumors and on Lung Cultures in Snell's Smoking and Coronary Disease (7): Smoking Habits and Mice.] , 71.1018 Coronary Disease in a Twin Study, 71-0484 M/iphological and Cytochemical Effects of Marijuana The Validity of Questionnaire Diagnosis. "Angina Pec- Cigarette Smoke on Epithelioid Cells of Lung Explants toris," 71-1206 \ From Mice, 71-1019 ll L. C. LetichteCJerger, R. 1 Association of Psychosocial Factors to the Smoking Influence of Chronic Inhalation of Fresh Cigarette Practices of High School Students, 71-0939 Smoke and Its Gas Phase on the Development of Lung Lind, C. Tumors in Snell's Mice, 71-0593 Effects of Chronic Administration of Nicotineon Drug- The Behavior of Macrophages in Lung Cultures After Induced Hypnosis in Mice, 71-0957 Exposure to Cigarette Smoke. Evidence for Selective Lindberg, H. A. Inhibition by Particulate Matter and Stimulation by Heart Rate: An Important Risk Factor for Coronary

272 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

MortalityTen-Year Experience of the Peoples Gas Tracheobronchial Tree of Normal SubjectsSmokers Co. Epidemiologic Study (195848). 71-0290 and Nonsmokers. 71-0620 Lindholm, B. Lovkova, M. Y. Socio-Economic Consequences of Smoking, 71-0580 Role of Aspartic Acid in the Biosynthesis of Nicotine Lindsey, S. and Anabasine, 71-0561 The Detection of Individuals Prone to Coronary Artery Lowe, C. R. DiseaseA Screening Program Conducted on Medical Obesity and Smoking Habits. 71-0912 Students, 71-0642 Lowrimore, G. R. Lindstrom B. Cigarette Smoking and Acute Non-Influenzal Respira- [PersonalityFeatures in Smoking. A Pilot Study.], tory Disease in Military Cadets, 71.0613 71-1247 Lowry,1. Q. Linn, B. S. A Study of the Mechanism of Intestinal Absorption of Determinants of Survivalof the Dialysis Cannula, Benzo(a)pyrene, 71-0567 71-0128 Luban-Plozza, B. LinneU, J. C. [Smoking andthePossibilities of GivingIt Up.], Plasma-Cobalamins in Neuro-Ophthalmological Diseases, 71-0330 71-0318 [Nicotine and s Healthful Life.] , 71-0347 Lippmann, M. [Nicotine and Health Behavior.] , 71.1264 Long Term Smoking in the Donkey, 71-0075 Luderitz, P. Lipscomb, H. [Experimental Studies on the Effect of Carbon Mon- A Study of the Mechanism of Intestinal Absorption of oxide From Motor Vehicle Exhaust Gases on the State Benzo(a)pyrene, 71-0567 of Health of Traffic Police.] , 71-1120 Lipscomb, W. Lukjan, Z. Acute Pulmonary Effects of Smoking a Reference Ciga- [The Effect of Occupational Dust Exposure on the Prev- rette, 71-0437 alence of Chronic Bronchitis Among Workmen of Sier- zan's Wool Industry at Bialystok.1, 71-0078 Little, C. C. [Chronic Bronchitis Among Textile Workers. Clinical Report of the Scientific Director, 1969-1970, 71-0713 Liu, H. M. and Radiological Detection.] , 71-0455 The Influence of Smoking and Drinking on Binocular Lundman, T. Smoking and Coronary Disease (6): Coronary Disease in Depth Perception, 71-0501 Smoking-Discordant Twins, 71-0657 Locke, G. B. The Validity of Questionnaire Diagnosis. "Angina Pec- Rheumatoid Serum Factor in Populations in the U.K. I. toris," 71-1206 Lung Disease and Rheumatoid Serum Factor, 71-0619 Lung,l. N. Lode, H. [Changes in Pulmonary Function of Young People as a Smoking, 71-0392 Result of Cigarette Smoking Over Many Years.] , Luquette, A.1. Some Immediate Effects of a Smoking Environment on 71-1163 of 3,4Loh, A. Cigarette Smoke: Stimulatory Effect on Metabolism of Children of Elementary School Age, 71-0129 Luthra, U. K. 3,4-Benzpyrene by Enzymes in Rat Lung, 71-0226 Ultrastructure of Human Oral Mucosa After Prolonged Lomonaco, T. Exposure to Tobacco, 71-0789 [Brief Compendium of Aeronautic and Space Medicine Lutz, F. (Continuation).] , 71-1119 Carbon Monoxide Partial Pressure in Tissue of Different Long, E. T. Animals, 71-0722 Results of Screening Patients for Peripheral Vascular Lyle, H. Disease by Paramedical Personnel, 71-0892 Association Between Elevated Hepatic Water-Soluble Longo, L. D. Protein-Bound Cadmium Levels and Chronic Bron- Carbon Monoxide in the Pregnant Mother and Fetus and chitis and/or Emphysema, 71-1169 hs Exchange Across the Placenta, 71-0391 Lopes, M. G. 1Micromethod of Astrup. Normal Values of pH, PCO2, Standard Bicarbonates and Base Excess in Capillary Mabuchi, K. Blood.' , 71-0472 Epidemiology of Cancer of the Prostate, 71-0759 LopezAmor, E. MacAirt,l. G. Hypersecretion of Arginine Vasopressin in Acromegaly, Occupational and Non-Occupational Factors Associated 71-1067 With Vesical Neoplasm in Ireland, 71-0601 Lopez:S., A. MacEwen, J. D. The Detection of Individuals Prone to Coronary Artery Hematological of Long-Term Continuous Animal Expo- DiseaseA Screening Program Conducted on Medical sure to Carbon Monoxide, 71-0843 Students, 71-0642 MacKenzie, W. F. Lorimer, A. R. Pathology in Animals Exposed to High Concentrations Multiphasic Screening Findings in Volunteers Examined of Carbon Monoxide for Six Months, 71-0826 at the Chest and Heart Association Health Exhibition Hematological Effects of Long-Term Continuous Ani- in Glasgow, 71-0087 mal Exposure to Carbon Monoxide, 71-0843 Lourenco, R. V. Mackler, A.D. Lung Tissue Hysteresis in Pulmonary Tuberculosis, horganic Particles in Cigars and Cigar Smoke, 71-0966 71-0089 Madan, B. R. Deposition and Clearance of 2Micron Particles in the Effect of Ganglion Blocking Agents on Spontaneous and

273 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Adrenaline-Induced Ventricular Ectopic Tachycardia Mamatsashvili, M. I. Following Coronary Occlusion, 71-0294 On the Detrimental Effect of Carbon Monoxide and Mach ly, A. C. Sulfur Dioxide on Fertility of Female Rats, 71-0968 Cyanide and Thiocyanate Levels in Blood and Urine of Mancuso, T. F. Workers With Low-Grade ExposuretoCyanide, Relation of Duration of Employment and Prior Respira- 71-0210 tory Illness to Respiratory Cancer Among Beryllium Magee, P. N. Workers, 71-0061 Metabolism of Dimethylnitrosamine by Human Liver Mandel, J. S. Slices In Vitro, 71-0029 A Household Survey of Chronic Methodological Prob- Toxicity of Nitrosamines: Their Possible Human Health lems and Results of Pilot Survey, 71-0092 Hazards, 71-0729 Mandelstam, P. Maher, V. M. A Study of the Mechanism of Intestinal Absorption of Mutagenic Action, Loss of Transforming Activity, and Benzo(a)pyrene, 71-0567 Inhibition of Deoxyribonucleic Acid Template Activ- Monica tide, M. ity In Vitro Caused by Chemical Linkage of Carcino- (Epidemiological Study of Chronic Bronchitis in Two genic Polycyclic Hydrocarbons to Deoxyribonucleic Regions Without Industrial Air Pollution.[, 71-1177 Acid, 71-0967 Mann, D. E. (Jr.) Mahon, J. K. Influence of Several Autonomic Drugs on Sodium Nitro- Effects of Smoking on Lung Structure of Appalachian prusside and Oxotremorine-Induced Hypothermia in Coal Workers, 71-0091 Immature and Mature Mice, 71-0190 Mair, A. Mann, P.E.G. Mesothelioma in Scotland, 71-0062 Alveolar Macrophages. Structural and Functional Differ- Maitrya, B. B. ences Between Nonsmokers and Smokers of Marijuana Ammonia Retention by Smokers: A Comparative and Tobacco, 71-0828 Study, 71-1109 Mansner, R. Majima, S. Effect of Cigarette Smoking on Diuresis Induced by Induction of Carcinoma of Glandular Stomach in Rats Furosemide, 71-0842 by Local Application of 7,12-Dimethylbenz(a) Menu, P. anthracene, 71-1153 (Epidemiological Studies on Chronic Bronchitis in a Malamed, M. Sample of the General Population of Bucharest.[, Results of Screening Patients for Peripheral Vascular 71-0451 Disease by Paramedical Personnel, 71-0892 Marasso, F. Malhotra, S. L. Smoking and Chronic Obstructive Lung Diseasein Clues to the Possible Mode of Action of Cigarette Alpha, -An titrypsin Deficiency, 71-0869 Smoke in the Pathogenesis of Lung Cancer, 71-0254 Marcelou-Kinti, U. Malik, E. Mycological Flora of Cigarettes 71-0716 Chronic Bronchitis inAgricultural and Chemical Marienfeld, C. J. Workers, 71-0284 A Tobacco Related Epidemic of Congenital Limb Matures, Y. Deformities in Swine, 71-0790 [Carboxyhemoglobinemia in the Child Born to a Mother Markicwicz, K. Who Smokes.] , 71-0006 (Passive Smoking. Harmfulness of Passive Inhalation of Presence of Carbon Monoxide in the Blood of a Child Smoke From Cigarettes Smoked by Others.[, 71-0393 Born of a Smoking Mother, 71-0807 (Tobacco in Religious Creeds and Ceremonies, in Magic Mall, W. and in Primitive Medicine.[, 71-0520 ( Epidemiology and Detection of BronchialCarci- [Some Problemsin the Psychotherapy of Chronic nomas.] , 71-0600 Nicotinism.(, 71-0533 Manion, J.-M. Passive Smokers. The Harm From Passively Inhaled (Thiocyanaturia of the Smoker.], 71-0040 Smoke of Cigarettes Smoked by Others, 71-0562 [Can the Tobacco Origin of Chronic Carbon Monoxide [ Some Aspects of Pharmacological Treatment of Poisoning Be Determined?', 71-0041 Chronic Nicotinism.], 71-1265 Can the Tobacco Origin of Chronic Carbon Monoxide Marks, E. Intoxication Be Determined? 71-0847 [Effect of Carbon Monoxide, Vibration and Lowered Malmejac; J. Atmospheric Pressure on the Cerebral Neurosecretory [Nicotine and Propranolol.], 71-0730 System and Catecholamine Levels(, 71-1224 Maio Camacho, R. Marraccini, L. [Myocardial Infarction in the Younger Age Groups.(, On the Incidence of Cardiovascular Disease Among the 71-0777 Workers of the Mining Industry of Sardinia. 2nd Com- Malomy, G. munication: Incidence in Relation to Habitual Smok- [Effects of Low Carbon Monoxide Concentrations in ing and Consumption of Alcohol, 71-1033 Man.] , 71-0321 Malone, R. L. Carbon Monoxide Partial Pressure in Tissue of Different A Short Duration Group Treatment of Smoking Be- Animals, 71-0722 havior by Stimulus Saturation. 71-0349 [Toxicity of Carbon Monoxide in Man Breathing Mix- Marsters, J. B. tures of CO and Air at Elevated Pressure.], 71-0962 Drug and Nutritional Factors in Optic Neuropathy, Maly, E. 71-0677 A Simple Test for Exposure to Polycyclic Hydro- Marston, A. R. carbons, 71-0827 Comparison of Behavior Modification Approaches to

276... 274 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX .

Smoking Reduction, 71-0521 May, J. F. Martin, J. C. [Coronary Disease Risk Factors in Young Managers.), The Effects of Nicotine Administration In Utero Upon 71-0900 Activity in the Rat, 71-0394 Mazzola, V. VitalEffectsof Chronic Nicotine Absorption and Chemical Studies on Tobacco Smoke. XI. Dibenzo- Chronic Hypoxic Stress During Pregnancy and the futons in Cigarette Smoke, 71-0385 Nursing Period, 71-0543 McCann, M. B. The Effects of Maternal Nicotine Absorption or Nutritional and Epidemiologic Factors Related to Heart Hypoxic Episodes Upon Appetitive Behavior of Rat Disease, 71-0776 Offspring, 71-0687 McCaughey, W.T.E. Martin, P. Occupational and Non-Occupational Factors Associated The Incidence of Fungi in the Throat, 71-1171 With Vesical Neoplasm in Ireland, 71-0601 Martin, W. J. McCoy, J. F. Tobacco Additives and Cigarette Smoke. Part I. Transfer The Association of Cigarette Smoking With Respiratory of DGlucose, Sucrose, and Their Degradation Pro- Symptoms and Pulmonary Function in a Group of ducts to the Smoke, 71-0813 High School Students, 71-0074 Tobacco Additives and Cigarette Smoke. Part 11. Or- McCreight, W. G. ganic, Gas-Phase Products From DGlucose and Su- Effects of Nicotine on Gastrointestinal Secretions. crose, 71-0814 71-0683 Marver, H. S. McDonald, A. D. Enzymatic Conversion of Benzo(a)pyrene. Hydroxy- Mortality in the Chrysotile Asbestos Mines and Mills of lation vs DNA-Binding, 71-0978 Quebec, 71-0421 Marwaha, R. McDonald, J. C. Lung Function in Indian Smokers. (Letter), 71-0277 Mortality in the Chrysotile Asbestos Mines and Mills of Masi, A. T. Quebec, 71-0421 Thromboembolism and Oral Contraceptives: An Epi- McEwen, J. demiologic Case-Control Study, 71-0664 Mesothelioma in Scotland, 71-0062 Mathes, P. McFall, R. M. The Effect of Nicotine on Regional Blood Flow in the Comparison of Behavior Modification Approaches to Canine Heart, 71-1049 Smoking Reduction, 71-0521 Mathiesen, F. R. Motivation, Structure, and Self-Monitoring: Role of Some Factors Influencing the Spontaneous Course of Nonspecific Factors in Smoking Reduction, 71.0935 Arterial Vascular Insufficiency, 71-0130 McFarland, R. A. (Rational Measures for Patients With Vascular Insuffi- The Effects of Exposure to Small Quantities of Carbon ciency of the Legs.) , 71-0485 Monoxide on Vision, 71-0395 Arterial Insufficiency in the Legs. 1. A Clinical Statis- McGanity, W. J. tical Analysis, 71-0898 MaternalNutrition andthe Courseof Pregnancy, Matthews, D. M. 71-0508 Plasma-Cobalamins in Neuro-Ophthalmological Diseases, McGlothlin, W. 71-0318 Marijuana and the Use of Other Drugs, 71-0151 Recent Research in Some Optic Neuropathies, 71-0795 McGrath, J. J. Matthews, V. L. Effect of lodoacetate on the Carbon Monoxide Toler- The Saskatoon Smoking ProjectThe Model, 71-0172 ance of the Chick, 71-0396 The Saskatoon Smoking StudyResults of the First McGuire, L. B. Year, 71-1 253 Clinical Correlations With Coronary Arteriography, Matliauda, J. 71-0131 [Second Infarct.], 71-1039 McHugh, W. D. Mallon, A. The Influence of Time of Examination, Eating, Smoking ("The Five-Day Plan"or "A Controlled Tobacco and Frequency of Brushing on the Oral Debris Index, Detoxification."], 71-1097 71-1070 Matts, S.G.F. McKendrick, A.J.W. Coronary Thrombosis, 71-0486 The Influence of Time of Examination, Eating, Smoking Matuchanski, J. and Frequency of Brushing on the Oral Debris Index, [Delayed After-Effects Gastrectomy.] , 71.1069 71-1070 Maulaz, P. B. McKenzie, H. I. [Influence of Smoking During Pregnancy on the Neo- Some Findings on the Post-Mortem Association of Right nate. Results and Conclusions on Human Observations Ventricular Wall Thickness and Chronic Obstructive and Animal Experiments.], 71-0313 Bronchitis, Pneumoconiosis, Emphysema and Tuber- Mounter, B. culosis, 71-0299 Some Comments on the Failure of Behavior Therapy as McLaughlin, R. F. a Technique for Modifying Cigarette Smoking, Anatomic and Histologic Changes of Early Emphysema, 71-0522 71-0621 Smoking: A Behavioral Analysis, 71.1084 McNamara, P. M. Maxwell, K. W. Serum Lipid Precursors of Coronary Heart Disease, Influence of Cigarette Smoke on Guinea Pigs. Effect on 71-0778 Pulmonary Cells and Serum Antitrypsin Levels, McNelis, F. L. 71-0198 Carcinoma In Situ of the Larynx, 71-0594

Individual has contributed to.this reference but is not listed as part of the main citation. 275 277 CUMULATIVE AUTHOR AND ORGANIZATIONALINDEX

McRae, C. F. Cement Factory. 71.0270 Youth to Youth Communication on Smoking and Meyer, D. H. Health, 71-0936 Nicotine Effects on Alveolar Macrophages Respiration Meares, R. and Adenosine Triphosphatase Activity, 71-0211 Smoking and Neuroticism. (Letter), 71-1248 Meyer, J. Medak, H. Ultrastructure of Surface Cells of the Oral Mucosa, Ultrastructure of Surface Cells of the Oral Mucosa, 71-0791 71-0791 Meyer, M. B. Medalie, J. H. Low Birth Weight and Neonatal Mortality Rate Related Distribution and Multiple Regression Analysis of Blood toMaternal Smoking and Socioeconomic Status, Pressure in 10,000 Israeli Men, 71-0666 71-0811 Medical Journal of Australia. Meyersburg, H. A. Smoking and Health Now, 71.0714 Psychological Factors in Smoking, Drinking, and Drug Is Smoking Teratogenic? 71-1207 Experimentation, 71-1089 Medical Letter on Drugs and Therapeutics Michael, L. W. Cigarette Smoking and Carbon Monoxide, 71-1071 Copper-Binding Activity of Tobacco Smoke Con- Medical Officer. densate, 71-0563 Smoke Reduction on Two Fronts, 71 -0527 Micheau, C. Medve, F. (Papular Leukokeratosis of the Palate.], 71-1223 (Data on the Effect of Low Carbon Monoxide Content Michel, F. B. of the Air on People.] , 71-0668 (Symposium on Chronic Bronchitis. 1. Nosology and Mehta, F. S. Epidemiology.] , 71-0614 An Epidemiologic and Histopathologic Study of Leuko- (Chronic Familial Bronchopneumopathies and Homo- edema Among 50,915 Rural Indian Villagers, 71-0681 zygotic Alpha1- Antitrypsin Deficiency.], 71-0881 Reverse Smoking in Andhra Pradesh, India: A Study of Michie, I. Palatal Lesions Among 10,169 Villagers, 71-0690 Lung Function in the Elderly, 71-0765 Meijler, F. L. Midwives Chronicle. (Doctors and Smoking.], 71-0658 Action on Smoking and Health, 71-0523 Melchionne, S. Migueres, J. Cocarcinogenesis Studies on Mouse Skin and Inhibition (Symposium on Chronic Bronchitis. 1. Nosology and of Tumor Induction, 71-0415 Epidemiology.], 71-0614 Cigarette Smoke Carcinogenesis: Importance of Tumor Mikulka, P. Promoters, 71-0602 The Effect of Carbon Monoxide on Human Perfor- Menakanit, W. mance, 71-0398 Cancer in Chiang Mai, North Thailand. A Relative Fre- Low Level Carbon Monoxide Exposure and Human quency Study, 71-0998 Psychomotor Performance, 71-0400 Menden, E. E. Miles, S. Copper-Binding Activity of Tobacco Smoke Con- The Respiratory System and Sport, 71-0152 densate, 71-0563 Miller, A. Menges, R. W. Operant Conditioning and Self-Control of Smoking and A Tobacco Related Epidemic of Congenital Limb Studying, 71-1266 Deformities in Swine, 71-0790 Miller, G. J. Menhart, F. A Community Survey of Respiratory Disease Among (Model for the Prediction of Demand for Tobacco East Indian and African Adults in Guyana, 71-0622 Products by Price Class With the Aid of Trend Calcu- An Assessment of Lung Volumes and Gas Transfer in lation.] , 71-1260 Sickle-Cell Anaemia, 71-0899 Mercado Contreras, E. The Lipoid Pneumonia of Blackfat Tobacco Smokers in Tobaccoism and Coronary Cardiopa thy. Long-Term Guyana, 71-1172 Effects in the Patient Who Has Suffered a Myocardial Miller, L. Infarct, 71-0660 An Experimental Model for Study of Cocarcinogenesis (Symposium on Medical Problems Originating in Tobac- in the Respiratory Tract, 71-1005 coism. II. Cardiovascular Alterations.], 71-0902 Miller, R. L. Merki, D. J. Alkylphenols and Arylnitriles in a Biologically Active Some Immediate Effects of a Smoking Environment on Neutral Subfraction of Cigarette Smoke Condensate, Children of Elementary School Age, 71-0129 71-0731 Merksamer, M. A. Miller, S. A short Duration Group Treatment of Smoking Association Between Elevated Hepatic Water-Soluble Behavior by Stimulus Saturation, 71-0349 Protein-Bound Cadmium Levels and Chronic Bron- Mesolella, C. chitis and/or Emphysema, 71-1169 IC/to-Neurological Observations in a Group of Workmen Miller, W. A. Chronically Exposed to the Action of Carbon Mon- Heart Rate: An Important Risk Factor for Coronary oxide.] , 71-0969 MortalityTen-Year Experience of the Peoples Gas Meszaros, J. Co. Epidemiologic Study (1958-68), 71-0290 The Effect of Some Cholinomimetic Drugs on Presyn- Miller, W. F. aptic Inhibition in the Lateral Geniculate Nucleus, Pulmonary Emphysema and Alpha, -Antitrypshi Defi- 71-0397 ciency, 71-0771 Metwally, M. Miller, W. W. Spirometric Measurements in an Egyptian Portland The Effects of Deoxygenadon of Adult and Fetal

27R 276 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Hemoglobin on the Synthesis of Red Cell 2,3-Dephos- Volatile Fatty Acids in Tobacco, 71-0725 phoglycerate and Its In Vivo Consequences, 71-0132 Predecessors of Organic Acidin Tobacco Smoke. Milman, D. 71-0821 Drug Usage and Related Patterns of Behavior in Univer- (Current Physicochemical Methods of Analyzing sity Students: I. General Survey and Marihuana Use, Tobacco and Tobacco Smoke.] , 71 -0829 71-0697 (Investigation of the Composition of Tobacco Smoke. I. Milne, J. F. Qualitative Composition of Tobacco Smoke Amines.), Survey of Workers Exposed to Dusts Containing Deriva- 71-1121 tives of Bacillis Subtilis, 71-0086 Monk, M. A. Miranda, A. Some Characteristics Related to the Career Status of Smoking and Chronic Obstructive Lung Diseasein Women Physicians, 71 -0340 Alphai-Antitrypsin Deficiency, 71-0869 Monson, R. R. Mirvish, S. Smoking and Cancer of the Lower Urinary Tract, Nitrosamine Studies: Induction of Lung Adenomas by 71-0054 Concurrent Administration of Sodium Nitrite and Monteleone, P. N. (Jr.) Secondary Amines in Swiss Mice, 71-0753 Pathology in Animals Exposed to High Concentrations Misfeld, J. of Carbon Monoxide for Six Months, 71-0826 IMathemetical Aspects of the Planning and Evaluation Hematological Effects of Long-Term Continuous Ani- of Experiments in Cancer Research. Presented Using mal Exposure to Carbon Monoxide, 71-0843 the Investigation of Cigarette Smoke Concentrates as Montesano, R. an Example.] , 71-0431 Metabolism of Dimethylniuosamine by Human Liver [Trend Analysis in the Problem of the Consumption of Slices In Vitro, 71-0029 Nicotine and Smoke Condensate in the Federal Re- Systemic Carcinogens (N-Nitroso Compounds) and public of Germany From 1961-1970.], 71-1249 Synergistic or Additive Effects in Respiratory Carcino- Miskicwicz, H. genesis, 71-0564 [Connection Between Tobacco Smoking and Digestive Montgomery, M. R. Tract Diseases.] , 71-0506 Mitchell, C. A. The Effect of Carbon Monoxide Inhalation on In Vivo Respiratory Symptoms and Skin Reactivity in Workers Drug Metabolism in the Rat, 71-1122 Exposed to Proteolytic Enzymes in the Detergent Moore, C. Industry, 71-0623 Cigarette Smoking and Cancer of the Mouth, Pharynx, Mitkov, V. and Larynx. A Continuing Study, 71-0854 Morales, A. [Neurotic and Neurotic-Like Morbidity in Manual and White-Collar Workers inthe Tobacco Industry in [Cigarettes and Gastric Secretion. 1. Analysis of Gastric Plovdiv.] , 71-0331 Secretion in Smoking and Nonsmoking Ulcer Pa- Mitre, D. K. tients.] , 71-1225 Changes- of Ventilatory Function Amongst Smokers and [Cigarettes and Gastric Secretion. 11. Effect of Ciga- Non-Smokers, 71-0445 rettes on Gastric Secretion.] , 71-1226 Mittel, S. R. Mordish, R. A Clinical Review of Thrombo-Angitis Obliterans, [Respiratory Symptoms and Byssinosis Among Textile 71-1 208 Workers in Israel.] , 71-1009 Mittman, C. More, R. H. Smoking and Chronic Obstructive Lung Diseasein Spontaneous Lesions of the Aorta inthe Rabbit, Alpha -Antitrypsbi Deficiency, 71-0869 71-0295 Modan, B. Moree-Testa, P. (Epidemiology of Sclerotic Heart Diseases.), 71-1050 IMitocbsticActivity and Chromosomal Aberrations Modern Medicine. Induced by Alpha and Beta Naphthonitrile Identified 34,627 Physicians Take Partin Smoking Survey, in a Cigarette Smoke Tar Fraction.1, 71-0726 71-0332 Morelli, G. Modolo, M. A. (Editor) (0to-Neurological Observations in a Group of Workmen (Smoking and Health. Practical Guide for Health Educa- Chronically Exposed to the Action of Carbon Mon- tion.] , 71-0065 oxide.) , 71-0969 Mogg, K. Morgan, L. G. The Association of Cigarette Smoking With Respiratory Cancers of the Lung and Nasal Sinuses inNickel Symptoms and Pulmonary Function in a Group of Workers, 71-0427 High School Students, 71-0074 Morgan, T. E. Mohr, U. Pulmonary Surfactant, 71.0624 Diethylnitrosamine-lnduced Alterations in the Tracheo- Morgan, W.K.C. bronchial System of Syrian Golden Hamsters, 71-0744 Coat Workers' Pneumoconiosis, 71-1173 Moltimachev, I. G. Hyperinflation of the Lungs in Coal Miners, 71-1114 [Investigation of the Alkaloid Composition in Tobacco Serum Trypsin Inhibitor Concentrations in Coal Miners, Smoke by Gas Chromatography.], 71-0001 With Respiratory Symptoms, 71-1179 (Investigation of the Paraffin Hydrocarbons in Main- Morishima, H. 0. Stream Tobacco Smoke by Gas Chromatography.], Pharmacologic Effects of Nicotine Upon the Fetus and 71-0002 Mother ir, the Rhesus Monkey, 71-1130 ISpecuophotometric Determination of Benzo(a)pyrcne Mork, T. in Tobacco Smoke Condensate.], 71-0028 On Smoking Behaviour, 71-0701

277 279 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Morrell, F. A. ing Angina Pectoris, 71-0783 The Quantitative Recovery of Smoke From Radio- Mushin, W. W. actively Labeled Cigarettes, 71.1269 The Normalityof the Abnormal.Eighth Annual Morrice, G. (Jr.) Baxter-Travenol Lecture, 71-0167 Fibrous Glass Manufacturing and Health. Results of a Mustafa, M. G. Comprehensive Physiological Study: Part 11. 71-0618 Nicotine Effects on Alveolar Macrophage Respiration Morris, J. F. and Adenosine Triphosphatase Activity, 71-0211 Spiromctric Standards for Healthy Nonsmoking Adults, Muysers, K. 71-0090 The Epidemiology of Bronchopulmonary Symptoms in Morris, N. Coal Miners, Foundry Workers, Chemical Workers Maternal Nutrition and the Course of Pregnancy, and Bakers, 71-0772 71-0508 Myers, R. D. Morrow, R. C. Hypothermia Produced by Nicotine Perfused Through Mucosal Changes and Cancer in Intra-Oral Smoking, the Cerebral Ventricles of theUnanaesthetized 71-0855 Monkey, 71-0818 Mos, R. Myrsten, A. L. [Epidemiological Picture of Chronic Nonspecific Lung Behavioural andPhysiologicalEffectsof Cigarette Diseases in One District of the City of Wroclaw.] Smoking in a Monotonous Situation. 71-1239 71-0456 Mysik, M. Motley, H. L. [Occurrence of Chronic Unspecific Diseases of the Res- Environmental AirPollutionEffect on Pulmonary piratory System Among Workers in the Plaster Works Function, 71-1020 at "Dolina Nidy" in Gacki.] , 71-1176 Mueller, H. My slinska, M. Myocardial and Systemic Responses to Carboxyhemo- [Influence of Tobacco Smoking on Thiocyanate Level globin, 71-0288 inSaliva Mixed orIsolated From theParotid Mueller, R. E. Gland.] , 71-0153 The Prevalence of Chronic Bronchitis, Chronic Airway Obstruction, and Respiratory Symptoms in a Colo- rado City, 71-0278 Mueller-Heubach, E. Pharmacologic Effects of Nicotine Upon the Fetus and Nadel, J. B. Mother in the Rhesus Monkey, 71-1130 Chronic Obstructive Pulmonary Disease With Inter- Muir, C. S. mediate Alpha, -Antitrypsin Deficiency, 71-0440 Cancer in Chiang Mai, North Thailand. A Relative Fre- Naeye, R. L. quency Study, 71-0998 Effects of Smoking on Lung Structure of Appalachian Mukherjee, S. K. Coal Workers, 71-0091 Some Observations on Peptic Ulcer (A Study of 500 Pulmonary Arterial Changes With Age and Smoking, Cases), 71-0507 71-1051 Mulcahy, R. The Anthracotic Pneumoconioses, 71-1175 Mediscan: A Population Screening Programme for the Nagrath, S. P. Detection of Coronary Heart Disease Risk Factors, Primary Carcinoma of Lung:Clinico-Pathological 71-0653 Study of 35 Cases, 71-0432 The Effect of Age, Parity, and Cigarette Smoking on Nakyama, K. Baby Weight, 71-0830 NicotinicAcetylcholine Receptors Subserving Noel- Muller, W. ception in the Dog Hindlimb, 71-0222 [Measurable Effects on the EOG by Cigarette Smok- Naranjo, F. ing?] , 71-0557 Sy mposium on Medical Problems Originatingin Munro-Faure, A. D. Tobaccoism. I.Alterations of the Respiratory Sys- Effects of Environmental Chemicals on the Metabolism tem.] , 71-0879 of Drugs, Carcinogens, and Normal Body Consti- Nasiell, M. tuents in Man, 71-0812 Smoking and Pubnonary Disease (2): Sputum Cytologi- Muramatsu, M. cal Studies of Smokers, 71-0625 [Evaluation of Tobacco Quality From Pyrolytic As- Nasser, M. G. pects. V. Statistical Study of Correlation Between Acute Change in Hemoglobin Affinity for Oxygen Gaseous Constituents of Cigarette Smoke From During Angina Pectoris, 71-0783 Which the K Value Was Computed and Organoleptic National Center for Health Statistics. Properties of Tobacco Smoke.], 71-0031 Changes in Cigarette Consumption Between June 1966 Murayama, M. and August 1968, 71-0168 Effects of Smoke on Tolerance of Rats to Hypoxia, National Research Council. Committee on Maternal 71-0185 Nutrition. Murphy, J. F. Maternal Nutrition and the Course of Pregnancy, The Effect of Age, Parity, and Cigarette Smoking on 71-0508 Baby Weight, 71-0830 National Research Council. Division of Medical Sciences. Murray, J. Committee on Effects of Atmospheric Contaminants Chronic Obstructive Pulmonary Disease With Inter- on Human Health and Welfare. mediate Alphai-Antitrypsin Deficiency, 71-0440 Effects of Chronic Exposure to Low Levels of Carbon Murray, J. A. Monoxide on Human Health, Behavior, and Perfor- Acute Change in Hemoglobin Affinity for Oxygen Dur- mance, 71-0399

Individual has contributed to this reference but is not listed as part of the maincitation. 280 278 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Nature Peer Pressure Hypothesis fur Adolescent Cigarette Clouds of Smoke, Confusion and Oblivion, 71-0179 Smoking, 71-0333 Premature Puff for Smoking Beagles, 71-0433 Ninth Grade SmokersTwo Years Later. 71-1085 Ned lock, J. W. Antismoking Education Study at the University of Illi- Tobacco Additives and Cigarette Smoke. Pat 1. Trans- nois. 71-1236 fer of D-Glucose, Sucrose, and Their Degradation Adolescent Cigarette Smoking in Two Societies. Products to the Smoke, 71-0813 71-1250 Tobacco Additives and Cigarette Smoke. Part II. Or- Newman, R. H. ganic, Gas-Phase Products From D-Glucose and Suc- Cigarette Smoke Formation Studies.I.Distribution rose, 71-0814 and Mainstream Products From Added "C-Dotria- Nelson, C. W. contane-16,17, 71-0387 Respiratory Function in Southe m Appalachian Coal Cigarette Smoke Formation Studies. II. Smoke Distri- Miners, 71-0279 bution windMainstreamPyrolytic Composition of Nelson, D. Added 'C-Menthol (U), 71-0388 Smoking Habits of Physicians and Their Wives, Analysis of Tobacco and Tobacco Smoke by Neutron 71-0928 Activation, 71-0846 Nelson, D. M. The Quantitative Recovery of Smoke From Radio- Youth to Youth Communication on Smoking and actively Labeled Cigarettes. 71-1269 Health, 71-0936 Newton, R. M. Nelson, J. F. ClinicalCorrelations With Coronary Arteriography. Intraoral Carcinoma: Predisposing Factors and They 71-0131 Frequency of Incidence as Related to Age at Onset, Nezamis, .1. E. 71-0255 PossibleRelationship Between Smoking and Peptic Nelson, R. L. Ulcer, 71-0974 Characteristics of Primary Tumors by Carcinogenic Nicholas, B. A. Polycyclic Hydrocarbons in Syrian Hamsters, 71-0241 Classificationof Nicotine Block at Neuromuscular Nelson, W. C. Junction, 71-1113 Cigarette Smoking and Hemagglutination Inhibition Nichols, P.J.R. Response to Influenza After Natural Disease and Im- Routine Pre- and Post-Operative Physiotherapy. Results munization, 71-0888 of a Trial, 71-0715 Neri, L. C. Nicolaescu, V. A Household Survey of Chronic Methodological Prob- [Epidemiological Study of Chronic Bronchitis in Two lems and Results of Pilot Survey, 71-0092 Regions Without Industrial Air Pollution.', 71-1177 Nettesheim, P. (Editor) Nielsen, J. Morphology of ExperimentalRespiratory Cardin"- 1 n tolerance of Tobacco inPatients With Gastric genesis, 71-1148 Cancer, 71-0605 Neufeld, H. N. Smoking Habits of Patients With Gastric Cancer, Distribution and Multiple Regn. sion Analysis of Blood 71-0860 Pressure in 10,000 Israeli Men, 71-0666 Smoking Habits of Patients With Pernicious Anaemia Neumann, V. in Whom Gastric Cancer Has Not Been Demon- Screening for Lung Cancer High-Risk Groups, 71-0252 strated, 71-1215 Newath, G. Nieveen, J. [Nitrogen Compounds in Tobacco Smoke.], 71-0030 [Coronary Disease Risk Factors in Young Managers.] , 1Invesdiptionof the"Semi-Volatiles" of Cigarette 71-0900 Smoke.] , 71-1123 Niewiadomska, S. Neutel, C. I. 'Epidemiological Picture of Chronic Nonspecific Lung Effect of Smoking During Pregnancy on the Risk of Diseases in One District of the City of Wroclaw.], Cancer in Children, 71-0595 71-0456 Neuvonen, P. J. Nikodemowicz, E. Effect of Cigarette Smoking on Diuresis Induced by [Pulmonary Tuberculosis and Cough and Expectora- Furosemide, 71-0842 tion in Inhabitants of Krakow.). 71.1021 Nevin, M. Nikolova, M. Y. DrugsA Report on a Study in Dublin Post - Primary [Radioactive Factors in Tobacco Smoke.], 71-0565 Schoolchildren, 1970, 71-0702 Nilsson, A. Newhouse, M. T. Harmful Clinical Effects of Smoking. The Effect of Regional Aerosol ClearanceinSmokers and Non- Smoking on the Central Nervous System, 71-0695 smokers, 71-0607 [PersonalityDifferences Among Smokers With Dif- Newill, V. A. ferent Cigarette Consumptions.', 71-1251 Cigarette Smoking and Hemagglutinadon Inhibition Nisbet, M. A. Response to Influenza After Natural Disease and The Effect of Acrolein on L-Asparaginase 2 From Immunization, 71-0888 Escherichia Con,71-0718 Newman, A. N. The Differentiation of Tobacco Smoke Condensates on How Teachers See Themselves in the Exemplar Role in the Basis of Reducing Properties, 71.1110 Smoking Education as Evidenced by Their Attitudes Effect of Tobacco Smoke Condensates on Ascorbate, and Practices, 71-0524 71.1111 Newman, I. M. Norman, M. M. Adolescent Cigarette Smoking, 71-0169 Interaction of Personality and Treatment Conditions

279 281 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Associated With Success in a Smoking Control Pro. Okkk, K. gram, 71-1262 (EpidemiologicalSituation of Chronic Non-specific Novotny, M. Diseases of the Lung in Inhabitants of the Town of Mass Spectrometric and Gas Chromatographic Evidence Zabrze.), 71-1024 for Some New Components inthe Gas Phase of Olafasson, 0. Tobacco Smoke, 71-0187 Peak Expiratory Flow in Healthy Persons Aged 45.65 Nussel, E. 3. Years, 71-0448 Social Class Trends in the Practices and Attitudes of Oliver, M. F. College Students Regarding Sex, Smoking, Drinking, Dietary Sugar Intake in Men With Myocardial Infarc- and the Usc of Drugs, 71-0919 tion. Report to the Medical Research Council by Its Nyhan, W. L. Working-Party on the Relationship Between Dietary Maternal Nutrition and the Course of Pregnancy, Sugar Intake and Arterial Disease, 71-0133 71-0508 Ono, H. Studies on the Antidotal Action of Drugs. Part I. Vita- min C and Its Antidotal Effect Against Alcoholic and Nicotine Poisoning, 71.0411 Obi, Y. Oppenhiem, A. Synergistic Effect of Mutagens and Incorporated DNA (Evaluation of Tobacco Quality From Pyrolytic As- In Vitro. AnalogyforBuccopharyngeal Cavity, pects. V. Statistical Study of Correlation Between 71-1001 Gaseous Constituents of Cigarette Smoke From Oram, S. Which the K Value Was Computed and Organoleptic Clinical Significanceof the CoronaryArteriogram, Properties of Tobacco Smoke.), 71 -0031 71-1190 O'Brien, W. M. Orne, M. T. Clinical Correlations With CoronaryArteriography, From the Subject's Point of View, When Is Behavior 71-0131 Ochsner, A. Private and When Is It Public: Problems of Inference, 71-0170 (Relation Between the Habit of Smoking and Lung O'Rourke, A. Cancer.) , 71-0063 A Study of Children's Smoking Habitsin Kerry, Bronchogenic Carcinoma, A Largely Preventable Lesion 71-0171 Assuming Epidemic Proportions. (Editorial), 71-0256 Smoking and School Children, 71 -0334 The Health Menace of Tobacco, 71-0422 DrugsA Report on a Study in Dublin Post-Primary 'Influence of Smoking on Sexuality and Pregnancy, Schoolchildren, 1970, 71-0702 71 -1227 Smoking, Drugs and Alcohol in Dublin Secondary O'Connor, M. L. schools, 71-1086 A Household Survey of Chronic Methodological Prob- Off, R. G. lems and Results of Pilot Survey, 71 -0092 O'Donnell, R. D. SmokingWithdrawal Clinics. (Letter), 71-1267 The Effect of Carbon Monoxide on Human Perfor- Orsingher, 0. A. mance, 71-0398 Effects of Alpha-Methyl Tyrosine and Adrenergic Low Level Carbon Monoxide, Exposure and Human Blocking Agents on the Facilitating Action of Am- Psychomotor Performance, 71.0400 phetamine and Nicotine on Learning inRats, 71-0212 Toxicological Evaluation of Carbon Monoxide in Effects of Learning, Amphetamine and Nicotine on the Humans and Other Mammalian Species, 71.0412 Level and Synthesis of Brain Noradrenaline in Rats, Human Sleep Pattems and Psychomotor Performance 71-0554 During Exposure toModerate Concentrations of Osborne, N. B. Carbon Monoxide, 71-0831 Systematic Studies on the Breakdown of p,i-DDT in Effect of Carbon Monoxide Exposure on Human Sleep Tobacco Smokes, 71-0365 and Psychomotor Performance, 71-0970 Ogg, C. L Osdene, T. S. Collaborative Study of the Determination of Tar and Cigarette Smoke Formation studies. I. Distribution and Nicotine in Cigarette Smoke, 71 -0032 Mainstream Products From Added 1'C-Dotria- Ogunmola, G. B. contane-16,17, 71-0387 Carbon Monoxide Binding Studies of Cytochrome a3 Oski, F. A. Hemes in Intact Rat Liver Mitochondria, 71.0419 The Effects of Deoxygenation of Adult and Fetal O'Hanlon, I. F. Hemoglobin on the Synthesis of Red Cell 2,3-De- phosphoglycerate and Its InVivo Consequences, Carbon Mown( ide and Human Vigilance. A Deleterious 71-0132 Effect of Present Urban Concentrations, 71-0965 Osman, S. F. Oia. P. Evidence for the Origin of Monoalkenes in Cigarette Association of Certain Social Habits and Attitudes Smoke. (Letter), 71-0217 With Risk Factors of CoronaryHeartDisease, Osorio, G. 71-0909 (Cigarettes and Gastric Secretion. II. Effect of Ciga- Okajima, Y. rettes on Gastric Secretion.), 71-1226 (Long Term Effect of Cigarette Smoking on Ciliary Ostfeld, A. Activity.1, 71-1022 Smoking and Personality: A Methodological Analysis, O'Keefe, M. T. 71-0518 The Anti-Smoking Commercials: A Study of Television Ostrander, L. D. (Jr.) Impact on Behavior, 71-0802 Electrocardiographic Patterns in Persons With Bron-

'Individual has contributed to this reference but is not listed as part of the main citation.

280 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

chitis and Without Bronchitis in Tecumseh, 71-0872 Cardiac Tissue Depolarized by Potassium, 71-0214 O'Sullivan, N. Negative ChronotropicEffects of McN A-343 and A Study of Children's Smoking HabitsinKerry, Nicotine in Isolated Guinea-Pig Atria: Insensitivity to 71-0171 Blockade by Tetrodotoxin, 71-0401 Oswald, P. Parade, D. (Changes in Pulmonary Function of Young People as a Cor Pulmonale and Smoking, 71.0901 Resultof Cigarette Smoking Over Many Years.(, Pans Chavero, E. 71-1163 Tobaccoism and Coronary Cardiopathy. Long-Term Otis, A. B. Effects in the Patient Who Has Suffered a Myocardial The Physiology of Carbon Monoxide Poisoning and Infarct, 71.0660 Evidence for Acclimatization, 71-0732 (Symposium on Medical Problems Originatingin Outhred, K. G. Tobaccoism. II. Cardiovascular Alterations 71-0902 Some Findings on the Post-Mortem Association of Pargaonkar, P. S. Right Ventricular Wall Thickness and Chronic Ob- The Detection of Individuals Prone to Coronary Artery structiveBronchitis, Pneumoconiosis, Emphysema DiseaseA Screening Program Conducted on Medical and Tuberculosis, 71-0299 Students, 71-0642 Owen, G. M. Park, J. F. MaternalNutrition and the Course of Pregnancy, Cocarcinogenic Studies in Pulmonary Carcinogenesis, 71-0508 71-0999 Owsrnski, J. Parker, M. G. (Occurrence of Chronic Unspecific Diseases of the Effects of Smoke on Tolerance of Rats to Hypoxia, Respiratory System Among Workers in the Plaster 71-0185 Works at "Dolina Nidy" in Gacki.1, 71-1176 Parks, V. R. Electron Microscopic Observations on Pulmonary Fi- brosis and Emphysema in Smoking Dogs, 71-0863 Partancn, T. Paasoncn, M. K. Association of Certain Social Habits and Attitudes Effect of Cigarette Smoking On Diuresis Induced by With Risk Factorsof Coronary HeartDisease, Furosemide, 71-0842 71-0909 Paffenbarger, R. S. (Jr.) Paskaleva, K. Characteristics of Longshoremen RelatedtoFatal (Influence of Porosityof Cigarette Paper on the Coronary Heart Disease and Stroke, 71.0659 Smoke Condensate and Its Composition.(, 71-1118 Chronic Disease in Former College Students. XI. Early Paslawska-Prus, J. Precursors of Nonfatal Stroke, 71-1209 (Epidemiological Picture of Chronic Nonspecific Lung Page, B.F.J. Diseases in One District of the City of Wroclaw.1, The Determination of Nicotine in Human Blood by 71.0456 Gas-Liquid Chromatography, 71-0644 Pasquazzi, M. Palmgren, B. (Coronary Risk Factors.(, 71-1052 Cigarette Smoking and Abortion. Consecutive Pro- Passey, R. D. spective Study of 4312 Pregnancies, 71-0688 Smoking Risks of Different Tobaccos, 71-0870 Pan American Sanitary Bureau. Patocka, F. Control of Cigarette Smoking. Report on Measures (Tobacco Mosaic Virus and Polyphenols as Naturally Taken in the Americas to Control the Advertising, Occurring Carcinogens in Tobacco.(, 71.0191 71-0937 Patois, E. Pande, J. N. (Prevention of Certain Acute and Chronic Effects of Bronchial Carcinoma An Analysis of120 Cases, Nicotine With N-Acetyl-hydroxyproline.(, 71-0727 71-0589 Paton, J. Pande, R. S. AU Pollution in Nurseries: Correlation With a Decrease Lung Function in Indian Smokers. (Letter), 71-0277 in Oxygen.Carrying Capacity of Hemoglobin, 71-0641 Pandey, M. R. Patrick, R. L. (Jr.) Myocardial Infarction in Nepal, 71,1210 Pathology in Animals Exposed to High Concentrations Pangbom, R. M. of Carbon Monoxide for Six Months, 71-0826 Visual Deprivation and Parotid Response to Cigarette Part, N. L. Smoking, 71.0566 Foreign Particle Embolism in Drug Addicts: Respira- Panminerva Medica. tory Pathophysiology, 71-1011 Campaign Against Smoking Promoted by the Ministry Paul, 0. of Health, 71-0335 Risks of Mild Hypertension: A Ten-Year Report, Papacostas, C. A. 71-0661 Pressor Action of Nicotine Following 'Reversal' During Myocardial Infarction and Sudden Death, 71-1053 Alpha Adrenergic Blockade, 71-0213 Paulson, S. K. Panpanek, M. Coordinating Health Organizations: The Problem of (Tobacco Mosaic Virus, Polyphenols and the Carcino- Cigarette Smoking, 71-1082 genicity of the Tobacco Habit-I, 71-0240 The Potential of Organizational Coordination as an Papavassiliou, J. InterventionProcess:Applied to the Problem of Mycological Flora of Cigarettes, 71-0716 Cigarette Smoking and Health, 71.1083 Pappano, A. J. Pavia, D. Nicotine-Induced Restoration of Action Potentials to Evidence for Temporary Slowing of Mucociliary Clear-

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( 281 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

anceinthe Lung Caused by Tobacco Smoking, StatesMexico Border Station, 71-0116 71-0452 Permutt, S. Pav lik, I. Effects of Chronic Exposure to Low Levels of Carbon Early Skin Reaction Against Tobacco Extract in Res- Monoxide on Human Health, Behavior, and Perfor- piratory System Disease, 71.453 mance, 71-0399 Pawlak, F. Penrod, 3. (Chronic Bronchitis in Tex We Industry Workmen.', [Incidence and Etiology of CoronaryDisease.(, 71-0079 71-0300 Pawlikowska, L. Pendia, F. (Pulmonary Tuberculosis and Cough and Expector- (Oto-Neurological Observations in a Group of Work- ation in Inhabitants of Krakow.(, 71.1021 men Chronically Exposed to the Action of Carbon Paymaster, 3. C. Monoxide. ] , 71-0969 The Problem of Gastro-Intestinal Cancer inIndia, Pestel, M. 71-0596 (Can One Smoke Without Danger:01, 71-0971 Peabody, H. D. (Jr.) (Tobacco and Life Expectancy.(, 71-0983 Epidemiologic Factors in Etiology of Chronic Respira- Petering, H. G. tory Disease, 71-0454 Copper-Binding Activity of Tobacco Smoke Conden- Pearce, M. L. sate, 71-0563 Incidence of Cancer in Men on a Diet High in Poly- Carcinoma of the Maxillary Antrum and Its Relation- unsaturated Fat, 71-0597 ship to Trace Metal Content of Snuff, 71-0583 Pearson, F. G. Peters, 3. M. Sputum Cytology Screening for Lung Cancer, 71-0749 Chronic Nonspecific Respiratory Disease, Berlin, New Pearson, G. Hampshire, 1961-1967: A Cross-Sectional Study, Serum Lipid Precursors of Coronary Heart Disease, 71-; 161 71-0778 Petit, 3. M. Pearson, 3. Muscular Exercise During Intoxication by Carbon Mon- Vibration Syndronie in Forestry Commission Chain Saw(" oxide, 71-0972 - Operators, 71-0694 Peto, R. Peck, A. W. The Effect of the Age of Mice on the Incidence of Effects of Environmental Chemicals on the Metabolism Skin Cancer, 71-0253 of Drugs, Carcinogens, and Normal Body Constitu The Mechanism of Carcinogenesis by the Neutral Frac- ents in Man, 71-0812 tion of Cigarette Smoke Condensate, 71-0258 Petrovic. D. Petrone, S. (Increase in the Number of Erythrocytes and in the (Action of Nicotine on Cells Cultured In Wool. Amount of Hemoglobin in the Blood of Smokers.(, 71-0033 71-0662 Peltier, A. Pettersson, F. Precipitation Reaction Between Certain Human Sera Harmful ClinicalEffects of Smoking. Smoking and and Soluble Tobacco Extracts, 71-0505 GynecologicalObstetrical Condition, 71-0509 Peltonen, T. Smoking in Pregnancy. Retrospective Study of the In- (The Child, Tobacco, and the Pediatrician.(, 71-0931 fluence of Some Factors on Birth Weight, 71-1228 Penman, R. W. Pettigrew, A. R. Conference on Pneumoconiosis. A Summary of the Biochemical Observations in Toxic Optic Neuropathy, Conclusions From an International Conference on 71-0786 Coal Workers' Pneumoconiosis, 71-0871 Pezzana. A. Pepeu, P. (Control of the State of Health of Personnel of a Behavioural Effects Caused by Intra-arterial Injection General Provincial Hospital.(, 71-0094 of Acetykholine and Nicotine in Conscious Rats, Pham, G. T. 71-0840 (Symposium on Chronic Bronchitis. I. Nosology and PePYs,3. Epidemiology.(, 71-0614 The Lipoid Pneumonia of Blackfat Tobacco Smokers Phtiippin, C. in Guyana, 71-1172 (Toxicological and Physiological Investigation on Acro- Pequignot, H. lein Inhalation in the Mouse.(, 71-0034 (Delayed After-Effects of Gastrectomy.l, 71-1069 Philips, C. Perales Goitia, M. G. The EEG Changes Associated With Smoking, 71-0510 [ Symposium on Medical Problems Originatingin Phaipson, K. Tobaccoism. IV. Morphological Alterations in Various Cigarette Smoking inMan. Short-TermEffect on Organs and Systems.], 71-0913 Mucociliary Transport, 71.1007 (Tracheobronchial Clearance in Man StudWWith Perkins, N. M. Konodispersed Teflon Particles Tagged With "F and Carbon Monoxide UptakeinCigarette Smoking, ""mTc.) , 71-1008 71-0117 Philips, A. 3. Pedman, L. V. The Smoking Habits of Professional Groups in Canada, Electrocardiographic Patterns in Persons With Bron 71-1087 chitis and Without Bronchitis in Tecumseh, 71-0872 Phillips, C. 1. Permutt, S. Vitamin B12 Content of Aqueous Humor. (Letter), Carbon Monoxide Uptake by Inspectors at a United 71-0312

Individual has contributed to this reference but is not listed as put of the main citation. 2' 4 282 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Some Observations on the Mechanism of Tobacco farction. Report to the Medical Research Council by Amblyopia and Its Treatment With Sodium Thio- Its Working-Party ontheRelationship Between sulphate, 71-0689 Dietary Sugar Intake and Arterial Disease. 71-0133 Phillips, V. A. Plavidal, F. Extent and Prevalence of Illicit Drug Use as Reported The Detection of Individuals Prone to Coronary Artery by 56,745 Students, 71-1079 DiseaseA Screening Program Conducted on Medical Peidrola Gil, G. Students, 71-0642 [Survey of Sixth-Year Medical Students at the School Plummer, J. of Medicine of Madrid. Habits, Recreation, Voca- The Prevalence of Chronic Bronchitis, Chronic Airway tions, Illnesses, Future Plans, and Aspects of Their Obstruction, and Respiratory Symptomsina Background.] , 71-0938 Colorado City, 71-0278 Pih laja, T. Pocock, S. .1. [The Child, Tobacco, and the Pediatrician.], 71-0931 Evidence for Temporary Slowing of Mucociliary Clear- Pincherle, G. anceinthe Lung Caused by Tobacco Smoking, Factors Affecting the Mean Serum Cholesterol, 71-0452 71-1054 Poland, A. Obesity and Smoking Habits. (Letter), 71-1229 Effects of Environmental Chemicals on the Metabolism Smoking and Neuroticism. (Letter), 71-1252 of Drugs, Carcinogens, and Normal Body Consti- Pinchon, M. C. tuents in Man, 71-0812 Incidence of Pulmonary Ferruginous Bodies in France, Pomeroy, J. R. 71-0424 Atmospheric Pollution and Pentazocine Metabolism, Pindborg, J. J. 71-0389 Lactate Dehydrogenase Isoenzyme Patterns in Leuko- Ponce de Leon, H. M. plakia, Submucous Fibrosis and Carcinoma of the [Chronic Obstructive Pulmonary Disease], 71-0281 Oral Mucosa in South Indians, 71-0060 Popova, L. P. An Epidemiologic and Histopathologic Study of [Current Physico-Chemical Methods of Akalyzing To- Leukoedema Among 50,915 Rural Indian Villagers, bacco and Tobacco Smoke.1, 71-0829 71-0681 Poppers, P. J. Reverse Smoking in Andhra Pradesh, India: A Study Effects of Environmental Chemicals on the Metabolism of Palatal Lesions Among 10,169 Villagers, 71-0690 of Drugs. Carcinogens, and Normal Body Consti- Oral Leukoplakia, 71-0856 tuents in Man, 71-0812 Piotrowilca, B. Poppius, H. [Pulmonary Tuberculosis and Cough and Expectora- Smoking and Pulmonary Disease (4):Clinico- tion in Inhabitants of Krakow.], 71-1021 Physiological Studies, 71-0626 Piper, G. W. Portheine, F. The Saskatoon Smoking ProjectThe Model, 71-0172 A Contribution to the Problem of "Passive Smoking," The Saskatoon' Smoking StudyResults of the First 71-0733 Year, 71-1253 ("Passive Smoking " Nonsmoker Protection.), 71-0973 Piperakis, G. Possner, W. Mycological Flora of Cigarettes, 71-0716 [Observation and Results of the Epidemiology of Non- Pirc, B. specific Respiratory Disorders.], 71-0766 Prevalence and Incidence of Coronary Disease in a Post, B. Population Study. The Yugoslavia Cardiovascular Dis- Behavioural and PhysiologicalEffects of Cigarette ease Study, 71-1205 Smoking in a Monotonous Situation, 71-1239 Pirnay, F. Poswillo, D. E. Muscular Exercise During Intoxication by Carbon Mon- The Effects of Exposure to Chewing Tobacco on the oxide, 71-0972 Oral Mucosa of Monkey and Man. A Histological and Pisa, Z. Ultrastructural Study, 71-0676 lschaemlc Heart Disease. Prognosis, Treatment, Rehab- Powell, G. M. ilitation, and Prevention, 71-1040 Investigation on the Effects of Cigarette Smoke on Pisklov, V. P. Rabbit Alveolar Macrophages, 71-1023 [Investigation of the Paraffin Hydrocarbons in Main- Powell, M. Stream Tobacco Smoke by Gas Chromatography.1, ChronicObstructive Pulmonary Disease With Inter- 71-0002 mediate Alphai-Antitrypsin Deficiency, 71-0440 (Spectrophotometric Determination of Benzo(a)pyrene Powers, G. J. in Tobacco Smoke Condensate.), 71-0028 Distribution of Inhaled Metal Oxide Particles in Pul- (Current Physico.Chernical Methods of Analyzing monary Alveoli, 71-0458 Tobacco and Tobacco Smoke.], 71-0329 Pradhan, S. N. Effects of Nicotine _on Self-StimulationinRats, Pita de la Vega, H. 71-0215 [Analysis of the Smoking Habit in Discharged Patients. Pratt, L. Study of 453 Cases.), 71-0064 The Relationship of Socioeconomic Status to Health, Plackova, A. 71-0703 Ultrastructure of Surface Cells of the Oral Mucosa, Pratt, P. C. 71-0791 Short-Term Exposure to Nitrogen Dioxide. Effect on Platt, E. S. Pulmonary Ultrastructure, Compliance, and the Sur- Smoking: A Behavioral Analysis, 71-1084 factant System, 71-1160 Platt, Lord Pratt, S. A. Dietary Sugar Intake in Men With Myocardial In- The Ultrastructure of Alveolar Macrophages From

283 2F.5 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Human Cigarette Smokers and Nonsmokers, 71 .0627 Regions Without Industrial Air Pollution.)71.1177 Pregowski, W. Radecki, T. [Chronic Bronchitis Among Textile Workers. Clinical Effects of Nicotine on Gastric Secretion and Ulcer and Radiological Detection.) , 71-0455 Formation in Cats, 71-1 2221 Prerovska, I. Radford, E. P. (Editor) [Influence of Chronic Effect of Carbon Monoxide on Twin Registries in the Study of Chronic Disease With Clinical State and Biological Changes in the Serum of Particular Reference to the Relation of Smoking to Exposed Persons With Respect to Precocious Devel- Cardiovascular and Pulmonary Diseases. 71-1193 opment of Atherosclerosis, 71-0903 Radhakrishnamurthy, B. Preuss, E. G. The Detection of Individuals Prone to Coronary Artery Risk Factors in Occlusive Diseases of the Peripheral DiseaseA Screening Program Conducted on Medical Arteries of Varying Severity, 71-1055 Students, 71-0642 Primrose, T. Radomski, J. L. A Study in Human Antepartum Nutrition, 71 -1230 The Role of N-OxidationProducts of Aromatic Prior, I.A.M. Amines in the Induction of Bladder Cancer in the Current Developments in the Pacific, 71-0781 Dog, 71-1149 Pritchard, J. A. Raf, L. E. MaternalNutrition and the Course of Pregnancy, Harmful Clinical Effects of Smoking. Smoking and Dip 71-0508 eases of the Peripheral Vessels. 71-0487 Procianoy, G. Raftery, E. B. [Influence of Smoking During Pregnancy on the Neo- ClinicalSignificance of theCoronary Arteriogram, nate. Results and Conclusions on Human Observa- 71-1190 tions and Animal Experiments.), 71-0313 Raichelson, R. I. Procita, L. The 5-Year Experienceof Modified Fat Diets on An Analysis of the Effects of Nicotine on the Cerebral Younger Men With Coronary Heart Disease, 71-0110 Circulation of an Isolated, Perfused, In Situ Cat Brain Rainey, C. H. Preparation, 71 -0204 Comparison on Effects of Phenobarbital and Nicotine Proks, C. on Nuclear Protein Synthesis in Rat Liver, 71-0407 [Cigarette Smoking and Infarction Changes on the Raju, M.V.S. Electrocardiogram.), 71-0497 Carcinoma of thePalateinVisakhapatnam Area Prominska, E. 71-0857 [Clinical and Metabolic Studies in Men With Myo- Rambaud, J. cardial Infarction at Young Age.), 71-0885 [Prevention of Certain Acute and Chronic Effects of Proteau, J. Nicotine With NAcetyl-hydroxyproline.), 71-0727 (Poisoning by Carbon Monoxide.), 71-0126 Ramos, A. 0. Provost, G. lsoaminile as Inhibitor of Muscarinic and Nicotinic [Pulmonary Emphysema Caused by Alpha-1Anti- Ganglionic Receptors, 71-00 0 7 trypsin Deficiency: A Family Study.), 71-1168 Ramos, J. Public Health. [Cigarettes and Gastric Secretion. I. Analysis of Gastric Special Report: Eight Years After, 71-0955 Secretionin Smoking and Nonsmoking Ulcer Pa- Pudehki, J. tients.), 71-1225 [Prevalence of Airways Obstruction in Patients With Ramstrom, L. M. Recent and Chronic Pulmonary Tuberculosis.), [ Some Viewpoints on Information Technology.) , 71-0095 71-1254 [Epidemiological Situation of Chronic Non-specific Ramulu, C. Diseases of the Lung in Inhabitants of the Town of Histopathological Study of Stomatitis Nicotina, Zabrze.] , 71-1024 71-1150 Pullman, J. S. Rana, M. W. Connecticut Anti-Smoking Action inthe1960s, Effect of Cigarette Smoke on the Cardiovascular Sys- 71-0539 tem in Dogs, 71-0883 Putney, J. W. (Jr.) Effect of Chronic Administration of Nicotine on the On the Mechanisms of "C-Nicotine Distribution in Concentrations of Adrenal Enzymes Involved in the Rat Submaxillary Gland In Vitro, 71-0734 Synthesis and Metabolism of Adrenaline, 71-0956 Randowa, D. [Epidemiological Picture of Chronic Nonspecific Lung Diseases in One District of the City of Wroclaw.) , Quintero Novella, A. 71-0456 Tobaccoism and Coronary Cardiopathy. Long-Term Rantanen, T. Effects in the Patient Who Has Suffered a Myocardial The Smoking Habits of Finnish Physicians, 71-1257 Infarct, 71-0660 Rao, P. [Symposium on Medical Problems Originating in To- Effect of Cigarette Smoke on the Cardiovascular baccohm. II. Cardiovascular Alterations.), 71-0902 System in Dogs, 71-0883 Rasmussen, D. L. Respiratory Function in Southern Appalachian Coal Miners, 71-0279 Racoveanu, C. Impairment of Oxygen Transfer in Dyspneic, Non- [Epidemiological Study of Chronic Bronchitis in Two smoking Soft Coal Miners, 7 1-06 28

Individual has contributed to this reference but is not listed as part of the main citation.

2FC 284 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Rasmussen, R. E. Reif. J. S. Enzymatic Conversion of Benzo(a)pyrene. Hydroxy- Effect of Carbon Monoxide on Function and Structure lation vs DNA-Binding. 71-0978 o: the Lung, 71-0271 Rat likantp, G. Reif fins. J. Chemical Studies on Tobacco Smoke. XIII. Inhibition of I Papular Leukokeratosis of the Palate] . 71.1223 the Pyrosyntheses of Several Selective Smoke Constit- Reimer, E. E. uents, 714)402 [Myocardial Infarct. Comparative Clinical and Thera. Rathor, R. S. peutic Regults.1, 714)904 Effect on Ciliary Movements of Some Agents Which Re in tjes, M. Come in Contact With the Respiratory Tract, 71-0720 [The Influence of Smoking a Cigarette on Lung Fune- Ravaioli, P. tion.1, 71-0767 [Action of Cigarette Smoking on Several Parameters of Rembish, R. A. Lipid , 77 1- 1-1194 1 Nicotine-Induced Restoration of Action Potentials to Ray, A. M. Cardiac Tissue Depolarized by Potassium, 71-0214 An Exploratory Study of Automobile Driving Perfor- Negative ChronotropicEffectsof McN A-343 and mance Under the Influence of Low Levels of Carboxy- Nicotine in Isolated uineaPig Atria: Insensitivity to hemoglobin , 71 -0403 Blockade by Tetrodotoxin, 71-04 0 1 Rayes, A. R. Remschmidt, II. [Epidemiology, Pathogenesis, Sex Distribution, Radia- [Clinical and Social Aspects of Drug Dependency in tion Therapy and Statistics of Laryngeal and Ilypo- Young People. Part 1.1,71-0173 pharyngeal Carcinomas. Experiences With 1121 Cases Rcnzetti, A. D. (Jr.) (1946-1969).1, 71 -0058 Influence of Cigarette Smoke on Guinea Pigs. Effect on Read, C. R. PulmonaryCelband ScrumAntitrypsinLevels. The Teenager Looks at Cigarette Smoking, 71-1088 71-0198 Why Do We Advertise the Chief Cause of Lung Cancer? Resnekov, L. 71.1101 Effects of Cigarette Smoking on I lcmcxlynam ics at Rest Reckzeh, G. and During Exercise. 1. Normal Subjects, 71-1042 [Experimental Animals, Their Maintenance and Test- Resnick, H. ing.1, 71-0404 Serum Trypsin Inhibitor Concentrations in Coal Miners Reddy, C.R.R.M. With Respiratory Symptoms, 71-1179 Carcinoma ofthePalateinVisakhapatnam Area, Resnick, J. 11. 71-0857 Modification of Smoking Behavior: Good Designs.. Ilistopathological Study of Stomatitis Nicotina, 71-1150 Inaccurate Reporting, 71.1255 Reddy, P. G. Richard, J. L. Ilistopathological Study of Stomatitis Nicotina, 71-1150 [Lipidemia, Tobacco Consumption and Corpulence. Rees, E. D. Study of an Active Male Population of 7,972 Sub. A Study of the Mechanism of Intestinal Absorption of jects.1, 71.0405 Benzo(a)pyrene, 7 1-056 7 Scrum Lipids, Smoking and Body Build. Study of 7,972 Reger, R. B. Actively Employed Males, 71-0907 Hyperinflation of the Lungs in Coal Miners, 71-1174 Richardson, J. F. Reginster.11aneuse, G. The Dietary Sugar Intake of Businessmen : The Results [Medico-SocialIncidenceofMyocardialInfarct. 1, of a Cross-Sectional Survey, 71 -0914 71-0044 Richardson, J. R. (Jr.) Reichel, G. Determinants of Survival of theDialysis Cannula, [Influence of Smoking Habits on the Incidence of 71-0128 Non-specific RespiratoryDiseases.III. Communica- Richert, J. tion.1, 71-0096 The Smoke Reflex in Rabbits. An Example of Auto- [The Epidemiology of Chronic Bronchitis and Its nomic Control of Cardiorespiratory Function, 71-0306 Relationship to Air Pollution. 1, 71-0103 Richmond, S. [Influence of the Locally Different Grade of Pollution Cigarette Smoke: Effects on Lactate Extraction in the in the Township of Duisburg on the Incidence of Presence of Severe Coronary Atherosclerosis, 71-1061 Non-specific RespiratoryDiseases. V. Communica- Richter, C. B. tion.1, 71-0280 Application of Infectious Agents to the Study of Lung Influence of Smoking Habits on theIncidence of Cancer: Studies on the Etiology and Morphogencsis of Non - specific Respiratory Diseases. 111. Communica- Metaplastic Lung Lesions in Mice, 71 -1000 tion, 71-0873 Richter, R. A Contribution to the Epidemiology of Chronic Bron- [Model for the Prediction of Demand for Tobacco chitis and to Its Relation to Air Pollution, 71-0878 Products byPriceClass Withthe Aid of Trend Effect of Air Pollution on the Prevalence of Respiratory Calculation.) , 71-1260 Diseases in West Germany, 71-1178 Rickard, V. D. Reid, D. D. Incidence of Bronchogenic Carcinoma in Negroes. Statis- Dietary Sugar Intake in Men With Myocardial Infarction. tical Analysis of 94 Cases, 71 -0257 ReporttotheMedical Research Council byIts Rieckcrt, C. Working-Party on the Relationship Between Dietary [Survey and Improvement of Efficiency of Cigarette Sugar Intake and Arterial Disease, 71-0133 Filters.1, 71-0181 International Studies in Chronic Respiratory Disease, Riggan, W. B. 71-0233 Cigarette Smoking and HemagglutinationInhibition

285 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Responseto Influenza After Natural Disease and .Products and the Incidence of Pulmonary Cancer.], Immunization, 71-0888 71-0755 Rimington, J. Rondia, D. Smoking, Chronic Bronchitis, and Lung Cancer, 71-0434 (Reduction in the Activity of Ilepatic Benzopyrene Rioufol, F. Hydroxylase InVivo After Inhalation of Carbon (Carbon Monoxide Content in Blood: Normal and After Monoxide.] , 71-0406 a Few Minutes Exposure to an Atmosphere Containing Ronge, H. One Part per Thousand Carbon Monoxidein 43 Acute Irritation Effects of Tobacco Smoke in Room Subjects.] , 71-0569 Air, 71.0147 Riss, E. Rose, C. L. Distribution and Multiple Regression Analysis of Blood Computer Based Data Analysis in Longevity Research, Pressure in 10,000 Israeli Men, 71-0666 71-0230 Rissanen, V. T. Rose, C. S. Occurrence of Coronary Occlusion in Cases of Coronary Acute Toxicity of Carbon Monoxide Under Hyperbaric Death and Accidental Death, 71-0301 Conditions, 71-0832 Ritli, 1. Rose, E. F. (Chemical Investigation on Domestic Cigarettes, Espe- CarbonMonoxide: A ChallengetothePhysican, cially the Newest Products of the Past Year.], 71-0022 71-0833 Rival, J. Rose, G. The Effect of Nicotine on Regional Blood Flow in the A Proposed Trial of Heart Disease Prevention in In- Canine Heart, 71-1049 dustry, 71-0134 Rivero-Serrano, 0. A Controlled Trial of the Effects of Health Education in (Chronic Obstructive Pulmonary Disease.], 71-0281 High-Risk Subjects, 71-0940 Robbins, P. R. Cigarette Smoking by Hospital Patients, 71.0953 Psychological Factors in Smoking, Drinking, and Drug Rose, M. Experimentation, 71-1089 CarbonMonoxide: A ChallengetothePhysician, Robert, A. 71-0833 PossibleRelationship Between Smoking and Peptic Roscrans, J. A. Ulcer, 71-0974 Effects of Nicotine on Behavioral Arousal and Brain Roberts, C. J. 54-1ydroxytryptamine Function in Female Rats Se- Association of Psychosocial Factors to the Smoking lected for Differences in Activity, 71-0,216 Practices of High School Students, 71-0939 Alteration of 5-Hydroxytryptamine-I"C Uptake and Robinet-Levy, M. Metabolism in Intestinal Smooth Muscle, 71-0225 (Chronic Familial Bronchopneumopathies and Homo- C.N.S. Effect of Nicotine as the Discriminative Stimulus zygotic Alphai-Antitrypsin Deficiency.], 71 -0881 for the Rat in a T-Maze. 71-0942 Rockwell, T. H. Effects of Nicotine on Brain Area 5-Hydroxytryptamine An Exploratory Study of Automobile Driving Perfor- Function in Male and Female Rats Separated for mance Under the Influence of Low Levels of Carboxy- Differences of Activity, 71-1124 hemoglobin, 71-0403 Rosenberg, A. Rode, A. Viewpoints on Smoking Withdrawal. Viewpoints on The Influence of Cigarette Smoking Upon the Oxygen Smoking WithdrawalCopenhagenExperiences, Cost of Breathing in Near-Maximal Exercise, 71-0874 71-0708 Smoking Withdrawal and Changes of Cardiorespiratory Rosenblatt, S. Fitness, 71-1025 Marijuana and the Use of Other Drugs, 71-0151 Smoking and Personality, 71-1090 Rosengren, A. Rodkcy, F. L. Effect of Different Aldehydes on Tracheal Mucosa, Discussion: Carbon Monoxide Estimation in Gases and 71-0192 Blood by Gas Chromatography, 71-0568 k Nasal Absorption of Organic Matter in Animal Experi- Rodriguez Rivera, L. ments. I. Experimental Technique and Tobacco Smoke (Analysis of the Smoking Habit in Discharged Patients. Absorption, 71-0268 Study of 453 Cases.] , 71-0064 Rosenman, R. H. Rodriguez Silva, H. Assessing the Risk Associated With Behavior Patterns (Analysis of the Smoking Habit in Discharged Patients. 71-0663 Study of 453 Cases.] , 71-0064 The Central Nervous System and Coronary Heart Di- Roe, F.J.C. sease, 71-1056 The Mechanism of Carcinogenesis by the Neutral Frac- Rosental, R. tion of Cigarette Smoke Condensate, 71-0258 (Second Infarct.] , 71-1039 Roisman, A. Z. Roske, G. Nonsmokers Have Rights, Too, 71-0343 (Influence of the Locally Different Grade of Pollution (4; Rokaw, S. N. in the Township of Duisburg on the Incidence of Heart Rate and Carbon Monoxide Level After Smoking Non-specificRespiratoryDiseases. V. Communica- High-, Low-, and Non-Nicotine Cigarettes. A Study in tion.] , 71-0280 Male Patients With Angina Pectoris, 71-0467 Ross, D. C. Carboxyhemoglobin Caused by Smoking Nonnicotine Studies on Figure Drawings: Biological Implications of Cigarettes. Effects in Angina Pectoris, 71-1031 Structural and Graphic Characteristics, 71-0706 Rokicki, W. Ross, R. (Connection Between the Technology of Tobacco Smoking and Personality, 71-1090

2?;'. . 286 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Rossiter, C. E. Lymphocytes In Vitro, and Certain Antibody Titers of Mortality in the Chrysotile Asbestos Mines and Mills of Healthy Smokers, 71-0513 Quebec, 71-04 21 Ruoff, P. A. Roth, D. The Smoke Reflex in Rabbits. An Example of Auto- Synergistic Effect of Mutagens and Incorporated DNA nomic Control of Cardiorespinitory Function, 71-0306 InVitro.AnalogyforBuccopharyngeal Cavity, Rusk, H.S. 71.1001 How Smoking Causes Lung Cancer, 71.1003 Rouch, Y. Russek, H. 1. (Carbon Monoxide Content in Blood: Normal and After 'Progress' in the Treatment and Prevention of Coronary a Few Minutes Exposure to an Atmosphere Containing Heart Disease, 71-0905 One Partper Thousand Carbon Monoxidein 43 Russell, M.A.H. Subjects.] , 71-0569 Cigarette Smoking: Natural History of a Dependence Roughton, F.J.W. Disorder, 71-0336 The Equilibrium of Carbon Monoxide With Human Cigarette Dependence: INature and Classification, Hemoglobin in Whole Blood, 71-0570 71-0525 Roussel, J.-J. Cigarette Dependence: II Doctor's Role in Manage- (Oral Protozoa. Epidemiologic Study.] , 71-0915 ment, 71-0534 Roventa, A. Smoking in Britain: Strategy for Future Emancipation, (EpidemiologicalInvestigations on lschemic Cardio- 71.1102 pathy in Industry. Study of a Group Involving Minimal Rybo, G. Physical Work (Engineers, Technicians,Designers).(, (Smoking and Logic.( (Letter), 71.1235 71-0897 Ryder, R. C. Rowland, J. A. A Quantitative Study of the Relationship Between How About Smoking? 71-0941 Chronic Bronchitis, Emphysema and Smoking 71-0438 Rowlands, J. R. A Quantitative Study of Bronchial Mucous Gland Reaction of Nitrogen Dioxide With Blood and Lung Volume, Emphysema and Smoking in a Necropsy Components.ElectronSpinResonanceStudies, Population, 71-0876 71-0571 Rylander, R. Roy, F. H. Nasal Absorption of Organic Matter in Animal Experi- Chronic Maternal Cigaret Smoking and Infant Retro- ments. I. Experimental Technique and Tobacco Smoke lental Fibroplasia: Negative Results, 71-0792 Absorption, 71-0268 Royal College of Physicians of London. Smoking and Pulmonary Disease (3): Studies of the Smoking and Health Now. A New Report and Summary Effect of Smoking in the Respiratory Organs Using on Smoking and Its Effects on Health From the Royal Experimental Animals, 71-0629 College of Physicians of London, 71-1134 .Reduction of Cigarette Smoke Ciliotoxicity by Certain Rubin, B. A. Tobacco Additives, 71-0959 Alteration of the Homograft Response as a Determinant Lung Clearance of Particles and Bacteria. Effects of of Carcinogenicity, 71-1002 Cigarette Smoke Exposure, 71-1026 Rubin, I. Free Lung Cell Studies in Cigarette Smoke Inhalation Inorganic Particles in Cigars and Cigar Smoke, 71-0966 Experiments, 71-1180 Rubin, R. J. Ryser, H. J.-P. The Effect of Carbon Monoxide Inhalation on In Vivo Chemical Carcinogenesis, 71-0834 Drug Metabolism in the Rat, 71-1122 Ryvkin, I. A. Rubinstein, E. H. (Risk Factors and Primary Prevention of Arterial Hyper- Modifications of the "Alarm" Pattern by Nicotine, tension and lschemic Heart Disease.] , 71-0782 71-0572 Rzeszutko, B. Ruddon, R. W. (Epidemiological Picture of Chronic Nonspecific Lung Comparison on Effects of Phenobarbital and Nicotine Diseases in One District of the City of Wroclaw.(, on Nuclear Protein Synthesis in Rat Liver, 71-0407 71-0456 Ruehl, A. Effect of Cigarette Smoke on the Cardiovascular System in Dogs, 71-0883 Ruffi, A. Behavioural Effects Caused by Intraarterial Injection of Sabin, S. AcetylcholineandNicotineinConsciousRats, Comparison of Direct and Indirect Measurement of 71 -0840 Airway Resistance. A Critical Analysis of the Forced Rulliere, R. Vital Capacity Curve, 71-0608 (Tobacco and Lungs.] , 71-0875 Saccomanno, G. Rumen, N. M. Histologic Types of Lung Cancer Among Uranium HemeHeme Interaction of Crystalline Lamprey Hemo- Miners, 71-0259 globin. Kinetics and Equilibrium of the Reaction of Metaplasia to Neoplasia, 71-1004 Carbon Monoxide, 71-0573 Sadokierska, H. Rumke, P. (The Effect of Occupational Dust Exposure on the (1mmunoglobulin Concentrations, Hemagglutinin (PHA) Prevalence of Chronic Bronchitis Among Workmen of Responses of Lymphocytes In Vitro and Some Anti- Sierzan's Wool Industry at Bialystok.) , 71-0078 body Levels in Healthy Smokers.) , 71-0316 (Chronic Bronchitis Among Textile Workers. Clinical Immunoglobulin Concentration, PHA Reactions of and Radiological Detection.) , 71-0455

287 2g.?9 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Sadoul, P. Miners, 71-0259 (Functional Picture of Radio logically Destructive Em- Metaplasia to Neoplasia, 71-1004 physema.] , 71-0097 Savino, A. Saha, N. C. Evaluation of a Rapid Index of Ambient Contamination Chronic Obstructive Lung Disease in Delhi. A Compara- by Cigarette Smoke, in Relation to the Composition of tive Study, 71-0457 the Gas Phases of the Smoke, 71-0035 Saigot, T. (Action of Ozone on Several Chemical Indices of Air (Tobacco and Lungs.], 71-0875 Pollution in Closed Areas.1, 71-0836 Sakurai, H. Sawicki, F. (Evaluation of TobaccoQualityFromPyroly tic !Pulmonary Tuberculosis and Cough and Expectiration Aspects. V. Statistical Study of Correlation Between in Inhabitants of Krakow.], 71-1021 Gaseous Constituents of Cigarette Smoke From Which Scassellati Sforzolini, G. the K Value Was Computed and Organoleptic Pro- Evaluation of a Rapid Index of Ambient Contamination perties of Tobacco Smoke.), 71-0031 by Cigarette Smoke, in Relation to the Composition of Saldi, G. the Gas Phases of the Smoke, 71-0035 Further Research on the Polycyclic Hydrocarbons of Further Research on the Polycyclic Hydrocarbons of Cigarette Smoke. Comparison of the Inhaled Smoke Cigarette Smoke. Comparison of the Inhaled Smoke and That Taken From the Ambient Atmosphere, and That Taken From the Ambient Atmosphere, 71-0036 7160036 Salzberg, P. M. (Action of Ozone on Several Chemical Indices of Air A Short Duration Group Treatment of Smoking Beha- Pollution in Closed Areas.] , 71-0836 vior by Stimulus Saturation, 71-0349 Scassellati Sforzolini, G. (Editor) Samaggia, S. (Smoking and Health. Practical Guide for Health Educa- (Cigarette Smoking Habits in Subjects With Myocardial tion.] , 71-0065 Infarction.] , 71-0302 Schade, G. Sampson, C. C. Changes of the Scrum Lipids Due to Smoking, 71-0890 Incidence of Bronchogenic Carcinoma in Negroes. Statis- Scharfenberg, G. tical Analyses of 94 Cases, 71-0257 (Doctors and Smoking. Results of an Investigation of Sampson, S. R. the Smoking Habits and of the Attitudes on Smoking Carotid Sinus Versus Carotid Body Origin of Nicotine Detoxification of Doctors in the Magdeburg District.], and Cyanide Bradycardia in the Dog, 71-0206 71-0337 $anda, M. (Cy tisine(Tabex)as a Drug Aid inBreaking the (Social Factors of Aging.], 71-0308 Smoking Habit.], 71-0535 Sanders, B. Schechter, M. D. The Relationship Between Extemal Calcium Concen- C.N.S. Effect of Nicotine as the Discriminative Stimulus tration and the Recovery Rate of Aortic Strips From for the Rat in a T-Maze, 71-0942 Nicotine Tachyphylaxis, 71-0975 Scheidt, S. Sanders, C. L. Shock After Acute Myocardial Infarction. A Clinical and Distribution of Inhaled Metal Oxide Particles in Pul- Hemodynamic Profile, 71-0135 monary Alveoli, 71-0458 Schepen,G.W.H. Sandifer, S. H. Lung Tumors of Primates and Rodents, 71-0756 Cigarette Smoking and Acute Non-Influenzal Respira- Scherbak, M. P. tory Disease in Military Cadets, 71-0613 A Colorimetric Method for the Determination of Total Sandrucci, M. G. Oxides of Nitrogen in Cigarette Smoke, 71-0574 Nepiopharmacology From theObstetric Viewpoint, Schiess, W. A. 71-0735 Unheeded Signals of Fatal Coronary Artery Disease, Sanyal, A. K. 71-1196 Effect on Ciliary Movements of Some Agents Which Schimmer, G. Come in Contact With the Respiratory Tract, 71-0720 (The SizeoftheSpatial T -AreaVectors Under Sanyal, R. K. Hypoxia.] , 71-0105 Action of Cholinergic Drug on Motility of Spermatozoa, The Size of the Spatial T-Area Vectors Under Condi- 71-0835 tions of Hyprix la, 71-0773 Sanz, R. Schirren, C. (Cigarettes and Gastric Secretion. I. Analysis of Gastric (The Childless Marriage. Possibilities and Limitations of Secretionin Smoking and Nonsmoking Ulcer Pa- the Treatment From the Andrological Viewpoint.], tients.] , 71-1225 71-0154 Sarji, N. M. Schlee, J. C. An Automated Method for the Determination of Total (Influence of Smoking During Pregnancy on the Neo- Aldehydes in Gas Phase of Cigarette Smoke, 71-0012 nate. Results and Conclusions on Human Observations Sartwell, P. E. r. and Animal Experiments.], 71-0313 Thromboembolism and Oral Contraceptives: An Epide- Schlotterer, M. miologic Case-Control Study, 71-0664 (Nicotine and Propranolol.) , 71-0730 Oral Contraceptives and Thromboembolism: A Further Schlotzhauer, W. S. Report, 71-0906 Evidence I'm' the Origin of Monoalkenes in Cigarette Sato, T. Smoke. (Letter), 71-0217 (Causative Factors in Laryngeal Cancer.], 71-0858 Schmid, D. Saunders, R. P. !Experimental Research on the Etiology of Bronchial Histologic Types of Lung Cancer Among Uranium Carcinomas.], 71-0066

288 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Schmauss, A. K. Schultz, E. F. (Jr.) Morphological Findings, Postoperative Complications, Collaborative Study of the Determination of Tar and Mortality and Duration of Bed Rest Following Ampu- Nicotine in Cigarette Smoke, 71-0032 tations Occasioned by Disorders of the Peripheral Schulz, W. Circulation, 71.1057 [Length of Cigarette Butts inthe Federal German Schmeltz, I. Republic in 1968.1,71-0350 Evidence for the Origin of Monoalkenes in Cigarette Schuman, L. M. Smoke. (Letter), 71-0217 The Benefits of Cessation of Smoking, 71-0423 Cigarette Smoke: Formation of Components and Modi- Schurer, D. fication of Composition by the Use of Additives, A New Time-Regulating Mechanism for a Pipe-Smoking 71-0837 Machine, 71-0351 Schmidt, F. Schwartz, D. Concerning the Problem of Passive Smoking, 71-0838 Lipidemia, Tobacco Consumption and Corpulence. [Are Smokers "Different" People?' , 71-1091 Study of an Active M:le Population of 7,972 Sub - [On Cigarette Deaths. Supplement and Commentary.), jects.), 71.0405 714093 Smoking and Leucocyte-Counts. Results of an Epide- [Why US. Life Insurance Companies Reduce Premium miological Survey, 71-0887 Rates for Nonsmokers. An Example Worth Men- Serum Lipids, Smoking and Body Build. Study of 7,972 tioning.1, 71.1103 Actively Employed Males, 71-0907 [Resolutions of the Medical Work Group for Smoking Schwartz, G. E. and Health at the First Annual Meeting on February 2, Smoking on Cue: A Behavioral Approach to Smoking 1971 in Mannheim.' , 71-1104 Reduction, 71-0704 Schmidt, G. Smoking Elimination by Gradual Reduction, 71.1263 112. Personality Characteristics.' , 71-0798 Scordamaglia, R. Schneider, R. [Control of the State of Health of Personnel of a The Effects of "Autonomic Drugs" on Villous Move- Gereral Provincial Hospital.), 71-0094 ment in the Small Intestine of the Pigeon, 71-0025 Scott, D. L. Schoenberg, B. S. A Survey of 216 Elderly Men and Women in General Certain Mortality Patterns of Esophageal Cancer in the Practice, 71-0693 United States, 1930-67, 71-0051 Seale, D. L. Schoendorf, T. .ClinicalCorrelations With CoronaryArteriography, Influence of Cigarette Smoking on Some Blood Coagula- 71-0131 tion Tests, 71-0488 Seaton, A. Schollield, C. N. Hyperinflation of the Lungs in Coal Miners, 71-1174 Uptake of Nicotine and Extracellular Space Markers by Sebbesse, P. Isolated Rat Ganglia in Relation to Receptor Activa- [Effects of Low Carbon Monoxide Concentrations in tion, 71-0359 Man.) , 71-0321 Schonberger, W. Seehofer, F. [The Size oftheSpatial T-Area Vectors Under [Length of Cigarette Butts in the Federal German Hypoxia.1, i 1 -0105 Republic in 1968.1, 71-0350 The Size of the Spatial T-Area Vectors Under Condi- Influence of Different Puff Volume Profiles on the tions of Hypoxia, 71-0773 Yield and Composition of the Smoke of Machine- Schott, L. Smoked Cigarettes.), 71.1126 [Comparative Values on the Question of the Influence Seely, J. E. of Tobacco Consumption on the PTC-Taste Capabi- Cigarette Smoking: Objective Evidence for Lung Dam- lity.), 71-0793 age in Teen-agers, 71.0459 Schouten, F.J.M. Segal, A. Sugar Consumption, Physical Activity, Smoking and Structure and Tumor-Promoting Activity of Anthralin Serum Composition in Man, 71-0292 (1,8-Dihydroxy-9-anthrone) and Related Compounds, Serum Lipids and Energy Expenditure in Old Men, 71-1127 71-0787 Seidman, H. Schuller, D. Longevity of Parents and Grandparents in Relation to (Cigarette Smoke Condensatefor Animal Tests.3. CoronaryHeart Disease and AssociatedVariables, Investigations of the Volatile Components of Solutions 71-0124 of Smoke Condensates.' , 71-0380 Selby, L. A. [Appearance of Norbornene Derivatives in Tobacco A Tobacco Related Epidemic of Congenital Limb Smoke Condensates.' , 71-0558 Deformities in Swine, 71-0790 [Analytical Investigation of Gas Phase Condensate.), Selikoff, 1. J. 71.1125 Inorganic Particles in Cigars and Cigar Smoke, 71-0966 Schubon, N. G. Sellick, H. Study of Asbestos Workers in British Columbia, 71-0429 Stimulation of Lung Irritant Receptors by Cigarette Schulte, J. H. Smoke, Carbon Dust, and Histamine Aerosol, 71-0768 The Effect of Exposure to Low Concentrations of Seltzer, C. C. Carbon Monoxide, 71-0839 Cigarettes and Heart Disease. (Letter), 71-0234 Schulte, J. H. Semaine des Hopitaux (Informations) Effects of Chronic Exposure to Low Levels of Carbon 'Evaluation of Myocardial Infarct.), 71-0665 Monoxide onHumanHealth,Behavior,and Semeraso, S. Performance, 71-0399 [Influenceof Cigarette Smoke on the "In Vivo"

Individual has contributed to this reference but is not listed as part of the main citation. 289 291 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Sensitivity-tolleparin Test, Studied by the Thrombo Shekelle, R.B. elastographic Method" 71-0121 Regional Differences in Prevalence. Incidence and Mor- Influence of Cigarette Smoke on the "In Vivo" Heparin tality From Atherosclerotic Coronary Ileart Disease. Sensitivity Test Studied by the Thromboelastrographic 71-1059 Method, 71-0649 Shekerova, N. Senewiratne, B. 'Neurotic and Neurotic like Morbidity in Manual and Tobacco Smoking in Ceylon, 71.944 WhiteCollar Workersinthe Tobacco Industryin Sepaha, G. C. Plovdiv. 1, 71-0331 Chronic Cor-Pulmonale. (A Study of 1,000 Cases.), Shephard, R. J. 71-0136 The Influence of Cigarette Smoking Upon the Oxygen Serdyuk, L. G. Cost of Breathing in Near-Maximal Exercise. 71-0874 'Current PhysicoChemical Methods of Analyzing To- Smoking Withdrawal and Changes of Cardiorespiratory bacco and Tobacco Smoke. 1, 71-0829 Fitness, 71.1025 Serise, M. Smoking and Personality, 71-1090 I Epidemiologic Study of Chronic Bronchitis and Respi Atmospheric Pollution and Chronic ChestDisease, ratory Insufficiency. Prevalence in a Sample of Women 71-1181 30 to 70 Years of Age" 71-0436 Sherstyaikh, N. A. Epidemiological Research on Chronic Bronchitis and Investigation of the Alkaloid Composition in Tobacco Respiratory Insufficiency. Study of Prevalence in a Smoke by Gas Ch ro m a tography.1, 71.0001 Sample of Women From 30 to 70 Years, 71-1010 Shibata, S. Serjeant, G. R. The Relationship Between External Calcium Concentra- An Assessment of Lung Volumes and Gas Transfer in tion and the Recovery Rate of Aortic Strips From Sickle-Cell Anaemia, 71-0899 Nicotine Tachyph yla xis, 71.0975 Sficas, A. G. Shields. C. E. Irrigation Experiments on Oriental Tobacco. 71-0408 Elevated Carbon Monoxide Levels From Smoking in Shabad, L. M. Blood Donors, 71-0489 Review of Attempts to Induce Lung Cancer in Experi- Shigematsu, II. mental Animals by Tobacco Smoke, 71-0067 'Studies on Composition of Tobacco Smoke. VII. Dose-Response Studies in Experimentally Induced Lung Composition of Volatile Phenol Fraction of Tobacco Tumours, 71-1151 Smoke. 1, 71-0822 Shah, F. K. Shillingford, J. P. Low Birth Weight and Neonatal Mortality Rate Related Dietary Sugar Intake in Men With Myocardial Infarction. toMaternal Smoking and Socioeconomic Status, ReporttotheMedicalResearch Council by Its 71-0811 Working-Party on the Relationship Between Dietary Shaikh, M. 1. Sugar Intake and Arterial Disease. 71.0133 Acute and Chronic Effects of Nicotine on Rat Gastric Secretion, 71-0916 Shimada, H. Shank, R. E. Some Viewpoints on Lung Cancer, ParticularlyIts MaternalNutrition and the Course of Pregnancy, Pathogenesis" , 71-0877 71-0508 Shimada. Y. Shapiro, D. 'EvaluationofTobaccoQualityFromPyrolytic Smoking on Cue: A Behavioral Approach to Smoking Aspects. V. Statistical Study of Correlation Between Reduction, 71-0704 Gaseous Constituents of Cigarette Smoke From Which Smoking Elimination by Gradual Reduction, 71-1263 the K Value Was Computed and Organoleptic Pro- Shappell, S. D. perties of Tobacco Smoke.1, 71.0031 Acute Change inHemoglobin Affinityfor Oxygen Ship, 1. 1. During Angina Pectoris. 71-0783 Intraoral Carcinoma: Predisposing Factors and Their Sharon, 1. M. Frequency of Incidence as Related to Age at Onset, Visual Deprivation and Parotid Response to Cigarette 71-0255 Smoking, 71-0566 Shnidman, S. R. Sharpless, S. K. Smoking on Cue: A Behavioral Approach to Smoking Effects of Nicotine and Recurrent Inhibition on Mono - Reduction, 71-0704 synaptic Reflexes in Acute and Chronic Spinal Cats, Shults, W. D. 71-0964 Tobacco Smoke Analysis Program Progress Report for Shaw, A. R. the Period JanuaryI. 1970, to September I. 1970, Obstructive Airway Disease in Patients With Treated 71-0202 Pulmonary Tuberculosis. 71-0460 Siedek, H. Shea, J. J. The Prophylaxis of Arteriosclerotic Cardiovascular Di- Management of Fluctuant Hearing Loss, 71-1072 seases.1, 71-1058 Shear, M. 'Siegel, E. South African Dental News, 71-0068 MaternalNutritionandthe Course of Pregnancy, Sheen, S. J. 71-0508 Changes of Alkaloid Composition During Curing in Siegel, J. Three isogenic Burley Tobaccos and Their F1 Hybrids, Effects on Experimental Animals of Long-Term Inhala- 71-0414 tion Exposure to Carbon Monoxide, 71-0654 Sheiham, A. Siemiatycki,J. Peridontal Disease and Oral Cleanliness in Tobacco Mortality in the Chrysotile Asbestos Mines and Mills of Smokers, 71-0691 Quebec, 71-0421

Individual has contributed to this reference but is not listed as part of the main citation. 206, 290 . t, CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Siggaard-Andersen, J. Pressure in 10,000 Israeli Men, 71-0666 Carbon-Monoxide-Induced Mountain Sickness Provoked Slodczyk, M. by Tobacco Smoking, 71-0775 [Chronic Bronchitis in Textile Industry Workmen.[, Signer, M. 71-0079 [Pathogenesis and Clinical Aspects of Infections of the Sluis-Cremer, G. K. Lower Respiratory Tract. (Part 1).), 71-0769 Allergic Diathesis in Relation to Chronic Bronchitis. Silva, S. 71-0282 [Cigarettes and Gastric Secretion. I. Analysis of Gastric Smidt, U. Secretionin Smoking and Nonsmoking Ulcer Pa- The Epidemiology of Bronchopulmonary Symptoms in tients.) , 71 -1 225 Coal Miners, Foundry Workers, Chemical Workers and [Cigarettes and Gastric Secretion. II. Effect of Cigarettes Bakers, 71-0772 on Gastric Secretion.) , 71 -1226 Smiech-Najda, B. Silver, H. M. [Chronic Non-specific Lung Disease Among the Work. Carbon Monoxide in health and Politics, 71 -0218 men of the Electro-Machine Works "EDA" at Ponia- Silverman, A. P. towa.1, 71.0083 Behavior of Rats Given a 'Smoking Dose' of Nicotine, Smit, H. 71 -0943 [The Effect of Several Ilumectants on the Properties of Silverman, S. (Jr.) a Flue-Cured Tobacco.) , 71-0219 Current Status of Oral Cancer and Premalignant Lesions, Smith, C. J. 71 -0692 Reverse Smoking in Andhra Pradesh, India: A Study of Oral Cancer, 71-1152 Palatal Lesions Among 10,169 Villagers, 71-0690 Silvers, D. Smith, H. E. In Southwestern Virginia, Students Set Up Antismoking Thromboembolism and Oral Contraceptives: An Epide- "Teach4ns"-207 of Them, 71-0183 miologic Case-Control Study, 71-0664 Simmons,.H. E. Smith, J. M. Your Psyche, the Cigarette and the Pill. The t'sychogenic Adolescent Cigarette Smoking, 71-0169 Theory of Disease, 71-1092 AdolescentCigaretteSmokinginTwo Societies, Simonson, E. 71.1250 Mortality and Coronary Heart Disease Among Men Smith, J. W. Studied for 23 Years, 71-0779 Elimination of Cigarette Smoking by Punishment and Simonsson, B. G. Self-Management Training, 71-0948 Smoking and Pulmonary Disease (6): Acute Effects, Smith, M. H. 71-0630 The Ultrastructure of Alveolar Macrophages From Hu- [Smoking and the Respiratory Organs.), 71 -1182 man Cigarette Smokers and Nonsmokers, 71-0627 Simpson, M.J.C. Smith, T. A. Insulation Workers inBelfast. 3. Mortality 1940.66, A Colorimetric Method for the Determination of Total 71-0848 Oxides of Nitrogen in Cigarette Smoke, 71-0574 Insulation Workers in Belfast. 2. Morbidity in Men Still Smith, W. E. at Work, 71-1016 An Experimental Model for Study of Cocarcinogenesis Sims, J. L. in the Respiratory Tract, 71-1005 Volatile Nitrogenous Bases and Aliphatic Secondary Snider, G. L. Amines of Burley Tobacco, 71-0010 Obstructive Airway Disease in Patients With Treated Sims, P. Pulmonary Tuberculosis 71-0460 Embryopathic Effects of 7,12-Dimethylbenz(a)anthra- So, B. T. cone andIts Hydroxymethyl Derivativesinthe Nitrosamine Studies: Induction of Lung Adenomas by Sprague- Dawlcy Rat, 71-0678 Concurrent Administration of Sodium Fitrile and Singh, A. P. Secondary Amines in Swiss Mice, 71-0753 Coronary Heart DiseaseSome Epidemiological, Clinical Sollet Guilarte, R. and Electrocardiographic Observations, 71-1 21 1 [Analysis of the Smoking Habit in Discharged Patients. Singh, S. P. Study of 453 Cases.1, 71-0064 Coronary Heart DiseaseSome Epidemiological, Clinical Solomon, T. E. and Electrocardiographic Observations, 71-1211 Effects of Nicotine 31iGastrointestinal Secretions, Sinha, L.N.K. 71-0683 A Smoking Problem CheckList for College Students, Somasundaran, P. 71-0705 Change in Gas VoMme During Puffing of a Lit Cigarette, Sinha, P. S. 71-00:47 Effect on Ciliary Movements of Some Agents Which Sonnenschein, R. R. Come in Contact With the Respiratory Tract, 71 -0720 Modifications of the "Alarm" Pattern by Nicotine, Sirotenko, A. A. 71-0572 [Current Physico-Chemical Methods of Analyzing To- Sorlie, P. bacco and Tobacco Smoke./ , 71-0829 Section 27. Coronary Heart Disease, Atherothrombotic Sivak, A. Brain Infarction, Intermittent ClaudicationA Multi- Cocarcinogenesis Studies on Mouse Skin and Inhibition variate Analysis of Some Factors Related to Their of Tumor Induction, 71-0415 Incidence: Framingham Study, 16-Year Followup, Cigarette Smoke Carcinogenesis: Importance of Tumor Promoters, 71-0602 Sot7gilu-1,P.304 Sive, P. H. Behavioural Effects Caused by Infra- arterial lnjectkon of Distribution and Multiple Regression Analysis of Blood AcetylcholineandNicotine inConsciousRats, 71-0840

291 CUMULATIVE AUTIIOR AND ORGANIZATIONALINDEX

Soustin, V. P. MortalityTen-Year Experience of the Peoples Gas Co. (The Ilistochemical Characteristics of the Epithelium of Epidemiologic Study (1958-68), 71-0290 True Vocal Cords in the Individual Development of Regional Differences in Prevalence, Incidence and Mor- Man.I, 71-0069 tality From Atherosclerotic Coronary Heart Disease, Soverini, A. 71-1059 (Cigarette Smoking Habits in Subjects With Myocardial Stan, R. Infarction.' , 71-0302 (Study of Current Prevalence of Chronic Bronchitis in Soyugenc, R. an Urban Population.' , 71-0763 Heart Rate: An Important Risk Factor for Coronary Stanescu, D. C. MortalityTen-Year Experience of the Peoples Gas Co. (Pulmonary Compliance in Patients With Silicosis and Epidemiologic Study (1958-68), 71-0290 Normal Spirographic Values,' , 71-0099 Spasova, V. Pulmonary Function in Workers With Chronic Exposure (Chemical and Technological Characteristics of Ciga- to Cadmium Oxide Fumes, 71-0100 rettes Produced in the Countries of the SIV. Report, (PulmonaryVentilation and Distributionin Young Cigarettes Produced in the USSR, German Democratic Healthy Males, Smokers and Nonsmokers.], 71-0101 Republic and Poland.', 71-0042 Lung Diffusing Capacity. Normal Values in Male Smo- Speer, F. kers and Non-Smokers Using the Breath-Holding Tech- Passenger Smoking Effects on Bus Drivers. (Letter), niques, 71-0283 71-0314 PulmonaryVentilationand DistributioninYoung Speizer, F. E. Healthy Males, Smokers and Nonsmokers, 71-0633 Cancers of the Lung and Nasal SinusesinNickel Stang, H. J. Workers, 71.0427 (Use/Abuse of Euphoriants Among Conscripted Youth Adult Mortality in Berlin, NH, From 1961 to 1967, at the 1969 Oslo Session.' , 71.1256 71-0981 Stare, F. J. Spezia, C. A. Nutritional and Epidemiologic Factors Related to Heart Rat Gastric Secretion and Mucosal Serotonin Following Disease, 71-0776 Chronic Oral Nicotine Ingestion, 71-0315 Stasck, V. Spilken, A. Z. Screening for Lung Cancer High-Risk Groups, 71-0252 Personality Patterns Associated With Heavy Cigarette Stauffer, H. P. Smoking in Male College Students, 71-1246 (A Spectrophotometric Method for the Determination Interaction of Personality and Treatment Conditions of Formaldehyde in Whole Smoke of Cigarettes.], Associated With Success in a Smoking Control Pro- 71-1129 gram, 71-1262 Stavraky, K. M. Spincer, D. A Study of Precursor Illness in Lung Cancer Patients, The Determinationof FormaldehydeinCigarette 71 -0598 Smoke, 71-1128 Spindle top Research, Inc. Stebbings, J. H. (Jr.) Synopsis of the Work Session Proceedings. September Chronic Respiratory Disease Among Nonsmokers in 10-12,1969. International Conference on CWP, Hagerstown, Maryland. 1. Design of the Study and 71-0093 Prevalence of Symptoms, 71.0631 Srch, M. Chronic Respiratory Disease Among Nonsmokers in The Significance of Carbon Monoxide in Cigarette Hagerstown, Maryland. II. Problems in the Estimation Smoke in Passenger Car Interiors, 71-0038 of Pulmonary Function Values in Epidemiological Srinivasan, S. R. Surveys, 71-0632 The Detection of Individuals Prone to Coronary Artery Chronic Respiratory Disease Among Nonsmokersis DiseaseA Screening Program Conducted on Medical Hagerstown, Maryland. III. Social Clas- and Chronic Students, 71-0642 Respiratory Disease, 71-1027 Stalhandske, T. Chronic Respiratory Disease Among Nonsmokers in Effects of Increased Liver Metabolism of Nico:ine on Its Hagerstown, Maryland. IV. Effects of Urban Residence Uptake, Elimination and Toxicity in Mice, 71-0220 on Pulmonary Function Values, 71 -1183 Stamler, J. Stedman, R. L. Heart Rate: An Important Risk Factor for Coronary Alkylphenols and Arylnitriles in a Biologically Active MortalityTen-Year Experience of the Peoples Gas Co. Neutral Subfraction of Cigarette Smoke Condensate, Epidemiologic Study (1958-68), 71-0290 71-0731 Acute Myocardial InfarctionProgress in Primary Pre- CompositionStudieson Tobacco.XLIV. Tumor. vention, 71-0667 Promoting Activity of Subfmctions of the Weak Acid The Primary Prevention of Coronary Heart Disease, Fraction of Cigarette Smoke Condensate, 71-0810 71-0908 Stefanin, E. Regional Differences in Prevalence, Incidence and Mor- [Study of Current Prevalence of Chronic Bronchitis in tality From Atherosclerotic Coronary Heart Disease, an Urban Population.] , 71-0763 71-1059 Steffens, G. L. Stamler, J. "Ripening" Tobacco With the Ethylene-Releasing Agent The Coronary Drug Project. Initial Findings Leading to 2-Chloroethylphosphonic Acid, 71-0409 Modifications of Its Research Protocol, 71.0043 Steffy, R. A. Stamler, J. (Chairman) Smoking Modification Procedures Tailored to Subject Primary Prevention of the Atherosclerotic Diseases, Characteristics, 71-1261 71-0137 Steinborn, J. Stamler, R. LS/MFT: Lung Screening by Meaningful Function Heart Rate: An Important Risk Factor for Coronary TestingPart 11, 71-0080 Individual has contributed to this reference but is not listed as part of the main citation.

292

wr , ' CUMULATIVE AUTIIOR AND ORGANIZATIONAL INDEX

Steinfcld, J. L. DieselExaust, and Cigarette Smoke in Dogs and Cigarette Smoking Is on the Increase Among Women I lamsters, 71-0599 and They Also Find It Harder to Quit, 71-0526 Cocarcinogenic Studies in Pulmonary Carcinogenesis. Stelzer, 0. 71-0999 Incidence of Risk Factors of Coronary Heart Disease in Stuart-I I arris, C. Different Age Groups and Social Classes in Men, Infection,the Environment and Chronic Bronchitis, 71-0643 71-0770 Stephens, R. J. Stunkard, J. A. Ultrastructural Changes in Connective Tissue in Lungs of Effects on Experimental Animals of Long-Term Inhala- Rats Exposed to NO2, 71-0461 tion Exposure to Carbon Monoxide, 71.0654 Stephens, W. B. Stupfel, M. Post-Myocardial Infarction Pain in a Series of Male Physiological and Biochemical Effects on Rats and Mice Patients in the Albury-Wodonga District, 71.0138 Exposed to Small Concentrations of Carbon Monoxide Sterling, T. D. for Long Periods, 71-0410 Comment on Smoking Dogs. (Letter), 71-0462 [Man's Organism, Source of Air Pollutionfor His A Review of the Claim That Excess Morbidity and Micro-Environment.), 71-0736 Disability Can be Ascribed to Smoking, 71-0742 Suarez, G. Smoking and Cancer. (Letter), 71-0757 Mucosa' Changes and Cancer inI ntra-Oral Smoking, Stevens, E. L. 71-0855 Heart Rate: An Important Risk Factor for Coronary Suero, J. T. MortalityTen-Year Experience of the Peoples Gas Co. The Respiratory Effects of Regular Cigarette Smoking in Epidemiologic Study (1958.68), 71-0290 Women, 71-0104 Stevens, P. M. Su frin, M. Pathophysiology of I lereditary Emphysema, 71.1184 To Screen or Not to Screen for COPD, 71.0098 Stewart, D. Sugawara, S. Immediate Effects of Cigarette Smoking on Simple [Composition of Tobacco Smoke. Part XIV. Formation Reaction Time of College Male Smokers, 71-0924 of Pyridines in Pyrolysis of Nicotine.), 71-0823 Stokholm, J. 3uhaila, A. [The Attitude of Danish Doctors Toward a Tobacco Response to Acetylcholine and Nicotine of the Perfuscd Smoking Control Program.) , 71-0711 Vessels of the Rabbit Ear, 71-0199 [ Awareness of I lealth Hazards of Tobacco Smoking Sulestrowski, W. Among Danish Doctors.) , 71-0926 [Treatmentof Nicotinism as a Link in Preventive Stone, D. B. Medicine.) , 71-0947 Antismoking Education Studyatthe University of Illinois, 71.1236 Sulheim, 0. Stone, II. L. Smoking and Coronary Disease (3): The Bergen Study, The Effects of Carbon Monoxide on Coronary Hemo- 71-0648 dynamics and Left Ventricular Function in the Con- Sullivan, P. D. scious Dog, 71 0806 Effects of Cigarette Smoking on Connecticut Residents. Storch, H. 71-0229 [Myocardial Infarct in Young People.] , 71-1060 Summers, D. N. Stoudt, H. W. Cigarette Smoke: Effects on Lactate Extraction in the Nutritional and Epidemiologic Factors Related to Heart Presence of Severe Coronary Atherosclerosis, 71-1061 Disease, 71-0776 Suomi, J. D. Stowe, D. F. Prevention and Control of Periodontal Disease, 71-1231 PossibleRelationship Between Smoking and Peptic Suri, K. Ulcer, 71-0974 Carcinogenic Effect of a Dimethyl Sulphoxide Extract Straat, P. A. of Betel Nut on the Mucosa of the Hamster Buccal Mutagenic Action, Loss of Transforming Activity, and Pouch, 71-0435 Inhibition of Deoxyribonucleic Acid Template Acti- Suzuki, K. vity In Vitro Caused by Chemical Linkage of Carcino- Pharmacologic Effects of Nicotine Upon the Fetus and genic Polycyclic Hydrocarbons to Deoxyribonucleic Mother in the Rhesus Monkey, 71-1130 Acid, 71-0967 Svandova, E. Strickland, J. A. Screening for Lung Cancer High-Risk Groups, 71-0252 Effects on Experimental Animals of Long-Term Inhala- Swain, A. P. tion Exposure to Carbon Monoxide, 71.0654 CompositionStudies on Tobacco. XLIV. Tumor- Strong, J. P. Promoting Activity of Subfractions of the Weak Acid Risk Factors and Atheroscloerotic Lesions, 71.0490 Fraction of Cigarette Smoke Condensate, 71-0810 Strube, G. Swartz, H. [Directed Prevention of lschamic Heart Disease in the Tobacco Smoke: A Noxious Air Pollutant. A Review Frameworkof anExperimentalEpidemiological (and Comment). Part 1 of II, 71-0737 Study.] , 71-0780 Tobacco Smoke: A Noxious Air Pollutant. A Review Strudel, G. (and Comment). Part II of II, 71-0738 [Experimental Teratology. Teratogenic Action of Nico- Swenson, E. W. tine on Chick Embryo.) , 71-0221 Human Alveolar Macrophages: Comparison of Phago- Stuart, B. 0. cytic Ability, Glucose Utilization, and Ultrastructure Studies of Inhaled Radon Daughters, Uranium Ore Dust, in Smokers and Nonsmokers, 71-0146

293 295 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Swensson, A. Tamura, K. Cyanide and Thiocyanate Levels in Blood and Urine of Pharmacological Features of the Gall Bladder and Its WorkersWithLow-GradeExposuretoCyanide, Vascular Bed of the Dog In Situ,71-0841 714)210 Tamura, T. Swiecicki, W. Studies on the Antidotal Action of Drugs. PartI. [Effect of Carbon Monoxide, Vibration and Lowered Vitamin C and Its Antidotal Effects Against Alcoholic Atmospheric Pressure on the Cerebral Neurosecrctory and Nicotine Poisoning, 71 -041I System and Ca techolamine Levels.] , 71-1224 Tanck, R.11. Swomley, J. A. Psychological Factors in Smoking, Drinking, and Drug The Cigarette Epidemic, 714)341 Experimentation, 71-1089 Szafnagel, A. Tannenbaum, A. [Treatmentof Nicotinism as a Link inPreventive [Report of Studies on the Inhalation of Carcinogens Medicine., 71-0947 With Special Reference to Tobacco Smoke.] , 71-0070 Szafranski, W. Tarkoff, M. P. [Chronic Non-specific Lung Disease Among the Work- Pulmonary Emphysema and Alphai-Antitrypsin Defi- menoftheElectro-MachineWorks "EDA" at ciency, 71-0771 Poniatowa.] , 71-0083 Taubc, A. [Chronic Non-specific Diseases of the Lung Among the Peak Expiratory Flow in Healthy Persons Aged 45.65 Rural Population of the Lublin Province.] , 71 -1012 years, 71-0448 Szaloky, L. G. Taylor, G. F. Sputum Cytology iithe Diagnosis of Bronchial Car- A Survey of 216 Elderly Mcn and Women in General cinoma, 71-0592 Practice, 71-0693 Szisajderman, M. Taylor, H. L. [Clinical and Metabolic Studies m Men With Myocardial Mortality and Coronary Heart Disease Among Men Infarction at Young Age. , 71-0855 Studied for 23 Years, 71-0779 Szollosi, E. Taylor, N. [Data on the Effect of Low Carbon Monoxide Content Results of Screening Patients for Peripheral Vascular of the Air on People.] .71-0668 Disease by Paramedical Personnel, 71.0892 Taylor, W. Vibration Syndrome in Forestry Commission Chain Saw Operators, 71.0694 Tabaironi, F. Taylor, W. F. lInfluenceof Cigarette Smoke on the "In Vivo" The Probability of Fetal Death, 71-0743 Sensitivity-to-Heparin Test, Studied by the Thrombo- Taylor, W.J.R. elastographic Method.] , 71-0121 HistoryandPharmacologyofPsychedelicDrugs, Influence of Cigarette Smoke on the "In Vivo" Heparin 71-1270 Sensitivity Test Studied by the Thromboelastographic Teculescu, D. B. Method, 71-0649 [Pulmonary Compliance in Patients With Silicosis and Tai, A. Normal Spirographic Values.] , 71-0099 Response to Acetylcholine and Nicotine of the Perfused Pulmonary Function in Workers With Chronic Exposure Vessels of the Rabbit Ear, 71-0199 to Cadmium Oxide Fumes, 71-0100 Taira, N. [Pulmonary Ventilationand Distributionin Young NicotinicAcetylcholine Receptors Subserving Noci- Healthy Males, Smokers and Nonsmokers.] , 71-0101 ception in the Dog Hindlimb, 71-0222 LungDiffusing Capacity.Normal ValuesinMale Takahashi, T. Smokers and Non-Smokers Using the Breath-Holding Induction of Carcinoma of Glandular Stomach in Rats Techniques, 71-0283 by Local Application of 7,12-Dbnethylbenz(a)anthra- PulmonaryVentilationandDistributioninYoung cene, 71-1153 Healthy Males, Smokers and Nonsmokers 71-0633 Takayama, S. [EpidemiologicalInvestigations on Ischemic Cardio Acceleration of Proliferation and Tumor Production pathy in Industry. Study of a Group Involving Minimal Rate of L-Strain Cells by Treatment With Cigarette Physical Work (Engineers, Technicians, Designers)" Tar, 71-1145 71-0897 Effect of Cigarette Tar Upon Tissue Culture Cells. Temmem-Brak, T. M. Neoplastic Transformation of Hamster Lung Cells by [Coronary Disease Risk Factors in Young Managers.] Tobacco Tar in Tissue Culture, 71-1146 71-0900 Talamo, R. C. Teraslinna, P. The Alpha i-Antitrypsin in Man, 71.1073 Association of Certain Social Habits and Attitudes With Talwar, J. R. Risk Factors of Coronary Heart Disease, 71-0909 Bronchial Carconoma An Analysis of 120 Cases, Terry, L. L. 71-0589 So Little Done...and So Much To Do! From the NTRDA Tamini, Y. AnrualMeeting Session onCigaretteSmoking, [Effect of Nicotine on Amylase Secretion by the Parotid 71-0184 Gland.] , 71-0039 The Future of an Illusion, 71-0235 Effects of Nicotine on Salivary Amylase Secretion From [SmokingSlow Suicide. Is There Any Hope?' , 71.1105 Rabbit Parotid Gland, 71-0205 Terry, L. L. (Chairman) Action of Ty-Ts:nine on the Salivary Amylase Secretion National Conference on Smoking and Health. A Sum- From i Parotid Gland in Reference to That mary of Proceedings. San Diego, September 9.11, Nicotine,?`l)740 1970,71 -0540

294 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

*Terzian, L. A. Thomson, M. L. A Review of the Biomedical Effects of Marihuana on Evidence for Temporary Slowing of Mucociliary Clear- Man in the Military Environment, 71-0197 anceinthe Lung Caused by Tobacco Smoking, Testa, B. 71-0452 Pio-Neurological Observations in a Group of Workmen Thor, P. Chronically Exposed to the Action of Carbon Mon- Effects of Nicotine on Gastric Secretion and Ulcer oxide.' , 71-0969 Formation in Cats, 71.1221 Theodore, J. Thornton, R. E. The Effect of Carbon Monoxide on Human Perfor- Reduction in the Concentration of Aromatic Polycyclic mance, 71-0398 Hydrocarbons in Cigarette Smoke, 71-0547 Low Level Carbon Monoxide Exposure and Human Thys, J. P. Psychomotor Performance, 71-0400 (Congenital Polycystic Lung. A Case Study and a Toxicological Evaluation of Carbon Monoxide in Hu- Review of the Literature.(, 71.0635 mans and Other Mammalian Species, 71-0412 Tibbfin, G. Human Sleep Patterns and Psychomotor Performance (Smoking and Coronary Disease (5): People Born in During Exposure to Moderate Concentrations of Car- 1913.1, 71-0140 bon Monoxide, 71-0831 Risk Factors in Coronary Heart Disease, 71-0303 Effect of Carbon Monoxide Exposure on Human Sleep Poir.ts in the Matter of Giving Up Smoking. Who Stops and Psychomotor Performance, 71-0970 Smoking After Acute Myocardial Infarct?, 71-0466 Thirion, J. Harmful Clinical Effects of Smoking. Myocardial Infarct The Determination of Malathion Residues in Tobacco and Smoking, 71-0492 and Tobacco Smoke Condensate, 71-0383 Smoking and Coronary Disease (5): Men Born in 1913, The Determination of Thiodan and Thiodan Sulphate on 71.0493 Tobacco and in Smoke Condensate, 71-1117 Smoking as a Risk Factor, 71-0669 Thiseus, S. Smoking and Coronary Disease (2): General Survey, (Smoking and Coronary Disease (9): Angina Pectoris or 71-0670 Angina Cardiac?' , 71-0139 (AtherosclerosisNicotine Therapy (1): Heart Infarct Smoking and Coronary Disease (9): Angina Pectoris or Risk Factors.] , 71-1212 Angina Cardiac?, 71-0491 (PersonalityFeatures in Smoking. A Pilot Study.(, Thomas, A. A. 71-1247 Hematological Effects of Long Term Continuous Animal Tibbling, L. Exposure to Carbon Monoxide, 71-0843 (Smoking and Coronary Disease (9): Angina Pectoris or Thomas, C. B. Angina Cardiac?' , 71-0139 Personality Characteristics of Medical Students as Re- Smoking and Coronary Disease (9): Angina Pectoris or flected by The Strong Vocational Interest Test With Angina Cardiac?, 71.0491 Special Reference to Smoking Habits, 71-0338 Smoking and Coronary Disease (16): Central Nicotine Some Characteristics Related to the Cancer Status of EffectStress Factor?, 71-0575 Women Physicians, 71-0340 Harmful Clinical Effects of Smoking. The Effect of Studies on Figure Drawings: Biological Implications of Smoking on the Central Nervous System, 71.0695 Structural and Graphic Characteristics, 71-0706 (Personality Differences Among Smokcrs With Different Thomas, G. 0. Cigarette Consumr lions.' , 71-1251 Alphas-Antitrypsin Deficiency and Pulmonary Emphy- Timm, J. sema, 71-1164 (Several Trend Analyses on thc Problem of Cigarette SmokingintheGermanFederalRepublicfor Thomas, H. E. (Jr.) 1961-1969.1 , 71-0352 Prevention of Myocardial Infarction, 71-0293 (Mathematical Aspects of the Planning and Evaluation Thomas, J. R. of Experiments in Cancer Research. Presented Using Immediate Effects of Cigarette Smoking on Simple the Investigation of Cigarette Smoke Concentrates as Reaction Time of College Male Smokers, 71-0924 an Example.) , 71-0431 Thompson, D. W. (Trend Analysis in the Problem of the Consumption of Sputum Cytology Screening for Lung Cancer, 71-0749 Nicotine and Smoke Condensate in the Federal Re- Thompson, J. H. public of Germany From 1961 - 1970.(, 71-1249 Rat Gastric Secretion and Mucosal Serotonin Following Tiso, B. Chronic Oral Nicotine Ingestion, 71-0315 (Myocardial Infarct. Comparative Clinical and Thera- Chronic Effects of Nicotine on Gastric Secretion in peutic Results.(, 71-0904 Vagotomized Rats, 71-0511 Tissari, A. Some Effects of Nicotine on Gastric Secretion in Rats, Effect of Cigarette Smoking on Diuresis Induced by 71-0512 Furosemide, 71-0842 Acute and Chronic Effects of Nicotine on Rat Gastric Tobacco. Secretion, 71-0916 U.S.S.R. Nothing Done by Authorities to Discourage Thomson, A. M. Smoking Habit, 71-0174 Dietary Sugar Intake in Men With Myocardial Infarction. Tobacco Research Council. ReporttotheMedical Research Council by Its Review of Activities, 1967-69, 71-0413 Working-Party on the Relationship Betweon Dietary Tocci, P. Sugar Intake and Arterial Disease, 71-0133 Effects of Cigarette Smoke on Incorporation of Radio- ' Thomson, A. M. isotopically Labeled Palmitic Acid Into Pulmonary MaternalNutrition andthe Course of Pregnancy, Surfactant and on Surface Activity of Canine Lung 71-0508 Extracts, 71-0864

Individual has contributed to this reference but is not listed as part of the main citation. 295 297 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Tuck, E.P.C. Turner, D. M. Lung Disease With Chronic Obstructionin Opium Metabolism of Small Multiple Doses of (14C) Nicotine Smokers in Singapore. Clinical, Electrocardiographic, in the Cat, 71-0223 Radiological, Functional, and Pathological Features, Turnescu, B. 71-1 158 /Study of Current Prevalence of Chronic Bronchitis in Tokich, T. J. an Urban Population.] , 71-0763 Heart Rate: An Important Risk Factor for Coronary Turpeinen, 0. MortalityTen-Year Experience of the Peoples Gas Co. Cancer Among Men on Cholesterol-Lowering Diets. Epidemiologic Study (1958-68), 71-0290 Experience From Five Clinical Trials, 71.1137 Tomanek, A. Tursky, B. [Dependence of the Bronchial Secretion and Cough Smoking on Cue: A Behavior Approach to Smoking Symptoms on the Microbial Flora in the Bronchial Reduction, 71-0704 Tree of Chronic Lung Disease Patients.] ,11.1159 Smoking Elimination by Gradual Reduction, 71.1263 Toporkova, 1. B. Tyldesley, W. R. Vitamin C Balance in Connection With Chronic Ex- Tobacco Chewing in English Coal Miners. A Preliminary posure of Tobacco Industrial Workers to Tobacco Report, 71-1074 Dust, 71-0794 Tyroler, H. A. Tornero Dias, C. Occupation and Physical Activity and Coronary Ileart (Symposium on tMedical Problems Originating From Disease, 71 -1034 Tobaccoism. V. Psychological Consideration ,7 1-0803 Body Weight and Cigarette Smoking as Risk Factors, Torrance, J. D. 71-1044 Acute Change in HemoglobinAffinityfor Oxygen Tyrrell, A. B. During Angina Pectoris, 71.0783 Occupational and Non-Occupational Factors Associated Toussaint, 1. With Vesical Neoplasm in Ireland, 71.0601 [Model fo; the Prediction of Demand for Tobacco Products byPriceClass With the Aid of Trend Calculation.] , 71-1260 Townes, B. I. Udechuku;J. C. Changes of alkaloid Composition During firing in Cigarette Smoking by Hospital Patients. 71-0953 Three Isom is Burley Tobaccos and Their Ulf tt, G. A. 71-0414 the Effects of Smoking Withdrawal on Quantitatively Tremonti, L. P Analyzed EEC, 71-0502 Toky -Yokohama Asthma, 71 -0102 Ulett, J. A. Trendelenburg, F. The Effects of Smoking Withdrawal on Quantitatively EpidemiologyandDetectionofBronchialCar- Analyzed EEC, 71-0502 cinomas.] , 71-0600 Ulmer, W. T. Trethewie, E. R. (Influence of Smoking Habits on the Incidence of Effect of Low Temperature of Combustion on Cigarette Non-specific Respirator/Diseases.III. Communi- Smoke Damage to Lung, 71 -075 8 cation.] , 71 -0096 Trethowan, W. H. (The Epidemiology of Chronic Bronchitis andIts Cravings and Aversions During Pregnancy, 71-1066 Relationship to Air Pollution.(, 71-0103 Trevelyan, M. H. /Influence of the Locally. Different Grade of Pollution Smoking and Neurotic Illness, 71 -0325 in the Township of Duisburg on the Incidence of Stress and Coronary Heart Disease, 71-1197 Non-specificRespiratoryDiseases. V. Communica- Trnka, L. tion.(, 71 -0280 [Dependence of the Bronchial Secretion and Cough Influence of Smoking Habits on the Incidence of Symptoms on the Microbial Flora in the Bronchial Non-specificRespiratory Diseases. III. Communica- Tree of Chronic Lung Disease Patients.] , 71-1159 tion, 71-0873 Trulson, M. F. A Contribution to the Epidemiology of Chronic Bron- Nutritional and Epidemiologic Factors Related to Heart chitis and to Its Relation to Air Pollution, 71-0878 Disease, 71-0776 Ulrich, L. Ts'o, P.O.P. ChronicBronchitisinAgriculturalandChemical Mutagenic Action, Loss of Transforming Activity, and Workers, 71-0284 Inhibition of Deoxyribonucleic Acid Template Acti- Uragoda, C. G. vity In Vitro Caused by Chemical Linkage of Carcino- Tobacco Smoking in Ceylon, 71-0944 genic Polycychc Hydrocarbons to Deoxyribonucleic Ury, H. K. inCigaretteSmoking, Acid, 71-0967 CarbonMonoxideUptake 71-0117 Tueller, E. E. US. Department of Health, Education, and Welfare. Anatomic and Histologic Chances of Early Emphysema, Public Health Service. 71 -0621 Marihuana and Health. A Report to Congress From the Turbott, S. Secretary, U.S. Department of Health, Education, and Changes in Smoking Habitsin.Men Under 65 Years Welfare, 71-0576 After Myocardial Infarction and Col.:nary Insuffi- Survey o: Lead in the Atmosphere of Three Urban ciency, 71-0125 Communities, 71-0577 Turnbull, M. J. The Health Consequences of Smoking. A Report of the Cigarette Dependence. (Letter), 71-0976 Surgeon General: 1971, 71-0984

296 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

U.S. Department of Health, Education, and Welfare. Serum Composition in Man, 71-0292 Public Health Service. National Clearinghouse for Smok- Serum Lipids and Energy Expenditure in Old Men, ing and Health. 71-0787 Bibliography on Smoking and Ilealth -1970,71-073 9 Van Haclst, L. Teenage Smoking. National Patterns of Cigarette Smok- (Congenital Polycystic Lung. A Case Study and a ing, Ages 12 Through 18, in 1968 and 1970, 71-0945 Review of the Literature.] , 71-0635 U.S. Federal Communications Commission. Van Peborgh, P. F. On Petitions for Review of Orders of the Federal Vitamin B12 Content of Ariceous Humor. (Letter), Communications Commission, 71-1094 71-0312 Petition for Review of a Report and Order of the Some Observations on the Mechanism of Tobacco Federal Communications Commission, 71-1095 Amblyopia and Its Treatment With Sodium Thiosul- U.S. Senate and House of Representatives, 91st Congress. phate, 71-0689 Public Law 91 -222. Public Health Cigarette Smoking Van Proosdij, C. Act of 1969, 71-0707 (The Problem of the Attachment to Tobacco Use.), 71-0175 Vapaatalo, H. I. Effect of Cigarette Smoking on Diuresis Induced by Vagoni, G. Furosemide, 7141842 (Lung Cancer and Air Pollution Due to Industrializa- Varga, E. tion.) , 71-0071 Analysis of the Depolarizing Effect of Nicotine on Valdez Ochoa, S. Frog's Skeletal Muscle, 71-0977 (Symposium on Medical Problems Originating in To- Vasileva, 1). baccoism. I. Alterations of the Respiratory System.] , (Neurotic and Neurotic Likc Morbidity in Manual and 71-0879 White-Collar Workers inthe Tobacco Industry in Valenti, C. Plovdiv.), 71-0331 Drug Usage and Related Patterns of Behavior in Univer- Vavercak, F. sity Students: I. General Survey and Marihuana Use, Smoking and Pregnancy, 71-0155 71-0697 Velican, C. Valic, F. (Mechanisms of PulmonaryEmphysema inHeavy Effects of Hemp Dust Exposure on Nonsmoking Female Smokers.) , 71-0463 Textile Workers, 71-1028 Vernot, E. H. A Comparative Study of Respiratory Functionin Hematological Effects of Long-Term Continuous Animal FemaleNonsmoking CottonandJute Workers, Exposure to Carbon Monoxide, 71-0843 71-1185 Vertes, L. Vallery-Mason, J. (Noxious Effects of Smoking on Gestation.), 71-0156 The Effects of Age on Masculine Sexual Activity. Viala, A. Incidenceof SeveralFactors Including Tobacco, (Determination of Nicotine by GasPhase Chromato- 71-0158 graphy. II. Applications.] , 71-0362 (Tobacco and Sexual Behavior of Men.) , 71-0923 Vich, V. Van Boxel, P. (Carbon Monoxide Poisoning.] , 71-0416 Sputum Cytology Screening for Lung Cancer, 71-0749 Victor, M. Van Dam, B. E. Tobacco Amblyopia, Cyanide Poisoning and Vitamin Serum Lipids and Energy Expenditure in Old Men, B12 Deficiency, 71-0224 71-0787 Vidal, J. Van Duuren, B. L. (Chronic Familial Bronchopneumopathies and Homo- Cocarcinogenesis Studies on Mouse Skin and Inhibition zygotic Alphas-Antitrypsin Deficiency.) , 71-0881 of Tumor Induction, 71-0415 Visser, J.W.E. Cigarette Smoke Carcinogenesis: Importance of Tumor (Coronary Disease Risk Factors in Young Managers.), Promoters, 71-0602 71-0900 Structure and Tumor-Promoting Activity of Anthralin Visser, W. (1,8-Dihydroxy-9-anthrone) and Related Compounds, Sugar Consumption, Physical Activity Smoking, and 71-1127 Serum Composition in Man, 71-0292 Van Ganse, W. Voisin, C. (The Epidemiology of Chronic Nonspecific Respiratory (Etiologic Factors in Chronic Bronchitis and Pulmonary Disease: The Problem and Methods of Studying It.] , Emphysema.), 71-0464 714880 (Symposium on Chronic Bronchitis. I. Nosology and Van Ganse, W. F. Epidemiology.), 71-0614 Cigarette Smoking and Pulmonary Diffusing Capacity, Von Hoist, H. E. 71-0634 Smoking and CoronaryDisease(1):Introduction, Chronic Nonspecific Respiratory Disease, Berlin, New 71-0494 Hampshire,19614967: A Cross-SectionalStudy, Smoking and Our HealthIntroduction, 71-0541 71-1161 Vos-Brat, L. C. Van Gernert, L. J. (1mmunoglobulin Concentrations, Hemagglutinin (PHA) Flame Photometric Detection of Volatile Sulphur Com- Responses of Lymphocytes In Vitro and Some Anti- pounds in Smoke From Various Types of Cigarettes, body Levels in Healthy Smokers.] , 71-0316 71-0556 Immunoglobulin Concentration, PHA Reactions of Van Hand, W. B. Lymphocytes In Vitro, and Certain Antibody Titers of Sugar Consumption, Physical Activity, Smoking, and Healthy Smokers, 71-0513

297 2,"9. CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Vuori, H. ReversalofRabbitAtheromatosis byHyperoxia, The Smoking Habits of Finnish Physicians, 71-1257 71-1201 Warbrick-Smith, D. Smoking Risks of Different Tobaccos 71-0870 Ward, S. Television Advertising and the Adolescent, 71.0946 Wagner, J. C. Warren, R. D. The Lipoid Pneumonia of Blackfat Tobacco Smokers in Smoking Behavior, 71-1075 Guyana, 71-1172 Smoking Behavior. Data Book, 71-1076 Wagner, M. The Potential of Organizational Coordination as an Mitochondrial Responses to Carbon Monoxide Toxicity, InterventionProcess?Appliedtothe Problem of 71-0548 Cigarette Smoking and Health, 71-1083 Wahi, P. N. Wassermann, D. Ultrastructure of Human Oral Mucosa After Prolonged [Nicotine and Propranolol.] , 71-0730 Exposure to Tobacco, 71-0789 Waterhouse, J. P. Recent Trends in Cancer Research, 71-0859 Ultrastructure of Surface Cells of the Oral Mucosa, Waissbluthd. 71-0791 [Cigarettes and Gastric Secretion. 1. Analysis of Gastric Waters, W. E. Secretionin Smoking and Nonsmoking Ulcer Pa- Smoking and Chronic Respiratory Disease: Findings in tients.] , 71-1225 Surveys Carried Out in 1957 and 1966 in 8 taveley in [Cigarettes and Gastric Secretion. II. Effect of Cigarettes Derbyshire, England, 71-0444 on Gastric Secretion.] , 71-1226 Smoking and Neuroticism, 71-0917 Wakefield, J. Watson, P. B. Advertizing and Smoking, 71-0339 The 5-Year Experience of Modified Fat Diets on Waks, M. Younger Men With Coronary Heart Disease, 71-0110 Studies of the Reaction of Haptoglobin With Hemo- Watson-Williams, E. J. globin and Hemoglobin Chains. Ill. Observations on Vitamin B12 Content of Aqueous Humor. (Letter), the Kinetics of the Reaction of the Haptoglobin 71-0312 HemoglobinComplexes With CarbonMonoxide, Watt, A. 71-0542 Survey of Workers Exposed to Dusts Containing Deriva- Wal, A.M.V.D. tives of Bacillis Subtilis, 71-0086 [Chronic Nonspecific Lung Disease, Smoking and Lung Wattenberg, L. W. Cancer.] , 71-0260 Carcinogenic Effects of Polycyclic Hydrocarbon Car- Walker, D. D. cinogen Administration to Mice During Pregnancy on Bronchitis in Men Employed in the Coke Industry, the Progeny, 71-0239 71-1186 The Role of the Portal of Entry in Inhibition of Walker, S. H. Tumorigenesis, 71-1006 The Prevalence of Chronic Bronchitis, Chronic Airway Waxier, E. B. Obstruction, and Respiratory Symptoms in a Colorado The Fate of Women With Normal Coronary Arterio- City, 71-0278 grams and Chest Pain Resembling Angina Pectoris, Wall, E. van de 71-0671 [Coronary Disease Risk Factors in Young Managers.] , Webb, W. R. 71-0900 Effects of Cigarette Smoke on Incorporation of Radio- Wallace, W.F.M. isotopically Labeled Palmitic Acid Into Pulmonary Insulation Workers in Belfast. 2. Morbidity in Men Still Surfactant and on Surface Activity of Canine Lung at Work, 71-1016 Extracts, 71-0864 Insulation Workers inBelfast.1. Comparison of a Weber, K. H. (Editor) Random Sample With a Control Population, 71-1029 [The Method of Investigation of Smoke Condensates in Wallander, B. Animal Experiments.] , 71-0417 Cigarette Smoking and Abortion. Consecutive Prospec- Wechsler, B. M. tive Study of 4312 Pregnancies, 71-0688 Cigarette Smoke: Effects on Lactate Extraction in the *Walsh, H. E. Presence of Severe Coronary Atherosclerosis. 71-1061 MaternalNutrition andthe Course of Pregnancy, Wehner, A. P. 71-0508 Distribution of Inhaled Metal Oxide Particles in Pul- Walton, F. P. monary Alveoli, 71-0458 Carcinogens in Cigarette Smoke. (Letter), 71-0844 Cocarcinogenic Studies in Pulmonary Carcinogenesis, Wang, 1. Y. 71-0999 Enzymatic Conversion of Benzo(a)pyrene. Hydroxyla- Wehrmacher, W. H. tion vs DNA-Binding, 7141978 Healing Waters and Healing Faith, 71-0495 Wang, M. K. Weil,. V. Some Observations on the Mechanism of Tobacco ."Isette Smoking as a Cause of Hypoxemia in Man at Amblyopia and Its Treatment With Sodium Thiosul- finitude, 71-0470 phate, 71-0689 Weiss, G. B. Wanstrupd. Alteration of 5-Hydroxytryptamhie-14C Uptake and Effects of Carbon Monoxide Exposure on the Arterial Metabolism in Intestinal Smooth Muscle, 71-0225 Walls, 71-0355 Weiss, W. The Effects of Exposure on Carbon Monoxide, Hypoxia How Smoking Affects Hearing, 71-0317 and Hyperoxia on the Development of Experimental The Philadelphia Pulmonary Neoplasm Research Project. Atheromatosis in Rabbits, 71-0468 Survival Factors in Bronchogenic Carcinoma, 71-0603

298 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX.

Cigarette Smoking, Asbestos, and Pulmonary Fibrosis, White, K. H. 71-1187 Some Findings on the Post-Mortem Association of Right Survivorship Among Men With Bronchogenic Car- Ventricular Wall Thickness and Chronic Obstructive cinoma. Three Studies in Populations Screened Every Bronchitis, Pneumoconiosis, Emphysema and Tuber- Six Months, 71 -1188 culosis, 71-0229 Wehsbecker, L. Whitmore, W. F. (Jr.) Cigarette Smoke and Tracheal Mucus Transport Rate. Epidemiology of Cancer of the Prostate, 71-0759 Isolation of Effect of Componehlt of Smoke, 71-1189 WHO Chronicle. Weissmann, K. Public Health Aspects of Climate in Cities, 71-0418 [A Test of Reality. Mourning and Tobaccoism.] , The Limitation of Smoking, 71-1271 71-0176 Widdicombe, J. G. Weizenecker, R. Stimulation of Lung Irritant Receptors by Cigarette Tobacco Cropper's Sickness, 71-0236 Smoke, Carbon Dust, and Histamine Aerosol, 71-0768 Welch, M. H. Wilbert, L. AlpharAntitrypsin Deficiency: Heterozygosity, Inter- [Nicotine Consumption and Arterial Occlusive Di- mediate Levels, and Pulmonary Disease, 71-0443 sease.] , 71-1062 Alphai-Antitrypsin Deficiency and Pulmonary Emphy- Wilhelmsen, L. sema, 71-0477 [Smoking and Coronary Disease (5): People Born in An Epidemiological Approach to Chronic Obstructive 1913.1, 71-0140 Pulmonary Disease and Alpha' Antitrypsin in Hospital Harmful Clinical Effects of Smoking. Smoking and the Patients: A Trl-Racial Study, 71-0616 Upper Respiratory Passages, 71-0465 Welch, R. Points in the Matter of Giving Up Smoking. Who Stops Effects of Environmental Chemicals on the Metabolism Smoking After Acute Myocardial Infarct?, 71-0466 of Drugs, Carcinogens, and Normal Body Constituents Smoking and Coronary Disease (5): Men Born in 1913, in Man, 71-0812 71-0493 Welch, R. M. Smoking and Coronary Disease (10): The Relationship Cigarette Smoke: Stimulatory Effect on Metabolism of Among Risk Factors in Coronary Disease, 71-0496 3,4- Benzpyrene by Enzymes in Rat Lung, 71-0226 Smoking and Pulmonary Disease (5): Ventilatory Capa- Weller, P. city and Smoking Habits of Men Born in 1913, Risk Factors in Occlusive Diseases of the Peripheral 71-0636 Arteries of Varying Severity, 71-1055 Smoking as a Risk Factor, 71.0669 Wells, H. Viewpoints on Smoking Withdrawal. Smoking With- Carcinogenic Effect of a Dimethyl Sulphoxide Extract drawal Clinic Activity in Goteborg, 71-0709 of Betel Nut on the Mucosa of the Hamster Buccal [AtherosclerosisNicotine Therapy (1): Heart Infarct Pouch, 71-0435 Risk Factors.] , 71-1212 Wennberg, D. Wilke, H. [Influence of 'Different Puff Volume Profiles on the [Toxicity of Carbon Monoxide in Man Breathing Mix- Yield and Composition of the Smoke of Machine- tures of CO and Air at Elevated Pressure.] , 71-0962 Smoked Cigarettes.] , 71-1126 Wakening, J. Wenzel, D. G. Influence 'of Cigarette Smoking on Some Blood Coagula- Chronically Administered Nicotine and the Blood Pres- tion Tests, 71-0488 sure of Normotensive and Renal Hypertensive Rats, Wilkinson, A. R. 71-0141 InhibitoryEffect of Cigarette Smoking on Gastric Effects of Nicotine on Cultured Rat Heart Cells, Secretion Stimulated by Pentagastrin in Man, 71-0918 71-0227 Willard, D. H. Studies on the Acute and Chronic Depressor Actions of Studies of Inhaled Radon Daughters, Uranium Ore Dust, Nicotine in the Rat, 71 -0979 Diesel Exhaust, and Cigarette Smoke in Dogs and Werf-Messing, B. van der Hamsters, 71-0599 [Occupations and Smoking Habits of Bladder Carcinoma Williams,). F. Patients in Rotterdam.] , 71-0261 An Automated Method for the Determination of Total Werko, L. Aldehydes in Gas Phase of Cigarette Smoke, 71.0012 Can We Prevent Heart Disease?, 71-0672 Collaborative Study of the Determination of Propylene West, R. H. Glycol, Glycerol, and Triethylene Glycol in Tobacco, Drug and Nutritional Factors in Optic Neuropathy, 71-0845 71-0677 Williamson, J. Westfall, T. C. Smoking arni Neuroticism. (Letter), 71-1 25 2 Studies on the Mechanism of Tolerance to Nicotine- Williamson, T. G. InducedElevationsofUrinaryCatecholamines, Analysis of Tobacco and Tobacco Smoke by Neutron 71-1131 Activation, 71-0846 Westling6WIkstrand, H. Wills, R. E. Some Characteristics Related to the Career Status of Acute Change in Hemoglobin Affinity for Oxygen Women Physicians, 71-0340 During Angina Pectoris 71-0783 Wetterqvist, H. Wilson, J. Points in the Matter of Giving Up Smoking. SmoP, -7 Plasma-Cobalamins in Neuro-Ophthalmological Diseases, Withdrawal in Lund, 71-0536 71-0318 Wheatley, J. W. Recent Research in Some Optic Neuropathies, 71-0795 Effects of Nicotine on Cultured Rat Heart Cells, Wilson, J. K. 71-0227 Ep idem iologicFactorsinEtiologyofChronic CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Respiratory Disease, 71-0454 Wulff, M. R. Wilson, R. Some Factors Influencing the Spontaneous Course of Diethyhdtrosamine-Induced Alterations in the Tracheo- Arterial Vascular Insufficiency, 71.0130 bronchial System of Syrian Golden Hamsters, 71-0744 Arterial Insufficiency in the Legs. I. A Clinical Statistical Wilson-Davis, K. Analysis, 71-0898 Smoking and School Children, 71-0334 Wyman, J. Drugs-A Report on a Study in Dublin Post-Primary Studies of the Reaction of Haptoglobin With Hemo- Schoolchildren, 1970, 71-0702 globin and Hemoglobin Chains. III. Observations on Smoking, Drugs and Alcohol in Dublin Secondary the Kinetics of the Reaction of the Haptoglobin Schools, 71-1086 HemoglobinComplexes With CarbonMonoxide, Wing, A. L. 71-0542 Chronic Disease in Former College Students. XI. Early Wynder, E. L. Precursors of Nonfatal Stroke, 71-1209 Etiological Aspects of Squamous Cancers of the Head Winkelvoss, E. and Neck, 71-0072 [Doctors and Smoking. Results of an Investigation of A Study of Tobacco Carcinogenesis. XI. Tumor lnitia- the Smoking Habits and of the Attitudes on Smoking tors, Tumor Accelerators, and Tumor Promoting Acti- Detoxification of Doctors in the Magdeburg District.], vity of Condensate Fractions, 71-0203 71-0337 Epidemiology of Cancer of the Prostate, 71-0759 Wirsen, C. Wysokinski, Z. [TV's Role in Information.] , 71-1 25 8 Effects of Tobacco Smoking on Certain Parameter. Wohlberg, G. W. Reflecting the Condition of the Cardiovascular System Interaction of Personality and Treatment Conditions atRest and During Exercise (Condensation of a Associated With Success in a Smoking Control Pro- Doctoral Thesis), 71-0637 gram, 71-1262 Wohlbrab, H. Carbon Monoxide Binding Studies of Cy tochrome a Hemes in Intact Rat Liver Mitochondria, 71-0419 Wolf, S. Xipell, J. M. The Smoke Reflex in Rabbits. An Example of Auto- The Incidence of Benign Renal Nodules. (A Clinic°. nontic Control of Cardiorespiratory Function, 71-0306 pathologic Study), 71-1154 Wolff, G. S to tisticalRelationshipBetweenEpidemiological Data.] , 71-0582 Wolff, J. A. Yacoub, M. Effects of Environmental Chemicals on the Metabolism [Carboxyhemoglobinemia in the Child Born to a Mother of Drugs, Carcinogens, and Normal Body Constituents Who Smokes.] , 71.0006 in Man, 71-0812 [Thiocyanaturia of the Smoker.] , 71-0040 Wolfson, L. L. Kan the Tobacco Origin of Chronic Carbon Monoxide Fate of Aflatoxins in Cigarette Tobacco, 71-0209 Poisoning Be Determined?] , 71-0041 Wood, C. Presence of Carbon Monoxide in the Blood of a Child Smoking and Neuroticism. (Letter), 71 -1248 Bom of a Smoking Mother, 71-0807 Woods, D. A. Can the Tobacco Origin of Chronic Carbon Monoxide The Effects of Exposure to Chewing Tobacco on the Intoxication Be Determined?, 71-0847 Oral Mucosa of Monkey and Man. A Histological and Yamagiwa, H. Ultrastructural Study, 71-0676 Studies on the Chronic Gastritis. II. Relationships of Ultrastructure of Human Oral Mucosa After Prolonged Gastric Diseases to Smoking, Drinking and Blood Exposure to Tobacco, 71-0789 Type, 71-0514 Woolf, C. R. Yamamoto, I. The Respiratory Effects of Regular Cigarette Smoking in Effects of Nicotine on Salivary Amylase Secretion From Women, 71-0104 Rabbit Parotid Gland, 71-0205 Worcester, J. Action of Tryamine on the Salivary Amylase Secretion Adult Mortality in Berlin, NH, From 1961 to 1967, From Rabbit Parotid Gland in Reference to That of 71-0981 Nicotine, 71 -0740 Worth, G. Yamanaka, A. The Epidemiology of Bronchopulmonary Symptoms in Pulmonary Emphysema in Japan, 71-0285 Coal Miners, Foundry Workers, Chemical Workers and Yanagisawa, T. Bakers, 71-0772 Induction of Carcinoma of Glandular Stomach in Rats Wouda, A. A. by Local Application of 7,12-Dhnethylbenz(a)anthra- [Coronary Disease Risk Factors in Young Managers.], cene, 71-1153 71-0900 Yarington, C. T. (Jr.) Wozniak, J. Epidemiological Aspects of Oral Cancer, 71-0991 (Epidemiological Picture of Chronic Nonspecific Lung Yarom, D. Diseases in One District of the City of Wroclaw.] , IA Survey of Smoking Habits Among Physicians in 71-0456 Israel.] , 71-1259 Wray, R. Yazudzhiyan, E. Late Occlusion of Aortofemoral Bypass Grafts: Influ- [Chemical and Technological Characteristics of Ciga- ence of Cigarette Smoking, 71-1213 rettes Produced in the Countries of the SIV. Report. Wright, H. B. Cigarettes Produced in the USSR, German Democratic Casualties of Middle Age, 71-1214 Republic and Pokutd.] , 71-0042

300 CUMULATIVE AUTHOR AND ORGANIZATIONAL INDEX

Yerushalmy, J. Communication: Incidence in Relation to Habitual The Relationship of Parents' Cigarette Smoking to Smoking and Consumption of Alcohol, 71-1033 Outcome of PregnancyImplications as to the Problem Zenk, H. of Inferring Causation From Observed Associations, [Occupational Laryngeal Carcinoma From the View- 71-0696 point of Expert Testimony.] , 71-0073 Yoshida, D. Zeller, G. [Effects of Cultural Practices on the Tar Content in the PharmacologicalDifferentiation of "Nicotinic" and Smoke of Cigarettes. VI. Effects of Chemical Com- "Muscarinic" Catalepsy, 71-0579 ponents in the Cigarettes on the Tar Contents.] , Zhelazkov, D. 71 -0578 [Chemical and Technological Characteristics of Ciga Yoshida, O. reties Produced in the Countries of the S1V. Report. Studies on Carcinoma of the Urinary Bladder.I. Cigarettes Produced in the USSR, German Democratic Statistical and Epidemiological Studies on Cancer of Republic and Poland.] , 71-0042 the Bladder in Japanese.] , 71-0604 Ziegler, E. Young, A. [The Relationship Between Cardiovascular Mortality The Effects of Age and Smoking on the Maturation of and Sugar Consumption in Switzerland.] , 71-0304 the Oral Mucosa, 714)142 Zielhuis, R. L. Yuri, R. W. [Air Pollution, Smoking and Medicine.] , 71-1132 Determinants of Survivalof theDialysis Cannula, Zietkowski, B. 71-0128 [Incidence of Tobacco Allergy in Patients With Bron- chial Asthma.] , 71-1157 Zimmerberg, B. Titration of Oral Nicotine Intake With Smoking Beha- Zechariah, J. vior in Monkeys, 71-0815 Lactate Dehydrogenase Isoenzyme Patterns in Leuko- Zimmermann, V. plakia, Submucous Fibrosis and Carcinoma of the Oral Catecholamine- Independent GlycogenolysisinBrain Mucosa in South Indians, 71-0060 During Carbon Monoxide Poisoning, 71-0194 Zacho, A. Zincati, G. Intolerance of Tobacco in Patients With Gastric Cancer, [Cigarette Smoking Habits in Subjects With Myocardial 71-0605 Infarction.] , 71-0302 Smoking Habits of Patients With Gastric Cancer, Zivy, P. 71-0860 [Tobaccoism, Bullous Emphysema and Spontaneous Smoking Habits of Patients With Pernicious Anaemia in Idiopathic Pneumothorax.] , 71-0286 Whom Gastric Cancer Has Not Been Demonstrated, [The Lung and Tobacco.] , 71-0441 71-1215 Lung and Tobacco, 71-1014 Zakowska, J. [Smokers' Pneumothorax and Tobacco Lung.] , 71-1030 [Incidence of Tobacco Allergy in Patients With Bron- Zukel, W. J. chial Asthma.] , 71-1157 Prevalence and Incidence of Coronary Disease in a Zavadina, S. P. Population Study. The Yugoslavia Cardiovascular Di- (Toxic Effect and Metabolism of Carcinogenic Aromatic sease Study, 71-1205 Hydrocarbons in Cultures of Normal and Tumor Cells Zuskin, E. in Golden Hamsters, 71-0980 Cigarette Smoking: Objective Evidence for Lung Dam- Zdichynec, B. age in Teen-Agers, 71-0459 [Cigarette Smoking and Infarction Changes on the Effects of Hemp Dust Exposure on Nonsmoking Female Electrocardiogram] , 71-0497 Textile Workers, 71-1028 [The Change in White Blood Cell Count in Long-Time A Comparative Study of Respiratory Function in Smokers. (Basis for the Comparison of Patients With Female Nonsmoking CottonandJute Workers, Transmural Myocardial Infarct and Patients Without 71-1185 Symptoms of Coronary Disease).] , 71.0673 Zwartz, J. A. Zechner, A. Sugar Consumption, Physical Activity, Smoking, and Physical Fitness in United States and Austrian Military Serum Composition in Man, 71-0292 Personnel. A Comparative Study, 71-0499 Serum Lipids and Energy Expenditure in Old Men, Zedda, S. 71 -0787 On the Incidence of Cardiovascular Disease Among the Zni, S. Workers of the Mining Industry of Sardinia. 2nd The Incidence of Fungi in the Throat, 71-1171

301 303 CUMULATIVE SUBJECT INDEX

ABNORMALITIES ADRENAL GLANDS effect of maternal smoking, 714)788 effect of nicotine, 71.0724, 71.0956 effect of nicotine, 71 -0221, 714)790 effect of tobacco fermentation products, 710724

ABORTION Adrenaline See CATECHOLAMINES effectofmaternalsmoking,714)006,71 -0686, 71.0688, 71-0807, 71-1064, 71-1217, 71-1227 ADVERTISING adolescents and, 714)946 ACETALDEHYDE in the Americas, 714)937 (See also ALDEHYDES) antismokingcampaignsand, 71.0985,71-1094, effect of ascorbic acid, 710411 71-1095,71-1237, 71-1243, 71-1254, 71-1258 effect on lung function, 71-1013 cigarette sales and, 71.0530, 71-1240 effect on mucociliary activity, 714)875 effect on smoking habit, 71 -0339, 71.0538, 71-1101, effect on respiration, 71-1013 71-1102, 71-1234, 71-1237, 71-1254, 71-1258 healthwarningsin,71 -0515,71 -0529,714)952, ACROLEIN 71-1101 (See also ALDEHYDES) labeling and, 714)529, 71-1101 determination in cigarette smoke, 714)004, 71 -0202, legislation,714)343,71.0530,71.0581,714)707, 71.0844 714)804, 71-1271 determination in cigarette tars, i i 9004 mass media and, 71.0343, 71.0420, 71.0530, 714)946, effect on asparaginasc, 71-0718 71-1094,71-1095,71-1234,71-1243,71-1254, effect on body weight in mice, 714)034 71-1258 effect on mortality, 71.0034 prohibition, 71-0515, 71 -0711, 71.0952, 71-1268 effect on mucociliary activity, 714)875 regulation of, 71.0515, 71-0529, 714)541, 714)937, effect on physical fitness, 714)034 71-1102 filtration, 71-0004 lung neoplasms and, 714)844 AGGLUTININS effect of tobacco smoke, 71 -0370 ACROMEGALY nicotine and, 71-1067 AGING effect of carbon monoxide, 71-0410 ADENOCARCINOMA effect of smoking, 71.0308 epidemiology, 71-0986 effect on sex behavior, 71.0923 experimentally induced in mice, 714)997 psychosocial aspects, 71.0308 smoking and, 714)986 smoking and, 71.0787, 71.0923

Adenoma See NEOPLASMS AIR POLLUTION in aircraft, 714)208 ADOLESCENTS aromatic hydrocarbons in, 71-0036 advertising and, 71-0946 asthma and, 71.0102 alcohol consumption and, 71-1238 in Berlin, New Hampshire, 71-1161 antismoking campaignsand,714)157,71-0172, bronchitis and, 714)103, 71-0455, 71-0878, 71-1176 71-0183,71.0326,714)335,714)539,71-0802, cadmium in, 71-1169 71.0929,71.0932,714)946,71-1088,71-1236, in Canada, 71-1181 71-1253 carbon monoxidein,714) 20 8, 71 -0218, 714)371, belief in smoking hazards and, 714)945 714)377,714)390,71.0418,71.0728,714)736, cannabis and, 714)173, 714)702, 714)920 71.0965 drug abuse and, 71-1079, 71-1238 carcinogens in, 71.0418 effect of parental smoking, 714)945 as cause of bronchial neoplasms, 71.0750 feeding behavior and, 714)933 chronicbronchopubnonarydiseaseand,71-0046, lung function and, 71-0074, 714)459 71.0280, 714)766, 714)880, 71-1161, 71-1181 mass media and, 71-0946 coronary disease and, 71-0471 morbidity, 71.0931 effect of cigar smoke, 71.0150 peer group influences, 71.0164, 714)333, 71.0945 effect of cigarette smoke, 71-0023, 71.0024, 714)035, smokinghabitand,714)074,71.0164,71 -0169, 714)036, 714)038, 71.0147, 71.0208, 71.0267 71.0171 71.0329,714)333,714)347,71.0459, effect on hemoglobin levels, 71-0641 71.0796,71.0797,714)929,714)930,71.0931, effect on lung function, 71-1020, 71 -1161 71.0933,71.0939,714)945,71-1079,71-1085, effect on morbidity and mortality, 71.0555, 71-1181 71-1086,71-1088,71-1232,71-1236,71-1238, effect on mortality, 71.0046, 71-0228 71-1244, 71-1250, 71-125 effect on mortality in Los Angeles County, California, stress and, 71.0933 71.0384

302 CUMULATIVE SUBJECT INDEX

effect on neonate, 71 .0641 in tobacco smoke, 71-0001, 71.0030 effect on pentazocine metabolism, 71.0389 tobacco variety and, 71-0414 effect on respiratory tract, 71.0363 lung function and, 71 -1178 ALLERGY in lung neoplasm etiology, 71 -0047, 71.0071, 71.0555 asthma and, 71-1157 in lung neoplasm induction, 71.0067 bronchitis and, 71-0282 in pancreatic neoplasm etiology, 71.0249 occupation as a factor, 71-0236 particulate matter, 71.0150, 71-0363 pharyngitis and, 71-0504 respiratory tract diseases and, 71 -0228, 71-1178 smokers vs. nonsmokers, 71-0282 smoking and, 71-0005, 71-0046, 71-0071, 71-0081, smoking and, 71-0453, 71-0673 71.0100,71-0228,71-0270,71.0280,71.0555, tobacco and, 71-0504, 71-1157 71.0728, 71.0736, 71-1 13 2 tobacco smoke and, 71-0738, 71-1157 tobacco smoke and, 71-0737, 71-0738 in United Kingdom, 71 -0527 ALTITUDE urban-rural influences, 71-0280 effect on blood, 71-0470 in urban traffic, 71-0965 effect on blood circulation, 71-0647 in Washington, D.C., 71 -0218 effect on brain, 71-0647 effect on carboxyhemoglobin levels, 71-0470 ALCOHOL CONSUMPTION hypoxemia and, 71-0470 adolescents and; 71-1086 adolescents in New England, 71-1238 cannabis and, 71-0151 AlveoliSeePULMONARY ALVEOLI children and, 71-1086 history, 71-0027 AMBLYOPIA, TOBACCO (See alsoEYE DISEASES) inmouth neoplasmetiology,71.0072, 71.0255, ascause,71-0224,71-0318,71-0689, 71-0991 cyanides religion as a factor, 71-0027 71 -0786 smoking and, 71.0051, 71.0072, 71.0114, 71-0255, diagnosis, 71-0784 71.0292,71-0469,71-0514,71.0798,71.0921, diet and, 71-0689 71-0982,71-0991,71-0996,71-1033,71-1089, metabolic disorders in, 71-0795 pathogenesis, 71-0224 71-1233,71-1256 smoking and, 71-0318, 71-0677, 71-0984, 71-1134 toxicity, 71-0027 smoking in etiology of, 71,0224 71-0677,71-0689, 71 -0784, ALDEHYDES therapy, 71-0307, (See alsoACETALDEHYDE; ACROLEIN) 71-0786 determination in cigarette smoke, 71-0012, 71-0202, vitamin deficiency and, 71-0224, 71-0312 71-1118, 71-1125, 71 -1128, 71-1129 effect on ciliary activity, 71 .0192 AMINES effect on tracheal mucosa, 71 -0192 determination in cigarette smoke, 71-1121 filtration, 71-0181, 71-1128 determination in tobacco, 71-0010 inhalation, 71-0034 determination in urine, 71-0976 toxicity, 71.0034 in tobacco smoke, 71-0030 tobacco variety and, 71-0010 ALICYCUC HYDROCARBONS determination in cigarette smoke, 71.0187, 71-1125 AMINO ACIDS in tobacco smoke, 71-0030 ALIPHATIC AMINES in tobacco leaf, 71 -0361 AMMONIA tobacco variety and, 71-0361 in bidi smoke, 71-1109 in cigarette smoke, 71-1109 ALIPHATIC HYDROCARBONS fate in body, 71-1109 determination in cigarette smoke, 71-0002, 71-0028, in tobacco smoke, 71-0030 71.0187, 71.0217, 71-0387, 71.1125 as pyrolysis products, 7 1-03 87 ANABASINE (See alsoALKALOIDS, TOBACCO) ALKALOID CONTENT biosynthesis in tobacco, 71 -0561 (SeealsoNICOTINE CONTENT; NORNICOTINE determination in tobacco leaf, 71-0414 CONTENT) effect of aspartic acid, 71.0561 effect of processing methods, 71-0003 tobacco variety and, 71-0414 tobacco variety and, 71-0414

ALKALOIDS, TOBACCO ANEMIA, PERNICIOUS (SeealsoANABASINE; COTININE; DIBEN7(a,1)- ex-smokers, 71-1215 ACRIDINE; NICOTINE) smokers vs. Nonsmokers, 71-1215 determination in tobacco leaf, 71-0414 vitamin B12 deficiency and, 71-1215 effect of processing methods, 71-0409 effect on avoidance learning in rats, 71-0324 ANEMIA, SICKLE-CELL effect on physical fitness in rats, 71.0188 smokers vs. nonsmokers, 71-0899

303 305' CUMULATIVE SUBJECT INDEX

ANESTHESIA roleof government,71-0179, 71-0235, 71-0342, effect of smoking, 71-1132 71-0516,71 -0528,71-0711,71-0952,71-1102, 71-1271 ANGINA PECTORIS role of health educators, 71-0323, 71-0334, 71-0540, (See alsoCORONARY DISEASE) 71-0805, 71-1271 body constitution and, 71-0139, 71-0491 role of health organizations, 71-1082, 71-1083 earboxyhemogobin levels and, 71-0288, 71-1031 role of medical personnel, 71-0941, 71-1101 diagnosis, 71-0671, 71-1206 role of medical societies, 71-0523 exercise and, 71-1031 roleofphysicians,71-0161,71-0319,71-0322, hemoglobin and, 71-0783 71-0332,71 -0334,71-0335,71-0337.71-0344. morbidity, 71-0107 71-0539, 71 -0669, 71-0711, 71-0931 nicotine and, 71-0107 role of physicians in Germany, 71-1104 predisposing factors, 71-0296 role of physicians in the Netherland, 71-0658 preventive medicine, 71-0297 role of teachers, 71 -0323, 71-0524. 71-0929, 71-0932 smoking and, 71-0107, 71-0139, 71-0288, 71-0467, in Russia, 71-0174 71-0491, 71-0648, 71-0783, 71-0905, 71-1061 in Salers, France, 71-1097 smoking in etiology of, 71-0296, 71-0891 inschools,71-0157,71-0159, 71-0172, 71-0183, in twins, 71-1206 71-0326, 71-0335, 71-0524, 71-0805, 71-0932 in women, 71-0671 in schools in Illinois, 71-1236 in schools in New York, 71-0936 ANOXIA in schools in Saskatoon, Canada, 71-1253 carbon monoxide and, 71-0396, 71-1119 in South Africa, 71-0068 smoking and, 71-1119 in Sweden, 71-1254, 71-1258 inUnitedKingdom,71-0178,71-0179,71-0232, ANTIBODIES 71-0319,71 -0523,71-0804,71-0952,71-0955, effect of smoking, 71-0888 71-1102,71-1134 effect of tobacco smoke, 71-0360, 71-0370 in United States, 71 -0184, 71-0235, 71-0332, 71-0804, 71-0985, 71-1 100 ANTIGEN - ANTIBODY REACTIONS in Virginia, 71-0183 smokers vs. nonsmokers, 71-0513 ANTITRYPSIN DEFICIENCY bronchitis and, 71.0616 ANTISMOKING CAMPAIGNS in bronchitis etiology, 71-0439 adolescents and, 71-0157, 71-0172, 71 -0183, 71-0326, chronicbronchopulmonarydiseaseand,71.0440, 71-0335,71-0539,71-0802,71-0929,71-0936, 71-0477,71-0616,71-0685, 61-0869,71-0881, 71-0946, 71-1088, 71-1236, 71-1253 71-1167, 71-1179 advertising and, 71-0516, 71-0937, 71-0946, 71-1094, in chronicbronchopulmonarydiseaseetiology, 71-1095,71-1101,71-1102,71-1237,71-1254, 71-0439 71-1 258 in cirrhosis etiology, 71-1073 in the Americas, 71-0937 emphysema and, 71-0477, 71-1017, 71-1164, 71-1168, in Bologna, Italy, 71-0805 71-1170 in Canada, 71-0172 in emphysema etiology, 71-0439, 71-0761, 71 -0762, cigarette sales and, 71-0182 71-0771, 71-0881, 71-1073, 71-1166, 71-1184 in colleges, 71-0323 etiology, 71 -1168 in Connecticut, 71-0341 heredityas afactor, 71-0443, 71-0685, 71 -0761, Connecticut State Medical Society, 71-0539 71-0762, 71-0771, 71-1073, 71-1184, 71-1222 in Denmark, 71-0711 lung diseases and, 71-0443 educationalprograms, 71-0326, 71-0932, 71-0936, lung function and, 71-1184 71-1 253 peptic ulcer and, 71-1170 evaluation,71-0701,71-0802,71-0955,71-1082, smoking and, 71-0440, 71-0616, 71-0621, 71-0771, 71-1083 71-0881,71-1015,71-1164,71-1166,71-1167, in Germany, 71-0157, 714093, 71-1104 71-1170 health warnings in, 71-0182 in hospitals, 71-0941 AORTIC ANEURYSM in Ireland, 71-0334 smoking and, 71-0984 in Italy, 71-0335 legislation, 71-0178, 71-0343, 71-1093, 71-1271 ARECA CHEWING mass media and, 71-0160, 71-0802, 71-0946, 71-1094, (See alsoTOBACCO CHEWING) 71-1095, 71-1254, 71-1258 effect on mouth, 71-0676, 71-0690 in medical centers, 71-0319 effecton mucous membrane, 71-0143, 71-0149, methods, 71-0137, 71-0183, 71-0949 71-0435 in Mexico, 71-0160 gastrointestinal neoplasms and, 71-0596 in Netherlands, 71-0342 laryngeal neoplasms and, 71-0994 public education and, 71-0160, 71-0172, 71-0237, in India, 71-0676 71-0539,71-0540,71-0701,71-0929,71-0937, in Malaysia, 71-0143, 71-0149 71-0955, 71-0985 in mouth disease etiology, 71-0435 public opinion and, 71-0802 oral hygiene and, 71-1231 research programs, 71-0237, 71-0540, 71-0985 periodontal diseases and, 71-1231 role of dentIsts, 71-0068 smoking habit and, 71-0944

t 3CS 304 CUMULATIVE SUBJECT INDEX

AROMATIC AMINES diet and, 71-0304, 71-0597, 71-0776 (See also HETEROCYCLIC NITKOGENCOM- epidemiology, 71-0481, 71-08%911-1050, 71.1058 POUNDS) experimentally induced in rabbits, 71-0112, 71-0295, in bladder neoplasm induction in dogs, 71-1149 7141468 in tobacco smoke, 71-0030 hyperoxia and, 71-1201 hypoxia and, 71-0468 AROMATIC HYDROCARBONS in Ireland and Boston, 71-0776 (See also BENZ(a)ANIHRACENES; BENZO(a)- mortality, and, 71-0468 PY RENE; BENZOPYRENES; mortality, 71-0234 D1BENZ(a,h)ANTHRACENE) nicotine and, 71-0896 analysis, 71-0036, 71-0354, 71-0827 pathogenesis, 71-0295, 71-04711, 714481 carcinogenicity, 71-0203, 71-0552, 71-0989, 71-1002 predisposingfactors,71-0478,71-0481,71-0490, incigarettesmoke,71-0036,71 -0547,71-0552, 71-0782,71-0886,71480, 71-0898,71-1046, 71-0837 71-1048, 71-1055, 71-1059, 71-1212 determination in air pollution, 71-0036, 71-0552 preventivemedicine,71-0137,71-0782,71-1048, determination in tobacco tars, 71-0203 71-1058 determination in urine, 71-0827 prognosis, 71-0130 effect &f nitrates, 71-0402 smokers vs. nonsmokers, 7141474, 7141482, 7141495 effect of tobacco additives, 71-0547 smoking and, 71-0108, 71-0234, 71-0304,71-0355, effect on DNA, 71-0015, 71-0364, 71-0967 71-0478,71-0782,71-0891,71-0895,71-0898, effect on hormones, 71-0989 71-0913,71-0982,71-1046,71-1048,71-1050, effect on hydroxylase activity, 71-0812 71-1055,71-1057, 71-1061, 71.1133, 71-1213 effect on mouth in hamsters, 71-1142 smoking in etiology of, 71-0298, 71-0474, 71-0490, effect on mucous membrane in hamsters, 71-1142 71-0886,71-0889,71-0896,71-0908,71-1058, effect on skin in hamsters, 71-1142 71-1059, 71-1212 mammary neoplasms and, 71-0989 in Switzerland, 71-0304 metabolism in cells, 71-0958 therapy, 71-0130, 71-1057 metabolism in hamster cells, 71-0980 thrombosis and, 71-0889 metabolism in neoplasms, 71-0958 in Wales, 71-0474 in tobacco leaf, 71-0354 water hardness as a factor, 71-0495, 71-0886 tobacco variety and, 71-0354 toxicity, 71-0980 ARTHRITIS rheumatoid factor and, 71-0619 ARSENICALS as cause of bronchial neoplasms, 71-0750 AryluninesSeeAROMATIC AMINES as cocarcinogens, 71-1135 ASBESTOS ARTERIAL DISEASES cardiovascular diseases and, 7141421 (See also ARTERIOSCLEROSIS; IIIROMBO- as cause of bronchial neoplasms, 71-0750 ANGIITIS OBLITERANS; VASCULAR DISEASES) as cocarcinogens, 71-1135 age as a factor, 71-0892, 71-1051 in pulmonary fibrosis etiology, 71-1187 in Ceylon, 71-0298 in respiratory tract diseases etiology, 7141421 mortality, 71-0130 in respiratory tract neoplasm. etiology, 7141421 nicotine and, 71-0115, 71-0652 pathogenesis, 71-0295, 71-0652 ASCORBIC ACID DEFICIENCY predisposingfactors,71-0898,71-1036,71-1048, in arteriosclerosis etiology, 7141474 71-1055 effect of nicotine, 71-0794 preventive medicine, 71-1048 effect of smoking, 71-0474 prognosis, 71-0130 effect on blood cholesterol, 71-0474 smoking and, 71-0115, 71-0122, 71-0130, 7141476, occupation as a factor, 71-0794 71-0479,7141485,71-0892,71-0898,71-0904, 71-1048, 71.1051 ASH, CIGARETTE smoking characteristics and, 71-1055 aflatoxins in, 71-0209 smoking in etiology of, 71-0298, 71-0487, 71-0896, effect of processing methods, 71-0014 71-1036 therapy, 71-1030.71-0652 ASTHMA (See alsoRESPIRATORY TRACT DISEASES) ARTERIOSCLEROSIS air pollution as a factor, 71-0102 (See alsoARTERIAL DISEASES; CORONARY DI- allergy and, 71-1157 SEASE) bronchitis and, 71-0262, 71-0614 ascorbic acid deficiency and, 71-0474 diagnosis, 71-0102 blood cholesterol and, 714482, 71-0597, 71-1201 etiology, 71-0262, 71-0281 in Boston and Ireland, 71-0776 in Finland, 71-0262 carbon monoxide in etiology of, 71-0355, 7141468, in Japan, 71-0102 71-0483, 71-0903 predisposing factors in Germany, 71-0867 carboxyhemoglobin levels and, 71-0482 smokers vs. nonsmokers, 71-0262, 71-0269 cessation of smoking and, 71-0953 smoking and, 71-0102, 7141453, 71-0867 in Ceylon, 71-0298 therapy, 71-0281

305 3C7 CUMULATIVE SUBJECT INDEX

ATAXIA 71-1075,71-1076,71-1077,71-1084,71-1088, effect of carbon monoxide, 71-0398 71-1099,71-1245, 71.1246, 71-1248, 71-1255 stress and, 71-0328,71-0933,71-1252 AtherosclerosisSeeARTERIOSCLEROSIS typology of smokers and, 71-1080 ATTITUDES (See alsoBEHAVIOR) BEN7.(a)ANTHRACENES adolescents, 71-1 232 (See alsoAROMATIC HYDROCARBONS) advertising and, 71-0946 carcinogenicity, 71-0239, 71 -0241, 71-0243, 71-0602 cannabis and, 71-0576, 71-0920 determination in cigarette smoke, 71-0202 college students, 71-1233 effect on cells, 71-0241 effect on cessation of smoking, 71-0466, 71-1080 effect on DNA, 71-0967 mass media and, 71-0946 effect on mouth in hamsters, 71-1142 smokers vs. nonsmokers, 71-0524, 71-1084, 71-1233 effect on mucous membrane in hamsters, 71-1142 smokinghabitand,71-0524,71-0919,71-0920, effect on skin in hamsters, 71-1142 71-1075,71-1088,71-1232,71-1242, 71-1244, effects during pregnancy in rats, 71-0239, 71-0584, 71-1250 71-0678 in lung neoplasm induction, 71-058/ '151 AUTONOMIC NERVOUS SYSTEM in mammary neoplasm induction 3:%, (see alsoCENTRAL NERVOUS SYSTEM) metabolism in cells, 71-0958, 7' ,ii`' effect of cannabis, 71-0576 metabolism in neoplasms, 71-0 effect of cigarette smoke, 71-0306 in neoplasm induction in hamste,b, I 1-0241 effectofnicotine,71-0214,71-0222,71-0353, in skin neoplasm induction in rats, 71-1136 71-0572, 71-0964 in stomach neoplasm induction in rats, 71-1153 structure-activity relationships, 71-0243 AVERSIVE THERAPY in cessation of smoking, 71-0948, 71-1261 BENZO(a)PYRENE (See alsoAROMATIC HYDROCARBONS) AVOIDANCE LEARNING absorption, 71-0567 in cessation of smoking, 71-0346, 71-0951 analysis, 71-0567 effect of alkaloids in rats, 71-0324 carcinogenicity, 71-0239, 71 .0241, 71-0602, 71-1002 effect of carbon monoxide, 71-0410 cocarcinogenicity, 71-0415 effect of cigarette smoke, 71-0700 effect on cell division, 71-0020 effect of nicotine in rats, 71-0212, 71-0324 effect on cells, 71-0241 extinction (psychology) in, 71-0324, 71-0700 effect on DNA, 71-0015, 71.0364, 71-0967, 71-0978 effect on enzyme activity, 71-0978 effect on hydroxylase activity, 71-0226, 71-0812 effect on mucous membrane in hamsters, 71-1142 BEHAVIOR effect on proteins, 71-0015 (SeealsoATTITUDES; MU/NATION; PERSON- effect on RNA, 71-0015 ALITY; SMOKING CHARACTERISTICS; SMOKING effect on skin in hamsters, 71-1142 HABIT) effects during pregnancy in rats, 71-0015, 71-0239, advertising and, 71.0339 71-0584 alcohol consumption and, 71-1099 fluorescence, 71-0372 cessation of smoking and, 71-1080 hydroxylation, 71-0978 cognitive dissonance and, 71-0934 in lung neoplasm etiology, 71-1005 coronary disease and, 71-0663 iq lung neoplasm induction, 71-0239, 71-0250, 71-0584, drug abuse and, 71-1099 71-0853, 71-1151 effect of alkaloids in rats, 71-0324 metabolism in cells, 71-0958 effect of cannabis, 71-0549, 71-0576, 71-0697 metabolism in gastrointestinal tract, 71-0567 effectofcarbonmonoxide,71-0399,71-0809, metabolism in hamster cells, 71-0980 71-0833 metabolism in neoplasms, 71-0958 effect of catecholamine levels, 71-1078 metabolism in rats, 71-0978 effect of cigarette smoke, 71-0306, 71-0700 metabolism in respiratory tract, 71-0226 effectofnicotine,71-0215,71-0216,7, -0324, in neoplasm induction, 71-0241, 71-0415 71-0327,71-0328,71-0572,71-0840,A-0943, in respiratory tract neopiasm etiology, 71-1005 71-1077 in skin neoplasm induction, 71-0239, 71-0258, 71-0584, effect of socioeconomic status, 71-0703 71-0852 extinction (psychology) in, 71-0324, 71-0709 health practices and, 71-0703 BENZO(a)PYRENE CONTENT neuroses and, 71-1 248 determination in cigarette smoke, 71-0028 smokinghabitand,71-0049,71-018,71-0159, 71-0162,71.0166,71-0170,71-0172,71.0176, BENZO(a)PYRENE HYDROXYLASE 71-0328,71-0336,71-0345,714)349,71.0517, effect of carbon monoxide, 71-0406 71-0518,71-0519,71-0520,71-0521,71.0522, metabolism in placenta, 71.0503 71-0524,71 -0525,71-0540,71-0698,71-0699 71-0704,71-0739,71-0796,71-0798,71-0801, BENZO(a)PYRENE PHARMACOLOGY 71-0802,71-0803,71-0896,71-0923,71-0933, effect of sulfur compounds, 71-0853

308 306 CUMULATIVE SUBJECT INDEX

BENZOPYRENES oxygen consumption and, 71-0132 (Se!, alsoAROMATIC HYDROCARBONS) smokers vs. nonsmokers, 71-0318, 71-0472 inneoplasm induction in laboratory animals, 71-0987 smoking and, 71-0185, 71-0472, 71-1047

Betel nut chewingSeeARECA CHEWING BLOOD CHOLESTEROL (See alsoHYPERCHOLESTEREMIA) BILLS arteriosclerosis and, 71-0481, 71-0482,71-0597, (See alsoLEGISLATION) 71 -1201 in antismoking campaigns, 71-0178 body constitution and, 71-0907 in United Kingdom, 71-0178 carboxyhemoglobin levels and, 71-0482 coronarydiseaseand, 71-0110, 71-0645, 71.0661, BIRTH WEIGHT 71-0778, 71-0909 (See alsoNEONATE) in coronary disease etiology, 71-0137 diet and, 71-1230 effect of ascorbic acid deficiency, 71-0474 effect of carboxyhemoglobin levels, 71-0830 effect of carbon monoxide, 71-0640 effect of hypoxia, 71-0543 effect of cigarette smoke, 71-0890 effect of maternal smoking, 71-0305, 11.0313, 71.9509, effect of smoking, 71-0405, 71-0483, 71 -0907, 71-1194, 7 1-06 86,71 -0688,71-0696,61-0788,71-0807, 71-1204 71-0811,71-0830,71-0910,71-0984,71-1217, ex-smokers, 71-1054 71-1219, 71-1227, 71-1228, 71-1230 ischemia and, 71-1054 effect of nicotine, 71-0543 myocardial infarct and, 71-0123 effect of socioeconomic status, 71-0811 neoplasms and, 71-0597, 71-1137 oxygen consumptiOn and, 71-0640 BLADDER NEOPLASMS smokers vs. nonsmokers, 71-0482, 71-1054 (See also)UROGENITAL NEOPLASMS) age as a factor, 71-0054 BLOOD CIRCULATION aromatic amines in etiology of, 71-1149 (See alsoHEART FUNCTION) epidemiology, 71-0604, 71-1141, 71-1143 effect of altitude, 71-0647 experimentally induced in dogs, 71-1149 effect of carbon monoxide, 71-0288, 71-0972 ex-smokers, 71-0992 effect of cigarette smoke, 71-0469 in Ireland, 71-0601 effect of nicotine, 71-0016, 71-0115, 71-1049, 71-1198 in La Plata, Argentina, 71-1138 effect of smoking, 71-0115, 71-0479, 71.0487, 71-0634, in Massachusetts, 71-0054 71-0647, 71-0882,71-1057 occupation as a factor, 71-0261, 71-0601, 71-1141 in Rotterdam, 71-0261 BLOOD COAGULATION sex as a factor, 71-0054, 71-0261, 71-0604 (See alsoFIBRINOLYSIS) smokers vs. nonsmokers, 71-0054, 71-0242, 71-0992 effect of cigarette smoke, 71-0121, 71.0649 smoking and, 71.0430, 71-0601, 71-0604, 71-1138, effect of exercise, 71-0292 71-1141 effect of heparin, 71-0121, 71-0649 smoking characteristics and, 71-0261 effect of nicotine, 71-0488 smoking in etiology of, 71-0426, 71-1143 effect of smoking, 71-0292, 71-0488 urban-rural in fluences, 71-1138 BLOOD LIPIDS BLOOD age as a factor, 71-0787 effect of carbon monoxide, 71-0403, 71-0410,71-0412, arteriosclerosis and, 71-0481,71-1201 71 -0489,71-0568,71-0570,71-0573,71-0654, coronary disease and, 71-0110,71-0645, 71 -0778 7 1-066 8,71-0722,71-0832,71-0843,71-0903, in coronary disease etiology, 71-0137 71-0969, 71-1112 diet and, 71-0292 effect of cessation of smoking, 71-1191 effect of cigarette smoke, 71-0890 effect of cigarette smoke, 71-0571, 71-0652,71-1195 effect of exercise, 71-0292 effectof exercise, 71-0489 effect of smoking, 71-0292, 71-0405, 71 -0787, 71-0891, effect of nitrogen dioxide, 71-0571 71-1194, 71-1204 effect of tobacco smoke, 71-0370 oxygen consumption and, 71.0640 lead levels in, 71-0577 nicotine content, 71-0644 BLOOD PHOSPHATES coronary disease and, 71-0778 BLOOD ANTITRYPSIN LEVELS effect of carbon monoxide, 71-0195, 71-0356, 71-0366, chronic bronchopulmonary disease and, 71-0272 71-0368 effect of cigarette smoke, 71-0198 effect of hypoxia, 71-0356 effect on lung function, 71-0275 effect on hemoglobin levels, 71-0639 in emphysema etiology, 71-0275 smokers vs. nonsmokers, 71-0272 BLOOD PRESSURE smoking characteristics and, 71-0275 (See alsoHYPERTENSION) age as a factor, 71-0129 BLOOD CHEMICAL ANALYSIS cerebrovasculardisordersand, 71-1209 carboxyhemoglobin levels, 71-0403 coronary disease and, 71 -0909 coronary disease and, 71-0303 effect of cigarette smoke, 71-0129, 71-0469, 71-0890, hemoglobin levels, 71 -1047 71-1061

307 CUMULATIVE SUBJECT INDEX

effect of nicotine, 71-0213,71-0378, 71-1049 BREAST FEEDING effect of nontobacco cigarettes, 71-0467 effect of maternal smoking, 71-0735 effect of smoking, 71-0113, 71-0467, 71-0637, 71-0918, effect of nicotine, 71-0735 71 -1204 smokers vs. nonsmokers, 71-0712 myocardial infarct and, 71-0135 smoking and, 71-0135, 71.0666 BRONCHIAL EPITHELIUM (See also CELLS, EPITHELIAL) BLOOD PROTEINS effect of cessation of smoking, 71-1155 chronic bronchopulmonary disease and, 71.0477 effect of nitrogen dioxide, 71-0461 effect of carbon monoxide, 71-0366, 71-0419, 71-1122 effect of nitrosamines. 71-0744, 71-0747 emphysema and, 71-0477 effect of smoking, 71-0461, 71-0591, 71-0754, 71-0849. 71-0863 BLOOD SUGAR emphysema and, 71-0876 (See also DIABETES) ex-smokers, 71-0849, 71-1155 effect of carbon monoxide, 71-0194, 71-0195 nucleic acids and, 71-0754 effect of cigarette smoke, 71-0890 smokers vs. nonsmokers, 71-0849, 71-0876, 71-1155 metabolism in brain, 71-0194 BRONCHIAL NEOPLASMS BLOOD VESSELS (See also CARCINOMA, BRONCHOGENIC; LUNG (See also CARDIOVASCULAR SYSTEM) NEOPLASMS) age as a factor, 71-0106 age as a factor, 71-0056, 71-0589 effect of cigarette smoke, 71-0469 in Ceylon, 71-0944 effect of nicotine, 71-0016,71-0199, 71-0652, 71-0841, diagnosis, 71 -0592, 71.0600 71-1119 epidemiology, 71-0057, 71-0600,71-0986, 71-1148 effect of smoking, 71-0106,71-0487, 71-0647 etiology, 71-0066 experimentally induced in rats and mice, 71.0066 BODY CONSTITUTION mortality, 71-0741, 71-0993 (See also BODY WEIGHT) nucleic acids and, 71-0754 blood lipids and, 71-0907 preventive medicine, 71-0750 coronary disease and, 71-0127, 71-0484 smokers vs. nonsmokers, 71-0056. 71-0057, 71-0589, effect of acrolein, 71-0034 71-0993 effect of carbon monoxide, 71-0410 smoking and, 71-0244, 71-0600, 71-0944, 71-0986, effect of cessation of smoking, 71-0801 71.1140, 71-1148 effect of smoking, 71-0127,714244, 71-0405, 71-0484, smoking as cause, 71-0750, 71-0875 71-0907, 71-1204 smoking characteristics and, 71-0056, 71-0057, 71-0741 ex-smokers, 71-0891 sputum analysis, 71 -0592 smokers vs. nonsmokers, 71-0891 therapy, 71-0993 tobacco tars and, 71-0066 BODY HEIGHT effect of maternal smoking, 71-1219 BRONCHITIS (See also CHRONIC BRONCHOPULMONARY DIS- BODY TEMPERATURE EASE) effect of nicotine, 71-0818 absenteeism and, 71 -0273 age as a factor, 71-0077, 71-0436, 71-0451, 71-0611, BODY WEIGHT 71-0763, 71-1010 (See also BODY CONSTITUTION) air pollution as a factor, 71-0081, 71-0103, 71-0228, coronary disease and, 71-1044 7 1-026 5,7 1-0 273, 71-0282, 71-0455, 71-0464, effect of cessation of smoking, 71-0801, 71-1025, 71-0766, 71-0877, 71-0878, 71-1176, 71-1181 71 -1229 allergy and, 71 -0282 effect of reduction of smoking, 71.1025 antitrypsin deficiency and, 71-0439, 71.0616 ex-smokers, 71-0912 asthma and, 71 -0262 smokers vs. nonsmokers, 71-0912, 71-1044, 71-1229 in Australia, 71-0265 smoking and, 71-1134 in Bratislava, 71-0284 socioeconomic effects, 71-1229 bronchial neoplasms and, 71-0589 cadmium and, 71-1169 BRAIN cessation of smoking and, 71-0953 (See also) CENTRAL NERVOUS SYSTEM; CERE- in Colorado, 71-0278 BRAL EMBOLISM AND THROMBOSIS; in Connecticut, 71-0229 CEREBROVASCULAR DISORDERS) diagnosis, 71-0076, 71-0082, 71-0264 455 effect of altitude, 71-0647 effect on mucociliary activity, 71.0606 effect of carbon monoxide, 71-0194, 71-0195, 71-0358, effect on pulmonary clearance, 71-0606 7 1-03 6 6,7 1-0 379, 71-0399, 71-0412, 71-0416, electrocardiographic effects, 71-0872 71 -0809, 71-0833 in emphysema etiology, 71-0438 effect of cessation of smoking, 71-0502 epidemiology,71-0103,71-0272,71-0436,71-0442, effect of nicotine, 71-0189, 71-0196, 71-0204, 71-0215, 7 1-04 56,71 -0591,71.0614,71-0865,71-0878, 71 -0216, 71.0223, 71-0353, 71-0378, 71-0554, 71-1010,71-1177, 71-1181 71-0695, 71-0818, 71-0927, 71-1124 etiology, 71-0281, 71-0464 effect of smoking, 71-0510,71-0647 in France, 71-0077, 71-0611

34° 308 CUMULATIVE SUBJECT INDEX

in Germany, 71-0103, 71-0878 in cigarette smoke, 71 -1169 in Guyana, 71-0622 emphysema and, 71-1169 heart diseases and, 71-0136, 71 -0299 in India, 71-0136 Cancer See NEOPLASMS infection and, 71-0770 leukocytes and, 71-0887 CANNABIS lung function and, 71-0456, 71-0608,71-1165 adolescents and, 71 -0157, 71-0161, 71-0173, 71-0702, in lung neoplasm etiology, 71-0254,71-0434 71-0920 mortality, 71-0085, 71-0229, 71-0233,71-0265 alcohol consumption and, 71-0151 nitrogen dioxide and, 71-0551 analysis, 71-1106 occupation as a factor, 71-0073, 71-0079, 71-0081, behavior and, 71-0697 7 1-00 8 2,7 1-0 083, 71-0273, 71-0282, 71-0284, cannabinoids in. 71-1106 7 1-0 299, 71 -0429, 71-0455, 71-014, 71-0766, chemical properties of, 71-0197 71-0772, 71-1165, 71-1186 collegestudentsand, 71-0151, 71-0161, 71-0697, opium smoking in etiology of, 71-1158 71-1081 pathogenesis, 71-0076, 71-0769 effect on cardiovascular system, 71-0549 inPoland, 71-0078, 71-0079, 71-0081, 71-0456, effect on cell division, 71-1019 71 -1162 effect on DNA, 71-1019 post-operative complications and, 71-0715 effect on lung epithelioid cells, 71-1019 predisposing factors, 71-0450, 71-0867 effect on macrophages, 71-0828 preventive medicine, 71-0272,71-0276 in Germany, 71-0157, 71-0173 pulmonary heart disease and, 71-0901 habituation, 71-0173, 71-0549, 71-0576 race as a factor, 71-0616, 71-0622 history, 71-0027 in Rumania, 71-1177 in Los Angeles, 71 -0151 sex as a factor, 71-0077, 71-0265,71-0282, 71-0284, in military services, 71-0197 71-0451, 71-0763 pharmacology, 71-0197, 71 -0576 smokers vs. nonsmokers, 71-0078,71-0079,71-0082, public attitudes and, 71-0799 7 1-0 1 03,71-0269,71-0274,71-0278,71-0282, research findings, 71-0197, 71-0576 7 1-0 2 8 4,71-0434,71-0631,71-0878,71-1176, research programs, 71 -0197, 71-0549 71-1177, 71-1111 smoking habit and, 71-0151, 71-0920, 71-1081, smokers vs. nonsmokers in Bordeaux, France, 71-0614 71-1256 smokers vs. nonsmokers in Krakow, Poland, 71-0450 in South Dakota, 71-0161 smokers vs. nonsmokers in Lublin, Poland, 71-1012 toxicity, 71-0027 smokers vs. nonsmokers in Bialystok, Poland, 71 -0455 typology of smokers and, 71-0697, 71-1081 smoking and, 71-0077,71-0085,71-0233,71-0264, 7 1-0 2 7 2, 71 -0413,71-0439,71-0441,71-0442, CARBOHYDRATE METABOLISM 71 -0447,71-0449,71-0453,71-0465,71-0611, effect of carbon monoxide, 71-0194, 71-0195 7 1-0 6 1 5,71 -0622,71-0715,71-0766,71-0769, 7 1-07 7 0,71 -0865,71-0867,71-0887,71-1014, CARBOHYDRATES 71-1015,71-1133,71-1134,71-1165 cardiovascular diseases and, 71-0304 smoking as cause, 71-0081, 71-0231, 71-0265, 71-0763, in cigarette smoke, 71-0813 71 -0877 effect of carbon monoxide, 71-0194 smoking characteristics and, 71-0273,71-1012 effect on blood lipids, 71-0292 smoking in etiology of, 71-0076, 71-0083, 71-0228, metabolism in brain, 71 -0194 7 1-0263,7 1-0 266,71-0276,71.0438,71-0450, metabolism in microorganisms, 71-0146 7 1-04 51,71 -0456,71-0464,71-0879,71.1162, myocardial infarct and, 71-0133 71-1186 pyrolysis products, 71-0814 Tecumseh study, 71-0872 smoking and, 71-0133 therapy, 71-0276, 71 -0281, 71-0769 as tobacco additives, 71-0813, 71-0814 in United Kingdom, 71-0273, 71-1186 in tobacco leaf, 71.0409 in Witwatersrand, South Africa, 71-0282 in women, 71-0611 CARBON DIOXIDE in women in Bordeaux, France, 71-0436, 71-1010 effect on smoking habit, 71-0922 inhalation, 71-0922 Bronchopulmonary disease See CHRONIC BRONCHO- PULMONARY DISEASE CARBON MONOXIDE absorption from cigarette smoke, 71-0021, 71-0023, Buccal cancer See MOUTH NEOPLASMS 71-0024, 71-0038, 71-0117 acclimatization, 71 -0732 Buerger's disease See THROMBOANGHTIS OBLIT- in air pollution, 71-0005, 71-0046,71-0116,71-0208, 11-0377,71-0384, ERANS 71 -0218, 71 -0366, 71-0371, 71 -0418,71 -0668,71-0728,71-0736,71-0955, Byssinosis See OCCUPATIONAL DISEASES; PNEUMO- 71-1020 CONIOSIS in air pollution in London, 71-0390 analysis, 71-0568 anoxia and, 71-1119 CADMIUM in arteriosclerosis etiology, 71-0355, 71-0468, 71-0483, bronchitis and, 71-1169 71-0903

309 3 CUMULATIVE SUBJECT INDEX

in arteriosclerosis induction, 71-0468 effect on visual evoked response, 71-1220 in blood, 71-0390, 71-0569 effects during pregnancy, 71-0807 incigarette smoke, 71-0005, 71-0046, 71-0377, electroencephalographic effects, 71.1220 71-0399,71-1071 exercise and, 71-0972 coronary disease and, 71 -1268 fate in body, 71-0719 affect on behavior, 71-0809 hypoxia and, 71-0775 effect on benzo(a)pyrene hydroxylase, 71-0406 inhalation, 71.0041, 71-0116,71-0721 effect on blood, 71-0021, 71-0023, 71-0038, 71-0041, metabolism 71-0719 7 1-0 116,71-0126,71-0218,71-0291,71-0366, in myocardial infarct etiology, 71-0492 7 1.0 399,71.0403,71-0410,71-0412,71-0483, pharmacology, 71-0366, 71-0391, 71.0410, 71 -0416, 7 1-04 89,71.0546,71-0553,71-0570,71-0573, 71-0833, 71-1122 71-0668, 71-0722,71-0847, 71-0903, 71-0969 poisoning, 71-0006, 71.0038, 71-0041, 71-0126, effect on blood cholesterol, 71-0483 71-0194, 71-0416,71-0732,71-0833 effect on blood circulation, 71-0288 smoking and, 71-0005, 71.0023, 71-0038, 71-0041, effect on bloodinlaboratoryanimals,71-0654, 71-0116,71-0126,71-0208,71-0355,71-0377, 71-0832, 71.0843 71-0390,71-0416,71-0467,71-0668,71 -0719, effect on blood phosphates, 71-0195, 71-0356, 71-0368 71 -0728,71-0736,71-0775,71.0833,71 -0847, effect on blood platelets in rabbits, 71-1112 71-0973, 71-1020 effect on blood proteins, 71-0419 standards, 71-0371 effect on blood proteins in rats, 71-1122 toxicity, 71-0005,71-0208,71-0218,71-0228, effect on blood sugar, 71-0194, 71-0195 71-0291,71-0363,71-0396,71-0733,71-0736, effect on blood vessels, 71-0640 71-0832, 71-0843, 71-0962 effect on brain, 71-0194, 71-0195, 71-0358, 71-0809 in vascular disease etiology, 71.1112 effect on carbohydrate metabolism, 71-0194, 71-0195 vascular diseases and, 71-1071 effect on carboxyhemoglobin levels, 71-0117, 71-0391, 71-0418, 71-0489, 71-0839, 71-0965 CARBON MONOXIDE CONTENT effect on cardiovascular system, 71-0972 (See alsoCARBOXYHEMOGLOBIN LEVELS) effect on cardiovascular system in dogs, 71-0806 determination in blood, 71-0569, 71-0568, 71-0847 effect on cardiovascular system in laboratory animals, determination in cigarette smoke, 71.0021, 71-0035 71-0826 effect of nontobacco cigarettes, 71.0467 effect on catecholamine levels, 71-1224 effect of ozone, 71-0836 effect on central nervous system, 71-0398, 71-0412, in respiratory gases, 71-0568, 71-0736 71-0969,71-1120 effect on cognition, 71-0395, 71-0398 CARBON MONOXIDE TOLERANCE effect on drug metabolism in rats, 71-1122 effect of iodoacetate, 71-0396 effect on endocrine system, 71 -1224 effect on erythrocytes, 71 -0132, 71-0356,71-0368 Carbonyl compoundsSeeALDEHYDES effect on fertility in rats, 71-0968 effect on fetus, 71-0132 CARBOXYHEMOGLOBIN LEVELS effect on hearing, 71-0358, 71 -0969 (See alsoCARBON MONOXIDE CONTENT) effect on heart function, 71-0288, 71-1041 angina pectoris and, 71-1031 effect on heart function in dogs, 71-0806 arteriosclerosis and, 71-0482 effect on hemoglobin, 71-0542, 71-0570, 71-0573 blood cholesterol and, 71-0482 effect on hemoglobin levels,71-0132, 71-0386, determination, 71-0546, 71-0721 71-0641,71-1114,71-1119 effect of altitude, 71-0470 effect on learning, 71-0321 effect of atmospheric pressure, 71.0962 effect on liver, 71-0406 effect ofcarbonmonoxide,71.0038,71 -0046, effect on liver cells, 71-0419 71-0116,71-0126,71-0195,71.0208,7 1-02 18, effect on lung function, 71-0271, 71-0546 71-0291,71-0321,71-0355,71-0358,71 -0366, effect on lungs, 71-0271, 71-0721 71-0377,71-0386,71-0391,71-0399,71-0400, effect on maternal-fetal exchange, 71-0006, 71-0391 71 -0403,71-0418,71.0467,71.0489,71-0546, effect on memory, 71-0395 71-0553,71-0569,71-0570,71-0640,71-0654, effect on mitochondria, 71-0548 71 -0668,71-0721,71-0832,71.0839,71-0843, effect on mortality In Los Angeles County, California, 71-0969,71-0972, 71-1112, 71.1120 71-0384 effect of cigarette smoke, 71.0005, 71-0021, 71-0046, effect on motor skills, 71-0321 71-0126, 71-0208, 71-0609, 71-1114 effect on neonate, 71-0006, 71-0396, 71.0641 effect of exercise, 71-0489 effect on nonsmokers, 71-0024, 71-0038, 71-0733, effect ofmaternalsmoking,71-0006,71-0391, 71-0962 71-0807, 71-1227 effect on perception, 71-0321 effect of nontobacco cigarettes, 71-0117, 71 -1031 effect on psychomotor perfonnance,71-0379, 71-0398, effectofsmoking,71-0038,71-0117,71-0218, 71 -0399, 71-0400, 71-0403, 71-0412, 71-0831, 71-0366,71-0377,71 -0390,71-0399,71-0482, 71-0839, 71.0970, 71-1071 71-0553, 71-0640, 71-0719, 71.0775, 71.1119 effect on respiration, 71-0972 effect on birth weight, 71-0811, 71-0830 effect on sleep, 71-0831, 71-0970 effect on blood circulation, 71-0288 effect on tissues, 71-0553, 71-0722 effect on blood in rabbits, 71-1112 effect on urine, 71.0041, 71 -0847 effect on blood phosphates, 71.0368 effect on vision, 71-0358, 71-0395, 71-0965 effect on brain, 71-0416

310 CUMULATIVE SUBJECT INDEX

effect on cardiovascular system, 71-0399, 71-0833 effect on DNA, 71-1001 effect on cardiovascular system in dogs, 71-0806 enzyme activity and, 71-1006 effect on central nervous system, 71-0366, 71-0403, in lung neoplasm etiology, 71.1148 71-0416 in lung neoplasm induction, 71-0756 in tobacco leaf, 71-0191 effect on heart function, 71-0288 71-0070,71-0191,71-0817, effect on heart function in dogs, 71-0806 intobaccosmoke, effect on infant mortality, 71-0811 71-0834 effectonpsychomotorperformance, 71-0379, 71 -0418,71-0970, CARCINOMA, BRONCHOGENIC 71-0400,71-0403,71-0416, BRONCHIAL NEOPLASMS; LUNG NEO- 71 -1071 (See also effect on sleep, 71-0970 PLASMS) effect on vision, 71-0395 follow-up studies, 71-0603 effect on visual evoked response, 71-1 2 20 in India, 71 -0745 electroencephalographic effects, 71-1220 mortality, 71.0603, 71-1188 occupation as a factor, 71-0116, 71-0291, 71-0668 occupation as a factor, 71-0429 oxygen consumption and, 71-0489 race as a factor, 71-0257 passive smoking and, 71-0393 smokers vs. nonsmokers, 71-0745, 71-0993 smokers vs. nonsmokers, 71-0023, 71-0024, 71-0116, smoking and, 71-0257, 71-0429, 71-0603, 71-0913 71 -0470,71-0483, smoking as cause, 71-0849 71 -0291,71-0390,71-0391, smoking in etiology of, 71-0228, 71-0256, 71-0879, 71-0562,71-0569,71-0662,71-0668,71-0708, 71-0819, 71-0833, 71-1020, 71 -1120 71-1188 vascular diseases and, 71-1071 survival and, 71 -1188 therapy, 7 1-099 3 CARCINOGENESIS (See alsoCARCINOGENICITY REDUCTION; CAR- CARCINOMA, EPIDERMOID CINOGENS; NEOPLASMS) (See alsoSKIN NEOPLASMS) aromatic hydrocarbons, 71-1002 smokers vs. nonsmokers, 71-0586, 71-0752 biologic models, 71-0853 effect of areca, 71-0435 Cardiac inputSeeHEART FUNCTION effect of aromatic hydrocarbons, 7 1-1 148 effect of benz(a)anthracenes, 71.0243, 71-1136 CARDIOVASCULAR DISEASES effect of benzo(a)pyrene, 71-0258, 71 -0852 (See also CEREBROVASCULAR DISORDERS; effect of carbon monoxide, 71-0410 HEART DISEASES; 'SCHEMA; THROMBOSIS; effect of cigarette smoke, 71-0997, 71 -0999, 71-1148 VASCULAR DISEASES) effect of cigarette tars, 71-0253, 71 -0258, 71-0417, asbestos in etiology of, 71-0421 71-0431, 71-1145 diet and, 71-0304 effect of ditnethylsulfoxide, 71-0435 epidemiology, 71 -1043, 71-1058, 71-1192 effect of enzymes, 71-0990, 71-1006 Framingham study, 71-1043 effect of irradiation, 71-0259 in France, 71-0665 effect of mycoplasma, 714000 morbidity, 71 -0661 effect of nitrosamines, 71-0729 mortality, 7 1-03 04, 71-0661, 71-1057 effect of phenols, 71.1127 predisposingfactors,71-0495,71-0642,71-0665, effect of tobacco pigments, 71-0425 71.1048 effect of tobacco tars, 71-0203, 71-0602 preventivemedicine,71-0087,71-0642,71-1048, effect of viruses, 71-1000 71-1058 inhibition,71-0852,71-0978,71-0989,71-0990, race as a factor, 71-1192 71- 1006 smoking and, 71.0087, 71-0495, 71-0642,71-0661, mechanism of action, 71-0254, 71-0834, 71-0989, 71-0665,71-0717,71-0737,71-0739,71-0984, 71-0990, 71.1002, 714006 71 -1048,71-1056,71.1105,71-1134,71-1192, preventive medicine, 71-1144 71-1193, 71-1 237, 71-1257 research programs, 71-0067, 71 -0431, 71 -0834 smoking in etiology of, 71-0228, 71-0422,71.0646, sex as a factor, 71.1136 71-0896, 71-1058 smoking and, 71-0996, 71.1001 in Switzerland, 71-0304 viral infection and, 71-1148 in twins, 71-1193 CARCINOGENICITY REDUCTION (See alsoCARCINOGENESIS) CARDIOVASCULAR SYSTEM aromatic hydrocarbons, 71-0547, 71-0990 (See alsoBLOOD VESSELS; HEART) effect of enzymes, 71-1006 effect of cannabis, 71-0576 filters and, 71-0971 effect of carbon monoxide, 71-0806, 71-0826 hydroxylase activity and, 71-1006 effect of cessation of smoking, 71-1025 effect of hypnosis, 71-0800 CARCINOGENS effect of nicotine, 71.1130 71-0113,71-0617,71.0637, (See alsoCARCINOGENESIS; COCARCINOGENS) effectofsmoking, aromatic hydrocarbons, 71-0011, 71 -0552, 71-0834 71-0800, 71-0913 asbestos, 71-0062 effect of tobacco smoke, 71-0817 in bronchial neoplasm etiology, 71-0750 effect on cells, 71-1001 CatecholSeePHENOLS

I is 311 31 CUMULATIVE SUBJECT INDEX

CATECHOLAMINES belief in smoking hazards and, 71-0926 effect of carbon monoxide, 71 -1224 in bronchial neoplasm etiology, 71-0057 effectofnicotine,71-0189,71-0214,71-0554, cognitive dissonance and, 71-0934, 71-1084, 71-126 1 71-0724, 71-0740, 71-1078, 71-1131 conditioning(psychology)in,71-0346,71-0948, effect of smoking, 71.1239 71-0951, 71 -1263 effect of tobacco fermentation products, 71-0724 counselingin, 71-0344, 71 -0708,71-0709,71 -0940, effect on autonomic nervous system, 71-1078 71-0953 stress and, 71-1078 cytisine in, 71-0535 diet and, 71-0381 CELLS drug therapy, 71-0180, 71-0330,71-0347,71-0531, (See alsoERYTHROCYTES; LEUKOCYTES; NEU- 71-0535,71-0536,71-0709,71-0947,71 -0950, RONS) 71-1096, 71-1262, 71-1265 antigen-antibody reactions in, 71-0316 educational therapy, 71-0709, 71-0940 effect of benzo(a)pyrene, 71 -0241 effect on blood, 71-1191 effect of cannabis, 71.0828 effect on body weight, 71.1025 effect of cigarette smoke, 71 -0198 effect on bronchial epithelium, 71-1155 effect of nicotine, 71-0214, 71-0227 effect on cardiovascular system, 71.1025 effect of smoking, 71-0828 effect on equilibrium, 71.0801 effect on gastric secretion, 71-0918 CELLS, EPITHELIAL effect on leukocytes, 71.1191 (See alsoBRONCHIAL EPITHELIUM) effect on lung function, 71-0075, 71-0626 effect of tobacco, 71-0789, 71-0791 effect on metabolism, 71-0381 effect on morbidity, 71-0423, 71-0854 CENTRAL NERVOUS SYSTEM effect on mortality, 71-0245, 71-0423, 71-0660 (See alsoAUTONOMIC NERVOUS SYSTEM; BRAIN; effect on mortality in physicians, 71-0905 SPINAL CORD) effect on pulmonary clearance, 71.1007 coronary disease and, 71-1056 effect on respiratory system, 71-1025 effect of cannabis, 71-0576 effect 'on stomach neoplasms, 71-0605 effectofcarbonmonoxide,71-0416,71-0969, effect on vision, 71-0307 71-1120, 71.1220 electroencephalographic effects, 71-0502 effectofnicotine,71-0397,71-0575,71-0695, evaluation, 71-0162, 71-1099 71-0816, 71-0942, 71-1113 follow-up studies, 71-0162, 71-1098, 71-1267 effect of tobacco fermentation products, 71-0357 group therapy, 71-0531, 71-0941, 71.1262 effect of tobacco smoke, 71-0817 hypnosis in, 71-0532, 71-1267 lobeline in, 71-0347, 71-0534 CEREBRAL EMBOLISM AND 'THROMBOSIS methods, 71-0175,71-0180,71-0330,71 -0332, (See also CERESROYASCULAR DISORDERS; 71-0346,71-0347,71-0519,71-0521,71-0522, THROMBOSIS) 71-0540,71-0708,71-0739,71-0922,71-0935, Framingham study, 71-1043 71-0949, 71-1097, 71-1264 predisposing factors, 71-1043, 71 -1209 motivation in, 71-0049, 71.0176, 71.0701, 71-0934, smoking and, 71-0655, 71-1209 71-0949, 71-1080 smoking in etiology of, 71-1043 myocardial infarct and, 71-0466 personality as a factor, 71-0176, 71-0336, 71 -1090, CEREBROVASCULAR CIRCULATION 71-1262 effect of nicotine, 71-0204 as preventive medicine, 71-0485, 71-0900, 71-0941, 71-1038, 71-1040, 71-1214 CEREBROVASCULAR DISORDERS as preventive medicine in Poland, 71-0947 (See alsoCARDIOVASCULAR DISEASES: CERE- psychosocial aspects, 71-0065, 71-1080 BRAL EMBOLISM AND THROMBOSIS) psychotherapy, 71-0330 epidemiology, 71-0655, 71-1192 reasonsfor,71-0162, 71-0516, 71-0926, 71-0949, predisposing factors, 71-0655, 71-0659 71-1087, 71-1257 race as a factor, 71-1192 relapse rates, 71-1099 smoking and, 71-0655, 71-0659, 71-0984, 71-1192 research programs, 71-0540 role of health organizations, 71-1082, 71.1083 CESSATION OF SMOKING role of medical personnel, 71.0953 (See also REDUCTION OF SMOKING;wrrH- roleofphysicians,71.0256,71.0320,71 -0322, DRAWAL CLINICS) 71 -0332,71-0344,71-0534,71-0708,71-0940, age as a factor, 71-0928, 71 -1257 71-0995, 71-1214, 71-1259 antismokingcampaignsand,71-0802,71-1082, scopolamine in, 71-0536 71-1083, 71-1100, 71-1101 sex as a factor, 71-0709 attitudes,71-0162,71-0466,71-0516,71-0701, statistics, 71-0516,71 -0928;71-0934,71-0985, 71-1075, 71.1084, 71-1100, 71-1250 71-1076, 71-1100 attitudes in adolescents, 71-0930 stimulus saturation,71-0346,71-0349,71 -0521, aversive therapy, 71-0948, 71-0951, 71-1261 71-0522, 71-0534 behavior therapy,71-0349, 71-0519,71-0521, astherapy,71-0044, 71.0049, 71-0120, 71-0125, 71-0522,71-0531,71-0533,71-0947,71-1084, 71-0130,71-0167,71-0175,71-0293,71-0307, 71-1263 71-0423,71-0473,71-0479,71-0485,71 -0487,

314 312 CUMULATIVE SUBJECT INDEX

71-0446,71-0453,71-0457,71-0460, 71-0677,71-0689,71-0854,71-0893. 71.0444, 71-0660, 71-0865,71-0873, 71-0878, 71-1193 71-0911 smokers vs. nonsmokers in Krakow, Poland, 71-0450 71-1213 as therapy in vascular diseases, smokers vs. nonsmokers in Lublin, Poland, 71-1012 tranquilizing agents in, 71-1265 71-0233, typology of smokers and, 71-0701, 71-1080 smoking and, 71-0085, 71.0092, 71.098, 71-0439,71-0447,71-0609, withdrawal symptoms, 71-0525, 71-0976 71-0272,71-0436, 71-0626,71-0737,71-0760,71-0766,71-0880, in women, 71-0526, 71-0928 71-1010,71-1024,71.1161,71-1167,71-1176, 71-1179 CHILDREN characteristicsand,71-0260, 71-0280, campaignsand, 71-0335,71-0932, smoking antismoking 71-1012 71-0936, 71.1253 smoking in etiology of, 71.0046, 71-0083, 71-0441, effect of cigarette smoking, 71-0129, 71-0326 71-0456, 71-0869, 71-0875, 71-1014 morbidity, 71-0931 socioeconomic status and, 71-1027 respiratory tract diseases and, 71-0266 therapy, 71-0281 smokinghabitand,71-0171,71-0329,71-0334, 71-0796, 71-0931, 71-0936, 71-1086, 71-1253 tuberculosis and, 71-0095, 71-0460 in twins, 71-1193 urban-rural influences, 71-0280 CHROMIUM in women in Bordeaux, France, 71-0436, 71.1010 (See also METALS) as cause of bronchial neoplasms, 71-0750 Chronic obstructive lung diseases See CHRONIC BRON- distribution in lungs, 71-0458 in lung neoplasm induction, 71 -0853 CHOPULMONARY DISEASE in snuff, 71-0583 CIGARETIE BUTTS tar content, 71-0352 Chronic bronchitis See BRONCHITIS CIGARETTE PAPER CHRONIC BRONCHOPULMONARY DISEASE effect on smoke, 71-1118 (See also BRONCHITIS; EMPHYSEMA; LUNG DIS- effect on tar content, 71-1118 EASES) adolescents and, 71-0074, 71-0088, 71-0095, 71-0096, porosity, 71-0710, 71-1118 71-0436, 71-0442, 71-0865, 71-0873, 71-1010 standards, 71-0710 air pollution as a factor, 71-0046, 71-0095, 71-0103, CIGARETTES 71-0280, 71-0766, 71-0878, 71-1161 71-0529,71-0530,71-0538, antitrypsin deficiency and, 71-0439, 71-0440, 71-0477, advertising,71-0515, 71-0804, 71-0937, 71-1101 71-0685,71-0869,71-0881,71.1167, 71-0616, analysis, 71-0022, 71-0042 71-1179 antitrypsin deficiency in etiology of, 71-1073 brand differences, 71-0022, 71-0530, 71-1240 combustion temperature and, 71-0758 in Berlin, New Hampshire, 71-1161 consumption, 71-0352, 71-0376, 71-0516, 71-0530, blood proteins and, 71-0477 71-0646, 71-1268 in Canada, 71-0092 consumption in Europe, 71.0954 in Colorado, 71-0278 consumption in France, 71-0954 diagnosis, 71-0098 epidemiology, 71-0092, 71-0260, 71-0272, 71-0442, consumption in Germany, 71-0350, 71-1249 consumption in United States, 71-0954 71-0446, 71-0772, 71-0865, 71-0880 formaldehyde in, 71-1128, 71-1129 epidemiology in Wroclaw, Poland, 71-0456 epidemiology in Zabrze, Poland, 71-1024 fungi in, 71-0716 in Germany, 71-0042 etiology, 71-0281 health warnings, 71-0515, 71-0804 ex-smokers, 71-0423, 71-0444 in Hungary, 71-0022 follow-up studies, 71-0446 labeling, 71-0420, 71-0529, 71-0952, 71-1101 in Germany, 71-0280 heredity as a factor, 71-0440 menthol, 71-1223 in Poland, 71-0042 in India, 71-0457 lung function and, 71-0456, 71-0608, 71-0610 radioactive particles in, 71-0207 in Russia, 71-0042 in lung neoplasm etiology, 71-0260 tar and nicotine content, 71-0515,71-0529, 71-1101, modality, 71-0233 in nonsmokers in. Hagerstown, Maryland, 71-0631, 71-1268 71-0632, 71.1027, 71-1183 tar content, 71-0352 occupation as a factor, 71.0081, 71-0082, 71-0083, thorium-232 in, 71-0207 71-0088, 71-0760, 71-0766, 71-1176 opium smoking in etiology of, 71-1158 Cigarette smoke See SMOKE, CIGARETTE predisposing factors, 71-0083, 71-0464, 71-1024 preventive medicine, 71-0272, 71-0464 Cigarette smoking See SMOKING race as a factor, 71-0460, 71-0616 71-0103, 71-0873, CIGARETIES, NONTOBACCO sex as a factor, 71-0095, 71-0096, effect on blood pressure, 71-0467 71-0878 smokers vs. nonsmokers, 71-0074, 71-0081, 71-0082, effect on carbon monoxide expiration, 71-0467 71-0096,71-0103,71-0269, effect on carboxyhemcglobin levels, 71-0117, 71-1031 71-0088,71-0095, effect on heart rate, 71-0467 71-0274,71-0278,71-0423,71-0440,71-0142,

313 31.5 CUMULATIVE SUBJECT INDEX

electrocardiographic effects, 71-0287 smoking and, 71-0248, 71-0684, 71-0906 hypoxia and, 71-0185 stress and, 71-1092 toxicity, 71 -0185 thremboembolism and, 11-0664, 11-0906

Cigarette tar See TARS, CIGARETTE CORONARY DISEASE (See also ANGINA PECTORIS; ARTERIOSCLERO- Cigar smoke See SMOKE, CIGAR SIS; HEART DISEASES; MYOCARDIAL INFARCT; THROMBOSIS) Cigar smoking See SMOKING, CIGAR age as a factor, 71-0110. 71-0122, 71-0125, 71-0303, 71.476, 71-0643, 71-0670, 71-0891, 71-1214 CILIARY ACTIVITY alcohol consumption and, 71-1033 (See also PULMONARY CLEARANCE) angina pectoris and, 71-0296 bronchitis and, 71-0606 behavior and, 71-0663, 71-1056 effect of aldehydes, 71-0192 blood lipids and, 71-0778 effect of carbon dioxide, 71-0720 body constitution and, 71-0127, 71-0484 effect of cigarette smoke, 71-0452, 71-0629, 71-0720, body weight and, 71-1044 71 -0959, 71-1007, 714022, 71-1175, 71-1189 carbon monoxide in etiology of, 71-0399 effect of cigar smoke, 71-0629 carboxyhemoglobin levels and, 71-0288 effect of nicotine, 71-0720 cerebrovascular disorders and, 71-1209 effectofsmoking,71-0452,71-0606,71-0607, cholesterol and, 71-0645 71-1008, 71-1022, 71-1182 in Czechoslovakia, 71-0122, 71-0476 effect of tobacco additives, 71-0959, 71-1189 diagnosis,71-0111,71-0131,71-0671,71-1190, effect of tobacco smoke, 71-0875 71-1206 in pulmonary clearance, 71-0452, 71.0606, 71-0607, diet and, 71-0110, 71-0776 714008 electrocardiographic effects, 71-0131, 71-0287 smokers vs. nonsmokers, 71-0620 epidemiology, 71-0109, 71-0137, 71-0289, 71-0481, 71-0776, 71-0895, 71-1050, 71-1205 COCARCINOGENS etiology, 71-0300 (See also CARCINOGENS) Evans County study, 71-1192 asbestos, 71-0988 ex-smokers, 71-0423 in cigarette smoke, 71-0258 follow-up studies, 71-0043 in croton oil, 71-0415 Framingham study, 71-0297, 71-0651, 71-1043 determination in tobacco tars, 71-0203 in Germany, 71-0643 ketones, 71-1127 in Glostrup, Denmark, 71-0891 inlung neoplasm induction in laboratory animals, heart rate and, 71-0290 71-0999 heredityas afactor, 71-0124, 71-0127, 71-0484, mechanism of action, 71-0834 71-0496, 71-0657 in neoplasm etiology, 71.0988 hyperlipidemia and, 71.0650 phenols, 71-0240, 71-0415, 71-0834, 71-1127 in India, 71-0289 terpenoids, 71-0415 in Ivory Coast, 71-0109 in tobacco extracts, 71-0435 longevity and, 71-0124 in tobacco leaf, 71-0425 metabolic disorders in, 71-1038 in tobacco smoke, 71-0834 morbidity, 71-0131, 71-0496, 71-0658 mortality,71-0043,71-0065,.71-0107,71-0137, COGNITION 71-0290,71-0301,71-0646,71.0658,71-0779, (See also LEARNING; PERCEPTION) 71-1196 effectofcarbonmonoxide,71-0395,71-0398, myxoedema and, 71-0111 71-0412 in Norway, 71-0140, 71-0493, 71-0648 occupation as a factor, 71-1033, 71-1034 COGNITIVE DISSONANCE pathogenesis, 71-0471, 71-0497 effect on cessation of smoking, 714261 personality as a factor, 71-0338, 71-0496, 71-1056 smoking habit and, 71-0934,714084 physical activity and, 71-1034 predisposingfactors,71-0108,71-0119,71-0122, COLON 71-0124,71-0127,71-0131,71-0137,71-0290, (See also GASTROINTESTINAL SYSTEM) 71-0296,71-0297,71-0303,71-0471,71-0476, effect of smoking, 71-0310 71-0481,71-0484,71-0486,71-0496,71-0642, 71-0643,71-0650,71-0653,71-0656,.71-0659, COLONIC NEOPLASMS 71-0663,71-0669,71-0778,71-0779,71-0886, smokers vs. nonsmokers, 71-0310 71-0908,71-0909,71-1035,71-1036,71 -1038, 71-1040,71-1043,71-1045,71-1046,71-1052, COMBUSTION TEMPERATURE 71-1056, 71-1059, 71-1190, 71-1202, 71.1214 in cigarette smoke, 71-0758 predisposing factors in India, 71-1211 effect of tobacco additives, 71-0837 predisposing factors in Netherlands. 71-0900 effect on lungs, 71-0758 predisposing factors in Oceania, 71-0781 effect on smoke, 71-0217 preventivemedicine,71-0108,71-0134,71-0137, 71-0293,71.0297,71-0486,71-0642,71-0645, CONTRACEPTIVES, ORAL 71-0656,71-0905,71-0908,71-0940,71-1040, endocrine environment and, 71-0248 71-1206

3:x.6 314 CUMULATIVE SUBJECT INDEX

psychosocial aspects, 71.1202 CYANIDES race as a factor, 71-0109, 71-0781, 71-1035, 71-1044, (See also THIOCYANATES) 71.1192 determination in blood, 71-0210, 71-0795 research programs, 71-0043 determination in cigarette smoke, 71-0004. 71-0202. screening, 71-0653 71-0731 sex as a factor, 71-0110, 71-0125, 71-0303, 71-0646, determination in cigarette tars, 71-0004 71-0648, 71-0657 determination in tobacco tars, 71-0726 smokers vs. nonsmokers, 71-0043, 71-0107,71-0110, determination in urine, 71-0210 71-0131,71-0137,71-0297,71-0338,71-0423, effect on cell division, 71-0726 71-0657, 71-1044 filtration, 71-0004 smoking and, 71-0111, 71-0119, 71-0122,71-0124, tobacco amblyopia and, 71-0224, 71-0786 71-0125,71-0127,71-0140,71-0287,71-0290, in tobacco smoke, 71-0030, 71-0040, 71-0224 71-0355,71-0471,71-0476,71-0484,71-0493, 71-0494,71-0496,71-0497,71-0645,71-0646, Death sates See MORTALITY 71-0650,71.0651,71-0658,71-0659,71-0663, 71-0776,71-0779,71-0781,71-0895,71-0900, DIABETES 71-0905,71-0940,71-0984,71-1033,71-1034, (See also BLOOD SUGAR) 71-1035,71-1038,71-1045,71-1046,71-1050, arteriosclerosis and, 71-1057 714052,71-1061,71-1190,71-1196,71-1197, cerebrovascular disorders and, 71-1209 71-1203,71-1205, 71-1211, 71 -1214 in coronary disease etiology, 71-0119 smoking as cause, 71-0231 myocardial infarct and, 71-1039 smokingcharacteristicsand,71-0065, 71-0108, smoking and, 71-1039 71-0120, 71-0303, 71-0473 smoking classification and, 71-0120, 71-0473, 71-0648 DIBENZ(a,h)ACRIDINE smoking in etiology of, 71-0289, 71-0296, 71-0300, (SeealsoHETEROCYCLIC NITROGEN COM- 71-0486,71-0653,71-0670,71-0886,71-0891, POUNDS) 71-0908,71-0909,71-0954,71-0995,71-1036, structure-activity relationships, 71-0011 71-1040, 71-1043, 71-1059 socioeconomic effects, 71-0643 DIBENZ(a.h)ANTHRACENE stress and, 71-0905 (See also AROMATIC HYDROCARBONS) sugar intake and, 71-1203 structure-activity relationships, 71-0011 in Sweden, 71-0127, 71-0303, 71-0484 therapy, 71-0043 DIBENZOFURANS tobacco chewing and, 71-1211 in tobacco smoke, 71-0385 in twins, 71 -1206 in United Kingdom, 71-0134 DIET water hardness as a factor, 71-0886 arteriosclerosis and, 71-0481 in women, 71-0671, 71-0778 carcinogenesis and, 71-0990 in Yugoslavia, 71-1205 coronary disease and, 71-0471, 71-1203 effect on birth weight, 71-1230 Coronas)? flow See BLOOD CIRCULATION effect on cessation of smoking, 71-0381 effect on enzyme activity, 71-0990, 71-1006 COTININE effect on eyes, 71-0677 (SeealsoALKALOIDS, TOBACCO;NICOTINE neoplasms and, 71-0597 METABOLITES) smoking and, 71-0921, 71-1203 determination in urine, 71-1107, 71-1108 tobacco amblyopia and, 71-0224, 71.0689 fate in body, 71-0220 metabolism, 71-1107, 71-1108 DNA metabolism in mice, 71-0220 (See also NUCLEIC ACIDS) as nicotine metabolite, 71-0220, 71-0223, 71-0544 effect of aromatic hydrocarbons, 71-0015, 71-0364, 71-0967 COUGH effect of benzo(a)pyrene, 71-0015, 71-0364 air pollution as a factor, 71-1178 in lung neoplasm etiology, 71-0252 DRUG ABUSE lung neoplasms and, 71-0260 adolescents and, 71-0173, 71-0702, 71-0920, 71-1079, in nonsmokers, 71-1185 71-1086 respiratory tract infections and, 71-1159 adolescents in New England, 71-1238 smokers vs. nonsmokers, 71-0264 behavior and, 71-0697 smokers vs. nonsmokers in Krakow, Poland, 71-0450 in Bern, Switzerland, 71-0920 smoking and, 71-1159, 71-1178 cannabis and, 71-0151, 71-0197, 71-0576, 71-0697, smoking as cause, 71-0085, 71-0263, 71-0772, 71-0866 71-0702, 71-0920, 71-1081 smokingcharacteristicsand, 71-0096,71-0260, children and, 71-1086 71-0873 collegestudentsand, 71-0151, 71 -0161, 71-0697, 71-1081 COUNSELING in Dallas, Texas, 71-1079 in cessation of smoking, 71-0322, 71-0344, 71-0534, in Dublin, Ireland, 71-0702 71-0708, 71-0709 effect on lung function, 71-1011

315 317- CUMULATIVE SUBJECT INDEX

history, 71-1270 opium smoking in etiology of, 71-1158 in Norway, 71-0799 pathogenesis, 71-0097, 71-0263, 71-0285 respiratory tract diseases and. 71-1011 pneumothorax and. 71-0286 role of physicians, 71 -0161 predisposing factors in Germany. 71-0867 smoking habit and, 71-1089, 71 -1238, 71-1256 preventive medicine, 71-0272 in Sydney, Australia, 71 -1081 pulmonary heart disease and, 71-0901 respiratory function tests, 71-0097 Duodenal ulcerSeeULCER, PEPTIC smokers vs. nonsmokers. 71-0064, 71 -0269, 71-0621, 71-0876 DUST smoking and, 71-0085, 71-0244, 71-0264, 71-0272, bronchitis and, 71-0455 71-0439.71-0441,71-0447,71-0463,71-0591, effect on respiratory tract, 71 -1176 71-0615,71 -0867.71-0913.71-1014.71-1015, pneumoconiosis and, 71 -1028 71-1133, 71-1134, 71-1164, 71-1184 smoking as cause, 71-0231, 71-0863 DYSPNEA smokingcharacteristicsand.71-0275,71-0285, (See alsoRESPIRATION; RESPIRATORY TRACT 71-0286, 71 -0902 DISEASES) smoking in etiology of, 71-0263, 71-0363, 71-0438, age as a factor, 71-0446 71-0464, 71-0879 air pollution and, 71-1176 therapy, 71-0281 diagnosis, 71-0446 occupation as a factor, 71-0628, 71-0760 ENDOCRINE SYSTEM smokers vs. nonsmokers, 71-0446 effect of carbon monoxide, 71 -0968.71 -1224 smoking and, 71-0760 effect of smoking, 71-0248, 71-1064 effect of sulfur dioxide, 71 -0968 lung neoplasms and, 71-0248 oral contraceptives and, 71-0248 EAR stress and, 71 -1092 (See alsoHEARING) effect of smoking, 71-0317, 71-0911, 71 -1072 ENZYMES antitrypsin deficiency and, 71-1017 ELECTROCARDIOGRAM carcinogenesis and, 71-0990, 71-1006 bronchitis and, 71-0872 effect of acroleln, 71 -0718 effect of carbon monoxide, 71-0410 effect of cigarette smoke, 71-1023 effect of hypoxia, 71-0773 effect of nicotine, 71-0956, 71-1131 effect of smoking, 71-0637 effect of smoking, 71-1132 smokers vs. nonsmokers, 71-07 7 3. 71 -0872 effect of tobacco fermentation products, 71 -0550 effect on lung function, 71-0623 ELECTROENCEPHALOGRAM effect on skin, 71-0623 effect of carbon monoxide, 71-1 220 emphysema and, 71-1017 effect of smoking, 71-0510 EpinedrineSeeCATECHOLAMINES EMPHYSEMA (See alsoCHRONIC BRONCHOPULMONARY DIS- ERYTHROCYTES EASE) (See alsoCELLS) age as a factor, 71-0064 effect of carbon monoxide, 71-0356, 71-0368 air pollution as a factor, 71-0285, 71-0363, 71-0464 effect of hypoxia, 71-0356 antitrypsin deficiency and, 71-0275. 71-0439, 71-0477, effect of smoking, 71-0662, 71-1047 71-0761,71-0762,71-0771,71 -0881,71-1017, hydrogen ion concentration, 71-0639 71- 1164,71 -1168, 71-1170, 71-1184 antitrypsin deficiency in etiology of, 71-1073 ESOPHAGEAL NEOPLASMS blood proteins and. 71-0477 (See alsoGASTROINTESTINAL NEOPLASMS) bronchial mucous glands and, 71 -0876 alcohol consumption and, 71-0051, 71-0982 bronchitis and. 71-0438, 71-0447, 71-0614, 71-1164 areca chewing and, 71-0596 cadmium and, 71-1169 demographic effects, 71-0051 in Connecticut, 71 -0229 mortality, 71-0051 in Cuba, 71-0064 smoking and, 71-0051, 71-0596, 71.0913, 71-0982 diagnosis, 71-0264, 71-0455 tobacco and, 71-0590 epidemiology, 71-0272 in United States, 71-0051 etiology, 71-0281, 71-0464 experimentally induced in dogs, 71-0863 ESOPHAGUS heart diseases and, 71-0299 effect of smoking, 71-0139, 71-0491, 71 -0500 heredityas a factor, 71 -0761, 71 -0762. 71-0771, hydrogen ion concentration, 71-0139, 71-0491 71-1168, 71-1184 infection and, 71-0770 EUSTACHIAN TUBE in Japan. 71-0285 effect of smoking. 71-0911 morbidity, 71-0263 mortality. 71-0064, 71-0085. 71-0229. 71-0263 EXERCISE occupation as a factor, 71-0299, 71-0772 carbon monoxide and. 71-0972

IL1-,P *. 316 CUMULATIVE SUBJECT INDEX

effect on cardiovascular system, 71-1042 71-0503,71-0505,71-0508,714674,71-0686, smoking and, 71-0609, 71-0637, 71-0874, 71-1042 71-0688,71-0696,71-0788,71-0792,71-0807, 71-0811,71-0830,71-0910,71-1217,71-1227, EX-SMOKERS 71-1228 antismoking campaigns and,11-0802 effect of nicotine, 71.0394, 71-0790, 71-1130 arteriosclerosisand,71-0886 bladder neoplasms and, 71-0992 FIBRINOLYSIS blood cholesterol, 71-1054 (See alsoBLOOD COAGULATION) body weight, 71-0912, 71-1229 effect of exercise, 71-0292 bronchial epithelium, 71-1155 smoking and, 71-0292 bronchial neoplasms and, 71-0750 bronchitis and, 71-0451 FIBROSARCOMAS coronary disease and, 71-0886 experimentally induced in hamsters, 71-0241 knowledge of health facts and, 71-0934 lung function, 71-0866 FILTERS lung neoplasms and, 71-0245, 71-0849 aldehyde retention, 71-1128 mortality, 71-0245, 71-0423 carcinogenicity reduction and, 71-0971 myocardial infarct and, 71-0884 evaluation, 71-0181 neoplasms and, 71-0854 in lung neoplasm induction, 71-0428 obesity and, 71-0912 nicotine retention, 71-0559, 71-0560 pernicious anemia and, 71-1215 tar retention, 71-0559, 71-0560 respiratory function tests, 71-0608 respiratory tract diseases and, 71-0613 Flicker fusionSeeVISION sugar intake, 71-0914 Forced expiratory volume testsSeeRESPIRATORY EYEDISEASES FUNCTION TESTS (See alsoAMBLYOPIA, TOBACCO) maternal smoking and, 71-0792 Forced vital capacity testsSeeRESPIRATORY FUNC- metabolic disorders and, 71-0795 TION TESTS smokers vs. nonsmokers, 71-0318, 71-0795 smoking and, 71-0677 Free fatty acids, in bloodSeeBLOOD LIPIDS therapy, 71-0677 vitamin deficiency and, 71-0312, 71-0318 FUNGI in cigarettes, 71-0716 EYES smoking and, 71-1171 (See alsoVISION) in tobacco, 71-0716 effect of alcohol, 71-0501 effect of nicotine, 71-0397, 71-0695 effect of smoking, 71-0501, 71-0557 effect of vitamin B13 deficiency, 71-0312 GALL BLADDER effect of nicotine, 71-0841

GANGLIA FATTY ACIDS effect of nicotine, 71-0359 determination in blood, 71-0864 determination in lungs, 71-0864 determination in tobacco leaf, 71-0725 GAS PHASE, CIGARETTE SMOKE formation in tobacco pyrolysis, 71-0821 aldehydes in, 71-0012 alicyclic hydrocarbons in, 71-0187 FERTILITY aliphatic hydrocarbons in, 71-0187 effect of carbon monoxide, 71-0410, 71-0968 analysis, 71-0031, 71-0035, 71-0187, 71-1125 effect of smoking, 71-0154, 71-0717, 71.1064 carbohydrates in, 71-0814 effect of sulfur dioxide, 71-0968 constituents, 71-1125 effect of processing methods, 71-1116 FETAL DEATH effect of tobacco additives, 71-0837 (See alsoINFANT MORTALITY) effect on enzyme activity, 71-1023 effect of maternal smoking, 71-0743 effect on hemoglobin levels, 71-1114 predisposing factors, 71-0743 effect on leukocytes, 71-1195 effect on macrophages, 71-0825, 71-1018 FETUS effect on macrophages in rabbits, 71-1023 (See alsoNEONATE; INFANT MORTALITY; PRE- effect on mucociliary activity in cats, 71.1189 MATURITY) effect on nuclear protein synthesis, 71-0825 antigen-antibody reactions in, 71-0505 effect on pulmonary clearance in cats, 71-1189 effect of aromatic hydrocarbons, 71-0584 effect on respiration, 71-1114 effect of benz(a)anthracenes, 71-0239, 71-0678 evaluation, 71-0031 effect of benzo(a)pyrene, 71-0239 filtration, 71-0035 effect of carbon monoxide, 71-0399, 71-0807 in lung neoplasm induction, 71-0593 effectofmaternalsmoking,71-0155,71-0156, in lung neoplasm induction in mice, 71-0997, 71-1018

317 31.6 CUMULATIVE SUBJECT INDEX

GASTRIC SECRETION HEARING ($ee alsoGASTRITIS) ($ee alsoEAR) effect of nausea, 71-0309 age as a factor. 71-0317 effect ofnicotine,71-0203,71-0315,71-0511, effectofcarbonmonoxide,71-0358.71-0395, 71-0512. 714)916. 71-0918, 71-1221 71-0969 effectofsmoking,71-0309,71-0367.71 -0918, effect of smoking. 71-0317, 71-1072 71-1218, 71-1 225, 71-1226 occupation as a factor. 71-0317 inhibition, 71-0309 HEART Gastric ulcerSeeULCER, PEPTIC (See alsoCARDIOVASCULAR SYSTEM) effect of aging. 71-0106 GASTRITIS effect of carbon monoxide. 71-0826 (See also GASTRIC SECRETION; GASTROINTES- effect of cigarette smoke, 71-0129 TINAL DISEASES) effectofnicotine.71-0196,71-0214,71-0227, smoking in etiology of, 71-0514 71-0401. 71-0975. 71-1198 effectofsmoking,71-0091,71-0105,71-0106, GASTROINTESTINAL DISEASES 71-0111, 71-0497 (See also GASTRITIS; LIVER CIRRHOSES; MOUTH myxoedema and, 71-0111 DISEASES; ULCER, PEPTIC) oxygen consumption and, 71-0105 post-operative complications and, 71-1069 pulmonary heart disease and, 71-0901 HEARTBURN smoking and, 71-1069, 71-1257 smoking as cause, 71-0500 smoking in etiology of, 71.0506. 71-0514 HEART DEFECTS, CONGENITAL GASTROINTESTINAL NEOPLASMS effectofmaternalsmoking,71-0674,71-1207. (See alsoESOPHAGEAL NEOPLASMS; INTESTINAL 71-1217 NEOPLASMS; LIVER NEOPLASMS; MOUTH NEO- PLASMS; PANCREATIC NEOPLASMS; STOMACH HEART DISEASES NEOPLASMS) (See alsoCARDIOVASCULAR DISEASES; CORO- caeca chewing and, 71-0596 in India. 71-0596 NARY DISEASE; PULMONARY HEART DISEASE) chronic bronchopulmonary disease and, 71-0299 sex as a factor, 71-0860 morbidity, 71-0140, 71-0493 smoking and, 71-0596, 71-0860 mortality,71-0140,71-0234,71-0301,71-0493, smoking in etiology of, 71-0514 71-0904 in Norway. 71-0140, 71-0493 GASTROIN'TESTINAL SYSTEM occupation as a factor, 71-0091, 71-0299, 71-0760, (See alsoCOLON; INTESTINES) 71-0897 benzo(a)pyrene absorption. 71-0567 oxygen consumption and, 71-0132 effectofnicotine,71-0008,71-0025,71 -0512, physical activity and. 710897 71-0683.71 -0808 predisposingfactors.71.0672,71-0782.71-1035. effectof smoking,71-0506,71-0507,71-0913, 71-1200 71-1069 preventive medicine. 71-0672. 7 1-07 82 effect of tobacco smoke, 71-0808, 71-0817 race as a factor. 71-1035 sex as a factor. 71-1200 GLYCERIN smokers vs. nonsmokers, 71-0091. 71-0094 (See alsoHUMECTANTS; TOBACCO ADDITIVES) smoking and, 71-0140, 71-0234. 71-0290, 71-0413. effect on nicotine content, 71-0219 71-0493,71-0760,71-0782,71-0897,71-1035. as humectants, 71-0219 71-1200 smoking in etiology of, 71-0672 GLYCOLS therapy, 71-0904 (See alsoHUMECTANT'S; TOBACCO ADDITIVES) determination in tobacco, 71-0845 HEART FUNCTION effect on nicotine content, 71-0219 (Seealso BLOOD CIRCULATION) as humectants, 71-0219, 71-0845 effectofcarbonmonoxide,71-0288.71-0806, 71-0833, 71-1041 effect of cigarette smoke, 71-0306, 71-0609. 71.1061 effect of ganglionic blocking agents, 71-0294 HAITOGLOBIN effect of hypoxia, 71-0773 effect of carbon monoxide. 71-0542 effect of nicotine. 71-0287, 71-0294, 71-0730 effect of smoking. 71-0287, 71-0288, 71-0773 Health education (smoking)SeeANTISMOKING CAM- PAIGNS HEART RATE bronchitis and, 71-0872 HEALTH PRACTICES in coronary disease etiology, 71-0290 alcohol consumption and, 71-0703 effect of cannabis, 71-0549 effect of socioeconomic status, 71.0703 effect of carbon monoxide, 71-0410, 71-0972 smoking and, 71-0703 effect of cigarette smoke, 71-1061

3 318 CUMULATIVE SUBJECT INDEX

effect of nicotine, 71-0206, 71-0401 HYPERTENSION effect of nontobacco cigarettes, 71-0467 (See also BLOOD PRESSURE) effectofsmoking,71-0467,71-0475,71-0637, cardiovascular diseases and, 71-0661 71-0891, 71-0918, 71-1239 cerebrovascular disorders and, 71-1209 cessation of smoking and, 71-0953 HEMATOCRIT coronary disease and, 71-0471, 71.0650 effect of carbon monoxide, 71-0654, 71-0843 incoronarydiseaseetiology,71-0119,71-0137, effect of smoking, 71-0891, 71-0894 71-0661 experimentally induced in rats, 71-0141 HEMOGLOBIN LEVELS myocardial infarct and, 71-0123, 71-1039 angina pectoris and, 71-0783 nicotine and, 71-0141 effect of air pollution, 71-0641 personality as a factor, 71-0338 effectofcarbonmonoxide,71-0386,71-0542, predisposing factors, 71-07E12 71-0570, 71-0573, 71-0641, 71-0832, 71-0843 preventive medicine, 71-0782 effect of smoking, 71-0891 smokers vs. nonsmokers, 71-0338 effect on erythrocytes, 71-0639 smoking and, 71-0141, 71-0661, 71-0782, 71-0908, smokers vs. nonsmokers, 71-0662 71-1039 smoking characteristics and, 71-0894, 71-1047 HYPNOSIS HEREDITY in cessation of smoking, 71-0531 antitrypsin deficiency and, 71-0685, 71-0761, 71-0762, effect of nicotine, 71-0957 71-0771,71-1073,71-1164,71-1168,71-1170, effect on cardiovascular system, 71-0800 71-1179, 71-1222 effect on respiration, 71-0800 chronic bronchopulmonary disease and, 71-0440 effect on smoking habit, 71-0532 effect on taste, 71-0793 emphysema and, 71-0761, 71-0762, 71-0771, 71-1073 HYFOXEMJA smoking as cause, 71-0470

HETEROCYCLIC NITROGEN COMPOUNDS HYPDXIA (See alsoAROMATIC AMINES;DIBENZ(g,h)- in arteriosclerosis etiology, 71-0468 ACRIDINE; INDOLES; NICOTINE DERIVATIVES; effectofcarbonmonoxide,71-0366,71-0399, PYRIDINES) 71-0775 in cigarette smoke, 71-1115 effect of cigarette smoke, 71-0185 in tobacco smoke, 71-0030 effect of smoking, 71-0775 effect on blood phosphates, 71-0356 HORMONES effect on carbohydrate metabolism, 71-0194 aromatic hydrocarbons and, 71-0989 effect on erythrocytes, 71-0356 effect of cannabis, 71-0576 effect on fetus, 71-0687 effect of nicotine, 71-1067 effect on neonate, 71-0687 mammary neoplasms and, 71-0989 effects during pregnancy in rats, 71-0543 metabolism in placenta, 71-0503 electrocardiographic effects, 71-0773 nontobacco cigarettes and, 71-0185 HUMECTANTS smokers vs. nonsmokers, 71-0647 (See also GLYCERIN; GLYCOLS; TOBACCO ADDI- smoking as cause, 71-0609 TIVES) determination in tobacco, 71-0845 -glycerin, 71-0219 glycols, 71-0219, 71-0845 IMMUNITY lipids, 71-1172 effect of carbon monoxide, 71.0410 effect of smoking, 71-0888 Hydrogen cyanide See CYANIDES effect of tobacco smoke, 71-0370

HYDROXYLASES INDOLES effect of benzo(a)pyrene, 71-0226 (SeealsoHETEROCYCLIC NITROGEN COM- effect of cigarette smoke, 71-0226, 71-0812 POUNDS) effect of nicotine, 71-0956 in cigarette smoke, 71-0837 Inhibition, 71-0226 effect of tobacco nitrate content, 71-0402

HYPERCHOLESTEREMIA INFANT MORTALITY (See also BLOOD CHOLESTEROL) (See also FETAL DEATH; FETUS; MORTALITY; age as a factor, 71-0907 NEONATE) coronary disease and, 71-0645, 71-0778 effect of hypoxia, 71-0543 in coronary disease etiology, 71-0119 effectofmaternalsmoking,71-0674,71-0686, smoking and, 71-0908 71-0696, 71-0811, 71-1068, 71-1217, 71-1227 effect of nicotine, 71-0543 HYPEROXIA effect of socioeconomic status, 71.0811 arteriosclerosis and, 71-0468, 71-1201 massive pulmonary hemorrhage and, 71-1068

319 3"1-.. CUMULATIVE SUBJECT INDEX

Infant, newborn (0-1 month) See NEONATE tar and nicotine content, 71-0529 in tobacco, 71-0515 Influenza See RESPIRATORY TRACT INFECTIONS LARYNGEAL NEOPLASMS Inspiratory reserve volume measurements See RESPIRA- (See also RESPIRATORY TRACT NEOPLASMS) TORY FUNCTION TESTS areca chewing and, 71-0994 cigarsmoking and, 71-0998 INTERMITTENT CLAUDICATION diagnosis, 71-0594 body weight and, 71-1037 epidemiology, 71-0058, 71-0073, 71-0752 diagnosis, 71-1037 in Germany, 71-0073 Framingham study, 71-1043 in Japan, 71-0858 predisposing factors, 71-1043 in La Plata, Argentina, 71-1138 smoking in etiology of, 71-1037, 71-1043 occupation as a factor, 71-0073 pathogenesis, 71-0058 INTESTINAL NEOPLASMS predisposing factors in India, 71-0994 (See also GASTROINTESTINAL NEOPLASMS; REC- sex as a factor, 71.0058, 71-0998 TAL NEOPLASMS) smokers vs.nonsmokers, 71-0058, 71-0858 areca chewing and, 714)596 smoking and, 71-0070, 71-0246, 71-0588, 71-0594, smoking and, 714)596 -71-0994, 71-1138 smoking as cause, 71-0752 INTESTINES smoking in etiology of, 71-0073, 714)854,714/858 (See also GASTROINTESTINAL SYSTEM) in Thailand, 71-0998 effect of nicotine, 714)196, 714)225, 11-0963 therapy, 71-0058, 71-0752 tobacco and, 71-0590 IRRADIATION in Ukraine, Russia, 71-0246 as cause of bronchial neoplasms. 71-0750 urban-rural influences, 71-1138 in lung neoplasm induction, 71-0853 LARYNX ISCHEMIA (See also RESPIRATORY SYSTEM) (See also CARDIOVASCULAR DISEASES) effect of smoking, 71-0069 age as a factor, 714)774 diet and, 71-0304 LEAD epidemiology, 71-0289, 71-1050 (See also METALS) in India, 71-0289 in air pollution, 71-0577 nicotine and, 71-0287, 71-1049 pharmacology, 71-0577 physical activity and, 714)897 predisposingfactors,71-0638,71-0672,71-0774, LEARNING 71-0780, 71-0782, 71-1190 (See also COGNITION) preventivemedicine,71-0638,71-0672,71-0780, effect of carbon monoxide, 71-0321 71-0782 effect of lobeline, 71-0927 smoking and, 71-0287, 71-0774, 71-0780, 71-0782, effect of nicotine, 71-0212, 71-0927, 71-0942 71-0897, 71-0905, 71-1050, 71-1061, 71-1190 smokers vs. nonsmokers, 71-0321 sugar intake and, 71-0914 LEGISLATION Lee also BILLS) advertising,71-0528,71-0529,71-0530,71-0581, Keratoacanthoma See SKIN NEOPLASMS 71-0707, 714)804, 71-0937, 71-0952, 71-1271 in antismoking campaigns, 71-0182, 71-0343, 71-0739, KETONES 714)804, 71-0985, 71-1093, 71-1271 as cocarcinogens, 71-1127 cigarette samples, 71-0530 KIDNEY NEOPLASMS M Germany, 71-1093 labeling, 71-0528, 71-0529, 71-0707, 71-0952 alcohol consumption and, 71-1154 in United. Kingdom, 714)528 epidemiology, 71-1154 in United States, 71-0707 smoking and, 71-0430 smoking in etiology of, 71-1154 LEUKOCYTES (SeealsoCELLS) KIDNEYS bronchitis and, 71-0887 (See also UROGENITAL SYSTEM) effect of cessation of smoking, 71-1191 effect of cigarette smoke, 71-0842 effect of cigarette smoke, 71-1195 effect of nicotine, 71-0196 effect of smoking, 71-0513, 71-0673, 71-0887 smoking and, 71-0128, 71-0891 effect of tobacco smoke, 71-0360

LEUKOPLAKIA (See also MOUTH NEOPLASMS) LABELING areca and, 71-0435 health warnings, 71-0529, 71-1271 areca chewing and, 71-0143, 714)149 legislation, 71-0529, 71-0707, 71-1271 bidi smoking in etiology of, 71-0856

320 CUMULATIVE SUBJECT INDEX

cigar smoking in etiology of, 71-0856 LUNG FUNCTION experimentally induced in hamsters. 71-0435 (See also PULMONARY CLEARANCE; RESPIRA- in India, 71-0060 TORY FUNCTION TESTS) menthol in etiology of, 71-1223 adolescents, 71-0074 reverse smoking in etiology of, 71-0690 age as a factor. 71-0080, 71-0101,71-0277, 71-0459, smoking and, 71-0060, 71.1074 71-0634, 71-0636.71 -0765, 71-1163, 71-1165 smoking in etiology of, 71 -1223 ail pollution as a factor, 71 -0100, 71-0270, 71-0555, snuff-dipping in etiology of, 71-0856 71-0618, 71-1020, 71-1161, 71.1178 tobacco chewing and, 71-0143, 71-0149 asbestos and, 71-1016 tobacco chewing in etiology of, 71-1074 body constitution and, 71-0080, 71-0448 bronchitis and, 71-0872, 71.1162, 71-1186 LIP NEOPLASMS chronic bronchopubnonary disease and, 71-0608 (See also MOUTH NEOPLASMS) college students, 71-1163 pipe smoking in etiology of, 71-0238 effect of acetaldehyde, 71-1013 preventive medicine, 71-0238 effectofcarbonmonoxide,71-0271,71-0546, race as a factor, 71-0238 71.1020 effect of cessation of smoking, 71.1025 LIVER effect of cigarette smoke, 71-0437, 71-0767, 71-1026 effect of carbon monoxide, 71-0406, 71-0419 effect of cigar smoking, 71-0630 effect of nicotine, 71-0196, 71-0407 effect of drug abuse, 71-1011 effect of nitrosamines, 71-0029, 71-0747 effect of enzymes, 71-0086, 71-0623 effect of smoking, 71-0812 effectofsmoking,71-0100,71-0274,71.0445, 71-0459,71-0465,71-0618,71-0626,71-0634, LIVER CIRRHOSIS 71-0637,71-0765,71-0861,71-0866,71-0874, (See also GASTROINTESTINAL DISEASES) 71-0875,71-1020,71-1162,71-1178,71-1182, alcohol consumption and, 71-0982 71.1186 smoking and, 71-0982 effect of surfactants, 71-0545 eximokers, 71-0444, 71-0866 LIVER NEOPLASMS follow-up studies, 71-0274 (See also GASTROINTESTINAL NEOPLASMS) height as a factor, 71-1165 smoking and, 71-0982 neuromuscular diseases and, 71-0610 in nonsmokers, 71-0632, 71-1027, 71.1028, 71-1183 LOBELINE occupation as a factor, 71-0086, 71-0100, 71-0270, in cessation of smoking, 71.1265 71-0274,71-0279,71-0429,71-044471-0618, effect on learning in rats, 71-0927 71-0623,71-0772,71-1016,71-1028,71-1165, 71-1174, 71-1186 LONGEVITY opium smoking and, 71-1158 in Boston, 71-0230 pneumoconiosis and, 71-1028, 71-1174 effect of smoking, 71-0124, 71-0230, 71-0983 race as a factor, 71-0862 heredity as a factor, 71-0124 sex as a factor, 71-0080, 71-0101,71-0104, 71-0283, 71-0448, 71-0634, 71-0636 Lung abscess See LUNG DISEASES smokers vs. nonsmokers, 71-0074, 71-0090,71-0101, 71-0104,71-0270,71-0277,71-0283,71-0429, LUNG DISEASES 71-0437,71-0444,71-0446,71-0459,71-0608, (See also PNEUMOCONIOSIS; PULMONARY FIBRO- 71-0610,71-0620,71-0626,71-0628,71-0633, SIS; RESPIRATORY TRACT DISEASES; TUBER- 71-0636,71-0766,71-0867,71-0873,71-0899, CULOSIS) 71-1161,71-1163 antitrypsin deficiency and, 71-0443 smokers vs. nonsmokers in Belfast, Northern Ireland, bronchial secretion and, 71-1159 71-1016 cough and, 71-1159 smokers vs. nonsmokers in Brussels, Belgium, 71-0449 diagnosis, 71-0080, 71-0635 smokers vs. nonsmokers in India, 71-0445 effect on lung function, 71-0099 smokers vs. nonsmokers in Nigeria, 71-0862 effect on macrophages, 71-0612 smokers vs. nonsmokers in Sweden, 71-0448, 71-0636 epidemiology, 71-0080 smokingcharacterisitcsand,71-0086,71-0279, in France, 71-0424 71-0873, 71-0894, 71-1047 mortality, 71-0231 urban -rural influences, 71-1183 occupation as a factor, 71-0091 opium smoking in etiology of, 71-1158 LUNG NEOPLASMS pathogenesis, 71-0285, 71-0635 (See also BRONCHIAL NEOPLASMS; CARCINOMA, rheumatoid factor and, 71-0619 BRONCHOGENIC; RESPIRATORY TRACT NEO- smoking and, 71-0091, 71-0233, 71-0581, 71-0619, PLASMS) 71-0635, 71-1105, 71.1159 acrolein and, 71-0844 smoking characteristics and, 71-1030 air pollution u a factor, 71-0067, 71-0071, 71-0555 smoking in etiology of, 71-0441, 71-0625, 71.1014 aromatic hydrocarbons and, 71-0584 in United Kingdom, 71-0619 in Australia, 71.0052 urban-rural influences, 71-0424 benz(o)anthracenes and, 71.1151

321 31"%3 CUMULATIVE SUBJECT INDEX benzo(a)pyrene and, 71-0250, 71-1151 smokingcharacteristicsand,71-0052,71-0068, beazo(a)pyrene in etiology of, 71-1005 71-0246, 71-0251, 71-0254, 71-0257, 71-0260 biologic models, 71-0853 smoking in etiology of, 71-0063, 71-0248, 71-0256, bronchitis in etiology of, 71-0434 71-0420,71-0422,71-0434,71-0954.71.0987, cigarette tars and, 71-1146 71-0988, 71-0997, 71.0999, 71-1148, 71-1188 combustion temperature and, 71-0758 sputum analysis And, 71-0749 in Cuba. 71-0064 statistics, 71-0432 in Czechoslovakia, 71-0251 survival and, 71-0603, 71-1188 demographic effects, 71-0065 in Switzerland, 71 -1140 diagnosis,71-0251,71-0252,71-05n,71-0625, tobacco processing methods and, 71-0755 71-0749 tuberculosis and, 71-0052 emphysema and, 71 -0285 in Ukraine, Russia, 71-0246, 71-1147 endocrine environment and, 71-0248 in United Kingdom, 71-0062, 71-0063 epidemiology, 71-0055, 71-0063, 71-0591, 71-0852, in United States, 71-0063 71-0859, 71-0986, 71-0988, 71 -1148 urban-rural influences, 71-0071, 71-0424, 71 -1138 etiology, 71-0053 viral infection and, 71-1000 experimentally induced in dogs, 71-0428, 71-0433, in Wales, 71-0427 71-0585, 71-0599, 71-0746, 71-0751, 71-0971 experimentally induced in hamsters, 71-0973, 71-1005, 71.1146 LUNGS experimentally induced in laboratory animals, 71-0067, (See alsoRESPIRATORY SYSTEM) 71-0420, 71-0599, 71-0756, 71-0999, 71.1148 carbon monoxide in, 71-0721 experimentally induced in mice, 71-0239, 71-0584, effect of acrolein, 71-0034 71-0593,71-0753,71-0758,71-0997,71-1000, effect of air pollutants, 71-0363 71-1018, 71-1151 effect of cannabis, 71-1019 experimentally induced in rats, 71 -0853 effect of =bon monoxide, 71-0271 ex-smokers, 71-0849 effect of cigarette smoke, 71-0198, 71-0571, 71 -0768, filters and, 71-1268 71-1019 in France, 71-0424 effect of nicotine, 71-0196 giant cell tumors, 71-0587 effect of nitrogen dioxide, 71-0461, 71-0551, 71-0571, in Italy, 71-0071 71 -1160 in Jersey, Channel Islands, United Kingdom, 71-0851 effectofsmoking,71-0091,71 -0167,71-0428, in La Plata, Argentina, 71 -1138 71-0459, 71-0462, 71-0863 mine air contaminants and, 71-0599 emphysema and, 71-0463 morbidity, 71-0047, 71-0055, 71-0061 ferruginous bodies in, 71-0424 mortality,71-0045,71-0047,71 -0052,71-0055, 71-0059,71-0064,7143065,71-0245,71-0603, 71-0741, 71-1188 mycoplasma infection and, 71-1000 in Netherlands, 71-0260 MacrophagesSeePULMONARY ALVEOLAR MACRO- nicotine and, 71-1003 PHAGES nitrosamines and, 71-0564, 71-0747, 71-0753 occupation as a factor, 71-0061, 71-0062, 71-0259, MAMMARY NEOPLASMS 71-0427, 71-0851, 71-0852, 71-1135 aromatic hydrocarbons and, 71-0989 pathogenesis, 71-0254 benz(a)anthracenes as cause, 71-0243 personality as a factor, 71-1091 experimentally induced in rats, 71-0243, 71-0989 phenols and, 71-0240 hormones and, 71-0989 in Poland, 71-0059 polonium-210 and, 71-0565 MarihuanaSeeCANNABIS predisposing factors, 71-0598 race as a factor, 71-0257 MATERNAL-FETAL EXCHANGE radiation and, 71-1004 benz(a)anthracenes and, 71-0678 research programs, 71-0067, 71-0585, 71-0751 effect of benzo(a)pyrene, 71-0226 respiratory tract diseases in etiology of, 71-0061 effectofcarbonmonoxide,71-0366,71-0391, in Russia. 71-0067 71-0807 sex as a factor, 71-0047, 71-0059, 71-0248, 71-0252 of of cigarette smoke, 71-0226 smokers vs. nonsmokers, 71-0062, 71-0064, 71-0065, effect of maternal smoking, 71-0503, 71-0735 71-0245,71-0252,71-0432,71-0434,71-0745, effect of nicotine, 71-0735, 71-1130 71-0749, 71-0849, 71-1237 smoking and, 71-0047, 714048, 71-0053, 71-0055, Maximum mid-expiatory Bow ate measurementsSee 71-0059,71-0070,71-0244,71-0245,71-0250, RESPIRATORY FUNCTION TESTS 71-0259,71-0413,71-0427,71-0555,71-0586, 71-0587,71-0598,71-0603,71-0615,71-0717, MEMORY 71-0741,71-0755,71-0757,71-0851,71-0859, effect of carbon monoxide, 71-0395 71-0877,71-0982,71-0986,71-1004,71-1105, 71-1133,71-1135,71-1138,71-1140,71-1147, MENTHOL 71-1268 (See alsoTOBACCO ADDITIVES) smokingascause,71-0067,71-0231,71-0433, in cigarette smoke, 71-0388 71-0585, 71-0746, 71 -0758, 71-1003, 71-1018 as tobacco additives, 71-0388

322 CUMULATIVE SUBJECT INDEX

METABOLISM heart disease, 71-1200 effect of cannabis, 71-0576 heart rate and, 71 -0290 effect of cessation of smoking, 71-0381 laryngeal neoplasms, 71-0246 in London, United Kingdom, 71-1188 METALS lung neoplasms, 71-0045, 71-0047, 71-0052, 71-0055, 71-0600,71-0603, (See alsoCHROMIUM; LEAD; NICKEL; POLONIUM- 71-0059,71-0064,71-0246, 210; RADIUM-226) 71-1188 effect on tobacco tars, 71-0563 myocardial infarct, 71-0904, 71-1045, 71-1053 neoplasms, 71 -0055, 71-0237, 71-0985 MINE AIR CONTAMINANTS pancreatic neoplasms, 71-0249 effect on mortality, 71-0599 in Philadelphia, Pennsylvania, 71.1188 effect on respiratory tract, 71 -0599 respiratory tract diseases, 71-0266 in burg neoplasm etiology, 71-0599 smokers vs. nonsmokers, 71-0043, 71-0065, 71-0107, 71-0245, 71-0420, 71-0423 smoking and, 71.0044, 71-0051, 71 -0124,71-0229, MITOCHONDRIA 71-0651, effect of carbon monoxide, 71-0548 71-0230,71-0233,71-0245,71-0265, 71 -0848,71-0981,71-1059,71.1105,71-1133, 71-1134, 71-1200 MODELS, BIOLOGIC 71-0233, cascinogenesis, 71-0853 statistics, 71-0050, 71-0059,71-0064, lung neoplasms, 71-0853 71-0237, 71-0265 in United States, 71-0051 MODELS, MATHEMATICAL research programs, 71-0417, 71-0431 MOTIVATION (See alsoBEHAVIOR) MOISTURE CONTENT advertising and, 71-0529 effect on nicotine content, 71-0014, 71-0219 in cessation of smoking, 71-0534, 71-0709, 71-0949 effect on proteins, 71-0014 in reduction of smoking, 71 -0935

MORBIDITY MOUTH DISEASES GASTROINTESTINAL DISEASES; PERIOD- (,See alsoMORTALITY) (See also air pollution as a factor, 71-0555 ONTAL DISEASES; STOMATITIS; TONGUE IX- in Belfast, Northern Ireland, 71-1016 SEASES) in Connecticut, 71-0229 age as a factor, 71-0142 coronary disease, 71-0109, 71 -0131, 71-0658 epidemiology, 71-0915 effectof smoking,71.0048,71-0231,71-0232, epidemiology in India, 71-0681 71-0235,71-0263,71-0422,71-0541,71-0739, menthol in etiology of, 71-1223 71-1016 sex as a factor, 71-0142 ex-smokers, 71-0423, 71-0854 smoking and, 71-0142, 71-0311, 71-0681, 71-0691, laryngeal neoplasms, 71-0246 71-0737, 71 -0915, 71-1074 lung neoplasms, 71-0047, 71-0048, 71-0246 smoking in etiology of, 71-1223 lung neoplasms in India, 71-0432 tobacco chewing and, 71-1074 neoplasms, 71-0048, 71-0985 preventive medicine, 71-0049 MOUTH MUCOSA sex as a factor, 71-0229, 71-0742 effect of areca, 71-0435 smokers vs. nonsmoken, 71-0423, 71-0742 effect of areca chewing, 71-0143, 71 -0149, 71.0676 smoking and, 71-0049, 71-0229, 71-0582, 71-1105, effect of reverse smoking, 71-0690, 71 -0855. 71-0145, 71-1133, 71-1134 effectofsmoking,71-0060,71-0142, statistical analysis, 71-0582 71-0681 effect of tobacco, 71-0789, 71-0791 MORTALITY tobacco chewing and, 71 -0143, 71-0145, 71-0149, (See alsoINFANT MORTALITY; MORBIDITY) 71-0676 air pollution as a factor, 71-0265, 71-0555 arteriosclerosis, 71-1059 MOUTH NEOPLASMS NEOPLASMS; LEU- in Australia, 71-0265 (See alsoGASTROINTESTINAL in Belfast, Northern Ireland, 71-0848 KOPLARIA; LIPNEOPLASMS) in Berlin, New Hampshire, 71-0981 alcohol consumption and, 71-0255 bronchial neoplasms, 71-0741 areca and, 71-0435 in Connecticut, 71-0229 cigar smoking and, 71-1150 coronary disease, 71-0043, 71-0107, 71-0124, 71-0137, epidemiology, 71-0247, 71-0255, 71-0859, 71-0991, 71-0290,71-0301,71-0651,71-0658,71-0779, 71 -1152 71-1045, 71.1059 etiology, 71-0072, 71-1001, 71-1152 effect of carbon monoxide, 71 -0384, 71-0410 experimentally induced in hamsters, 71-0435, 71-1142 effectofsmoking,71-0085,71-0231,71-0232, in India, 71.0060, 71-0247 71-0234,71-0235,71-0249,71-0263,71-0421, predisposing factors, 71-0692, 71-1152 71-0422,71-0541,71-0648,71-0739,71-0741, reverse smoking and, 71-0855, 71.1150 71-0954,71-0982, 71-0983, 71-1093 reverse smoking in etiology of, 71-0690,71-0857 ex-smokers, 71-0423 sex as a factor, 71-0748 Framingham study, 71-0420 smoking and, 71-0060, 71-0748

323 3 7.--!5 CUMULATIVE SUBJECT INDEX

smoking characteristics and, 71-0068 NaphthylaminesSeeAROMATIC AMINES smoking in etiology of, 71-0072, 71-0247, 71-0255, 71-0422, 71-0854, 71-0991 NASAL MUCOSA snuff -dipping in etiology of, 71-0991 effect of cigarette smoke, 71 -0268 tobacco and, 71-0590, 71-0692 effect of nickel, 71.0427 tobacco chewing and, 71 -0859 tobacco chewing in etiology of, 71-0247,71-09 87 NASOPHARYNGEAL NEOPLASMS MUSCLES (See alsoRESPIRATORY TRACT NEOPLASMS) effect of nicotine, 71 -0382, 71-0977 nickel refining and, 11-0427 smoking and, 71-0427 MYOCARDIAL INFARCT snuff -dipping and, 71-0583 (See alsoCORONARY DISEASE) in South Africa, 71-0583 age as. a factor, 71-0114, 71-0125, 71-0483, 71-0669, tobacco and, 71-0590 71-0670, 71-0777 in Wales, 71-0427 alcohol consumption and, 71-0114 in Australia, 71 -0138 Naas chewingSeeTOBACCO CHEWING behavior and, 71-1056 carbon monoxide and, 71-0492 diet and, 71-0110, 71-0118, 71-0133 NEONATE effect on cessation of smoking, 71-0466 (See alsoBIRTH WEIGHT; FETUS; INFANT MOR- electrocardiographic effects, 71.1205 TALITY; PREMATURITY) epidemiology, 71-01 23, 71-0670 carbon monoxide tolerance, 71 -0396 etiology, 71-0480 effect of air pollution, 71.06 4 1 exercise and, 71 -0138 effect of carbon monoxide, 7 1-064 1, 71-0807 ex-smokers, 71-0884, 71-1 199 effect of hypoxia, 71-0543 in France, 71-0665 effectofmaternalsmoking,71-0155,71-0156, hypertension and, 71-0123 71-0313,71-0509,71 -0595,71-0674,71-0686, in Kathmandu, Nepal, 71-1210 71-0696,71-0735,71 -0788,71-0807,71-0811, in Mexico, 71-0660 71-0830,71-1068, 71-1217 effect morbidity, 71-0119 ofnicotine,71-0543,71-0687,71-0735, 71-0790 mortality,71-0044, 71-0135,71-0301,71-0483, oxygen consumption and, 71-0132 71-0660, 71-0669, 71-0902, 71-1053 mortality in Netherlands, 71-0658 peptic ulcer and, 71-0114 NEOPLASMS personality as a factor, 71-1056 (See alsoCARCINOGENESIS; SARCOMA) in Philippines, 71-0123 age as a factor, 71-0048, 71-1137 predisposingfactors,71-0114,71-0135,71-0293, air pollution as a factor, 71-0555 71-0303,71-0480,71-0638,71-0656,71-0665, in Arkansas, 71-0050 71-0667,71.0672,71-0777,71-0893,71-0904, aromatic hydrocarbons and, 71 -0980 71-1039,71-1045,71-1053,71-1056,71-1060, blood cholesterol and, 71 -1137 71-1190, 71-1205, 71-1210, 71-1212 in Bombay, India, 71-0590 predisposing factors in Leningrad, Russia, 71-1199 diagnosis, 71-0987 predisposing factors in Poland, 71-0885 diet and, 71-0597 preventivemedicine,71-0293, 71-0297, 71-0480, epidemiology, 71-0048, 71 -0582, 71-0859, 71-1139 71-0638, 71-0656, 71-0667 etiology, 71-0050 prognosis, 71-0120, 71-0135, 71-0473,71-0902 experimentally induced in hamsters, 71-0241 psychosocial aspects, 71-0044 experimentally induced in laboratory animals, 71-0070, sex as a factor, 71-0044, 71-0125, 71-0138 71-0404, 71-1001 smokers vs. nonsmokers, 71-0110, 71-0133, 71 -0138, experimentally induced in mice, 71-1145 71-0483, 71-0884, 71-1199 ex-smokers, 71-0423 smoking and, 71 -0118, 71-0120, 71-0122, 71 -0125, localization, 71-0985 71-0135,71-0140,71-0473,71-0476,71-0493, maternal smoking and, 71 -0595 71-0497,71-0648,71-0656,71-0658,71-0661, morbidity, 71-0048 71.0665,71-0667,71-0673,71-0777,71 -0885, mortality, 71-0050, 71-0055 71-0893,71-0904,71-0905,71.1032,71-1039, mortality in United States, 71 -0985 71-1045,71-1053,71-1060,71.1133,71-1199, preventive medicine, 71-0237, 71 -0985 71-1196, 71-1205, 71-1210 sex as a factor, 71-0237, 71-0985 smoking as cause, 71 -0669 smoking and, 71-0423, 71-05 8 2, 71-0597, 71-0737, smokingcharacteristicsand,71-0044,71 -0114, 71-0739, 71-0984, 71-1134, 71-1137 71-0123, 71-0302, 71-0660 smoking in etiology of, 71-1139 smoking in etiology of, 71-0293, 71-0492, 71.-0670, statistical analysis, 71-0582 71-0672, 71-0902, 71 -1212 statistics, 71-0237, 71-0985 sudden death and, 7 1-1196 in Taiwan, 71-0050 sugar intake and, 71-1032 therapy, 71-0987 in Sweden, 71-0120, 71 -0473, 71-0669 in United States, 71-0237 therapy, 71-0904 viral infections and, 71-0987

3?-6 324 CUMULATIVE SUBJECT INDEX

NEOPLASMS, MULTIPLE PRIMARY effect on brain in rats, 71-0189, 71-0215, 71-0216, (See alsoNEOPLASMS) 71-0927, 71-1124 alcohol consumption and, 71-0072 effect on cardiovascular system, 71-0652, 71-0727, body constitution and, 71-0072 71-0730, 71-0896 smoking and, 71 -0072 effect on cardiovascular system in monkeys, 71.1130 effect on carotenoids, 71-0820 NEURONS effect on catalepsy, 71-0579 (See alsoCELLS) effectoncatecholaminelevels,71-0189, 71-0214, effectofnicotine,71-0222,71-0359,71-0977, 71-0554,71-0724,71-0740,71-0883,71-1078, 71.1113 71-1131, 71-1239 effect on cells, 71-0033, 71-0227 NEUROSES effect on central nervous system, 71-0397, 71-0575, coronary disease and, 71-1202 71-0579, 71-0695, 71-0942, 71-1113 occupation as a factor, 71-0331 effect on central nervous system in cats, 71-0816 sex as a factor, 71-0917 effect on cerebrovascular circulation, 71-0204 smoking and, 71 -1248, 71-1252 effect on embryo, 71-0221 smoking characteristics and, 71-0917 effect on enzyme activity, 71-0039, 71-0205, 71-0211, smoking habit and, 71-0917 71-0956, 71-1131 tobacco factory workers and, 71-0331 effect on equilibrium, 71 -0801 effect on eyes. 71-0397, 71-0695 NICKEL effect on fertility, 71.1064 (See alsoMETALS) effect on fetus, 71-0790, 7 1-0910 as cause of bronchial neoplasms, 71-0750 effecton fetus in monkeys, 71-1130 as cause of lung neoplasms, 71-0427 effect on fetus in rats, 71-0394 as cause of nasal neoplasms, 71-0427 effect on gall bladder in dogs, 71 -0841 distribution in lungs, 71-0458 effect on ganglia, 71-0359 in snuff, 71-0583 effecton ganglionic receptors, 71-0979 effect on gastric secretion, 71 -0367 NICOTINE effect on gastric secretion in cats, 71-1221 (See alsoALKALOIDS, TOBACCO) effect on gastric secretion in rats, 71-0315, 71-0511, acromegaly and, 71-1067 71-0512, 71-0916, 71-0918 analysis, 71-0362 effect on gastrointestinal system, 71-0808 biosynthesis in tobacco, 71-0561 effect on gastrointestinal tract in dogs, 71-0683 consumption in Germany, 71-1249 effectongastrointestinaltractinrats,71-0511, determination in air, 71-0961 71-0512 determination inurine, 71-0220, 71-0362, 71 -0733, effect on heart, 71-0214, 71-0227, 71-0730 71-1107, 71-1 108 effect on heart in chick embryos, 71 -1198 &toxicants, 71-0411 effect on heart in rabbits, 71-0975 di:ittibution in tissues, 71-0220, 71-0223, 71-0359 effect on heartrate,71-0206, 71-0294, 71-0401, effect on adrenal glands, 71-0724 71-0467, 71-1239 effect on adrenal glands in rats, 71-0956 effect on hormones, 71-1067 effect on appetite in rats, 71-0687 effect on hydroxytryptamine function, 71.1124 effect on ascorbic acid deficiency, 71-0794 effect on intestines, 71-0008, 71-0025, 71-0225 effect on autonomic nervous system, 71-0007, 71-0008 effect on intestines in rats, 71 -0963 effect on autonomic nervous system in cats, 71 -0572, effect on learning in rats, 71 -0212, 71-0927, 71-0942 71-0964 effect on liver in rats, 71-0407 effect on autonomic nervous system in rats, 71-0979 effect on macrophages, 71 -0211 effect on avoidance learning, 71-0212, 71-0324 effect on maternal-fetal exchange in monkeys, 71-1130 effect on avoidance learning in rats, 71-0700 effect on mucociliary activity, 71-0720 effect on barbiturate metabolism in mice, 71-0957 effect on muscles, 71-0225, 71-0382 effectonbehavior,71-0327,71-0328,71-0525, effect on muscles in frogs, 71-0977 71-0572 effect on myocardium, 71 -1049 effect on behavior in rats, 71-0215, 71-0216, 71-0687, effect on neonate, 71.0687, 71-0735 71-0840, 71-0943 effect on nervous system, 71-0156 effect on birth weight, 71-0910 affect on neuromuscular junction, 71-0977, 71-1113 effect on blood circulation, 71-0115 effect on neurons, 71-0214, 71-0359, 71-0378 effect on blood circulation in chick embryos, 71-1198 effect on neuroreceptors, 71-0222 effect on blood circulation in dogs, 71-1049 effect on nuclear protein synthesis, 71-0407 effect on blood coagulation, 71-0488 effect on organs, 71-0196 effect on blood pressure, 71-0141, 71-0213, 71 -0378, effect on parotid glands, 71 -0039, 71-0205 71-0467, 71-0883 effect on parotid glands in rabbits, 71.0740 effect on blood vessels, 71-0016, 71-0199,71-1119 effect on pepsin levels, 71 -0315, 71-0367 effect on blood vessels in dogs, 71-0841 effect on physical activity in rats, 71-1124 effect on body temperature, 71-0190 effect on physical fitness, 71 -0188 effect on body temperature in monkeys, 71-0818 effect ors protein metabolism, 71-0211 effect on brain in cats, 71-0204, 71-0378 effect on proteins, 71.0039 effect on brain in mice, 71-0353 effect on psychomotor performance, 71-1239 effect on brain in monkeys, 71-0818 effect on respiration, 71-0211

325 327 CUMULATIVE SUBJECT INDEX

effect on respiratory tract, 71.1003 fate in body, 71-0734 effect on salivation, 71-0205 smokers vs. nonsmokers, 71-0362, 71 -1108 effect on serotonin levels, 71-0216, 71-0225, 71-0315 effect on smoking characteristics in monkeys, 71-0815 NICOTINE METABOLITES effect on spermatozoa, 71-0835 (See alsoCOTININE) effect on spinal cord, 71-0221 cotinine, 71-0220, 71-0223, 71-0544 effect on spinal 4ord in cats, 71-0964 determination in air, 71-0961 effect on tissues, 71-0196 fate in body, 71-0544 effect on tranferases, 71-0956 effect on urine, 71 -0148 NICOTINE PHARMACOLOGY, 71-0336, 71-0740 effect on vision, 71-0679 in brain in rats, 71-1124 effects during pregnancy, 71-0735, 71-0790 effect of acetylcholine, 71-0189 effects during pregnancy in rats, 71-0394, 71-0543 effect of adrenalectomy, 71-0039, 7 1-0205 electrocardiographic effects, 71-0287 effect of antagonists, 71-0579 electroencephalographic effects, 71-0502 effect of anticonvulsants, 71-0727 electronystagmographic effects, 71-0695 effect of ascorbic acid, 71-0411 habituation, 71-1270 effect of aspartic acid, 71.0561 in lung neoplasm etiology, 71-1003 effect of atropine, 71-0199, 71-0315 metabolism, 71-1107 effect of barbiturates, 71-0959 metabolism in guinea-pigs, 71-0544 effect of botulinum toxin, 71.0199 metabolism in liver, 71-0220 effect of bretylium compounds, 71-0039, 71-0205 pancreatic juice inhibition and, 71-0974 effect of calcium, 71-0975 parasympathomimetic effects in mice,.71-0353 effect of carbon monoxide, 71-0816 parkinsonism and, 71-0682 effect of chlorisondamine, 71-0883 passivesmoking and,71-0023, 71-0024, 71-0393, effect of epinephrine, 71-0294 71-0723, 71-0733, 71-0819, 71-0838 effect of ganglionic-blocking agents, 71-0007, 71-0025, peptic ulcer and, 71 -0683, 71-0974, 71-1221 71-0294, 71-0401 poisoning, 71-0196, 71 -0411 effect of ganglionic-stimulatingagents,.71-0401 pyrolysis products, 71-0823 effect of guanethidine, 71-0213, 71-0979 in reduction of smoking, 71-0815 effect of hexamethonium, 71-0039, 71 -0205, 71-0294, sympathomimetic effects, 71-0214, 71.0401 71-0942 tachyphylaxis and, 71-0975 effect of histamine, 71-0189 teratogenetic effects, 71-0221 effect of hydrogen ion concentration, 71-0816 toxicity, 71-0220, 71-0382, 71-0562 effect of hypothalamic lesions, 7 1-05 12 effect of mecamylamine, 71-0215, 71-0579, 71-0815, NICOTINE CONTENT 71-0840, 71-0942 (SeealsoALKALOID CONTENT; NORNICOTINE effect of alpha-methyl tyrosine, 71 -0212 CONTENT) effect of metoclopramide, 71-0008 brand differences, 71-0529 effect of monoamine oxidase inhibitors, 71-0189 determination in blood, 71-0644 effect of N-acetyl-hydroxyproline, 71-0727 determination in cigarette smoke, 71-0001, 71-0032, effect of norepinephrine, 71-0199, 71-0975 71-0042,71-0202,71 -0529,71-0559,71-0560, effect of oxotremorine, 71-0190 71-1126 effect of pempidine, 71-0579 determination in tobacco leaf, 71-0414 effect of phenobarbital, 71-0220 effect of cigarette paper, 71-1118 effectofphenoxybenzamine,71 -0039,71-0205, effect of filling density, 71-0018 71-0213 effect of humectants, 71-0219 effect of phentolamine, 71-0199 effect of moisture, 71-0014 effect of pressor agents, 71-0979 effect of ozone, 71-0836 effectof propranolol, 71-0039, 71-0205, 71-0730, effectofprocessingmethods, 71-0003,71-0014, 71-0883 71-0408, 71 -1116 effect of quaternary ammonium compounds, 71-0294 effect on carbon monoxide expiration, 71.0467 effect of sodium nitroprusside, 7 1-0 190 effect on smoking habit, 71-1077 effect of sympatholytics, 71-0212 labeling, 71-0529 effect of tetradotoxin, 71-0401 in salivary glands, 71-0734 effect of tyramine, 71-0883 tobacco variety and, 71-0408, 71-0414 effect of vagotomy, 71-0511, 71 -0512, 71-0963 effect of vasodilator agents. 71-0013 NICOTINE DERIVATIVES oxygen consumption and, 71-0211 (See also HETEROCYCLIC NITROGEN COM- research programs, 71-0413 POUNDS) determination in urine, 71-1107 Nicotine withdrawalSeeWITHDRAWAL CLINICS metabolism, 71-1107 metabolism in laboratory animals, 71-0544 NICOTINISM behavior therapy, 71.0533, 71-0947 NICOTINE METABOLISM drug therapy, 71-0947 degradation in laboratory animals, 71-0223 preventive medicine, 71-0322 distribution in brain, 71-0223 preventive medicine in Poland, 71-0947

IR :- 326 CUMULATIVE SUBJECT INDEX

NITRATES determination in tobacco leaf, 71-0010, 71-0414 (See alsoNITROSAMINES) tobacco variety and, 71-0414 effect on tobacco smoke, 71-0402 NUCLEIC ACIDS Nitric oxideSeeNITROGEN OXIDES (See alsoDNA) benz(a)anthracenes and, 71-0958 NITROBENZENES benzo(a)pyrene and, 71-0958 effect of tobacco nitrate content, 71-0402 in bronchial epithelium, 71-0754

NITROGEN CONTENT determination in tobacco leaf, 71-0010 tobacco variety and, 71-0010 OatcellcarcinomaSeeCARCINOMA, BRONCHO- GENIC NITROGEN DIOXIDE determination in cigarette smoke, 71-0035 OBESITY effect on blood, 71-0571 cerebrovascular disorders and, 71-1209 effect on bronchial epithelium, 71-0461 smoking habit and, 71-0912, 71-1229 effecton lungs, 71-0461, 71-0551, 71-0571 socioeconomic effects, 71-1229 effect on lungs in dogs, 71-1160 effect on pulmonary alveoli, 71-1160 OBSTRUCTIVE AIRWAY DISEASE effect on pulmonary surfactant, 71 -1160 occupation as a factor, 71-0760, 71.0764 tobacco smoke and, 71-0551 smoking and, 71-0760, 71-0764

NITROGEN OXIDES OCCUPATIONAL DISEASF.3 determination in cigarette smoke, 71-0035, 71-0574 (See alsoPNEUMOCONIOSIS) effect of tobacco nitrate content, 71-0402 allergy, 71-0236 toxicity, 71-0551 antitrypsin deficiency and, 71-1179 asbestos and, 71-0421, 71.1016, 71-1187 NITROPARAFFINS bronchitis, 71-0770, 71-1028, 71-1165 effect of tobacco nitrate content, 71-0402 carbon monoxide and, 71-0903, 71-0969, 71-1120 coronary disease, 71-1034 NITROSAMINES plaster dust and, 71-1176 (See alsoNITRATES) pneumoconiosis and, 71-1028 biosynthesis in laboratory animals, 71 -0729 radiation and, 71-1004 biosynthesis in mice, 71-0753 smokers vs. nonsmokers, 71-0062, 71-0078, 71-0079, carcinogenicity, 71-0564 71-0081,71-0082,71-0086,71-0088,71-0116, determination in cigarette smoke, 71-0202 71-0210, 71-0282, 71-0284, 71-1187 effect on bronchial epithelium in hamsters, 71-0744 smoking and, 71-0073, 71-0083, 71-0093, 71-0100, effect on liver cells in mice, 71-0747 71-0208,71-0259,71-0270,71-0291,71 -0421, 71 -0628, effecton lungs inmice,71-0747 71-0427,71-0429,71-0601,71-0623, effect on respiratory tract, 71-0564 71-0659,71-0668,71-0694,71-0760,71-0764, effect on trachea in hamsters, 71-0744 71-0766,71-0770,71-0772,71-0794,71-0848, in lung neoplasm induction in mice, 71-0753 71-0852,71-0868,71-0871,71-0988,71-1004, metabolism, 71-0564 71-1009,71-1015,71-1016,71.1029,71-1119, metabolism in liver, 71-0029 71-1135,71-1141,71-1148,71.1165,71 -1173, in tobacco smoke, 71-0010, 71 -0030, 71-0729 71-1175, 71-1176, 71-1179, 71-1186, 71-1204 71-0 26 1, toxicity, 71-0729 smokingcharacteristicsand,71-0084, 71-0273, 71 -0279 NONSMOKERS tobacco and, 71-0331, 71-0498 antismoking campaigns and, 71 -0802 vibration syndrome, 71-0694 chronicbronchopuhnonarydiseaseand,71.0631, 71-0632, 71-1027, 71 -1183 OCCUPATIONS effect of carbon monoxide, 71-0733, 71-0970 agricultural workers, 71-0284 effect of tobacco smoke, 71 -0737 airline .pilots, 71-0208 lung function, 71-0628, 71 -1027, 71-1183 asbestos workers, 71-0062, 71-0084,71-0848, passive smoking and, 71-0562, 71-0723, 71-0819, 71 -0988,71-1016,71-1029,71-1135,7 1-114 8, 71-0824, 71-0838, 71-0973 71-1187 rights of, 71-0540, 71-0824 asbestos workers in British Columbia, Canada, 71-0429 asbestos workers in Quebec, Canada, 71-0421 NoradrenalineSeeCATECHOLAMINES bakers, 71-0772 bank clerks in Brussels, Belgium, 71-0449, 71-1204 NotepinepluineSeeCATECHOLAMINES beryllium workers, 71-0061 border inspectors, 71-0116 NORNICOTINE CONTENT bus drivers, 71-0314 (See alsoALKALOID CONTENT; NICOTINE CON - business executives, 71-0317, 71-0914 business managers, 71-0900 determination in cigarette smoke, 71-0202 cement workers, 71-0084, 71-0270

327 329 CUMULATIVE SUBJECT INDEX

chain saw operators, 71-0694 OZONE chemical factory workers, 71-0284, 71-0766, 71-0772, effect on air pollution, 71-0836 71-1041 effect on carbon monoxide, 71-0836 chemical workers, 71-0903 effect on cigarette smoke, 71 -0836 clay pipe workers, 71-0084 coal miners, 71-0091, 71-0093,71-0279,71-0299, 71-0446,71.0614,71-0760,71-0764,71-0772, 71-0868,71-0871,71-1015,71-1073,71-1174, 71-1175, 71 -1179 PANCREATIC NEOPLASMS coal miners in Appalachia, 71-0628 (See alsoGASTROINTESTINAL NEOPLASMS) coal miners in Pennsylvania, 71.1174 mortality, 71-0249 coke workers, 71-1186 race as a factor, 71-0249 cotton workers, 71.1185 smoking and, 71-0982 designers, 71-0897 smoking in etiology of, 71-0249 detergent workers, 71-0086, 71-0623 engineers, 71-0897 Payer, cigaretteSeeCIGARETTE PAPER factory workers, 71-0614 farm workers, 71-1034 ParaffinsSeeALIPHATIC HYDROCARBONS fibrous glass workers, 71-0618 firemen, 71-0454 PARKINSONISM flying personnel, 71-1020, 71.1119 etiology, 71-0682 foundry workers, 71-0772 smoking and, 71-0682 gas workers, 71-0903 gold miners, 71-1135 PAROTID GLANDS government workers, 71-0666, 71-0940 (See alsoSALIVARY GLANDS) grain handlers, 71-0082 effect of nicotine, 71-0205, 71 -0740 industrial workers, 71-0274, 71-0552 bffect of smoking, 71-0369, 71-0566 jute workers, 71-1185 longshoremen, 71-0081, 71-0291, 71-0659 PASSIVE SMOKING, 71-0023, 71.0024, 71-0733 machine construction workers, 71-0083, 71-0897 effect on carboxyhemoglobin levels, 71-0393 miners, 71-0282, 71-1033 effect on cardiovascular system, 71-0562, 71-0723, nickel workers, 71-0427 71-0819 physicians,71-0056,71-0319,71-0322,71-0337, effect on children, 71-0129, 71-0717 71 -0340, 71 -0928, 71-1104 effect on motor skills, 71 -0314 plaster workers, 71-1176 effect on nonsmokers, 71-0023, 71-0024, 71-0147, police, 71 -1120 71-0156,71-0314,71-0562,71-0723,71-0819, rubber workers, 71-1141 71-0824, 71-0838, 71-0973 smoking research personnel, 71-0934 effect on urine, 71 -0362 steel workers, 71-0273, 71-0912, 71-1165 in hamsters, 71-0193, 71-0960 storage battery workers, 71-0100 in lung neoplasm induction in hamsters, 71-0973 teachers, 71-0524 nicotine absorption and, 71-0393, 71-0723, 71-0819, textile workers, 71-0079, 71-0517, 71-1028 71-0838 textile workers in Israel, 71-1009 tobacco mosaic virus and, 71-0240 textile workers in Poland, 71-0455 tobacco factory workers, 71-0331, 71-0482, 71-0498, Peak expiratory flow measurementsSeeRESPIRATORY 71-0794 FUNCTION TESTS; LUNG FUNCTION tobacco field workers, 71-0236 transportation workers, 71-0668, 71-0770 Peptic ulcerSeeULCER, PEPTIC uranium miners, 71-0259, 71-1004, 71-1148 wool workers, 71-0078, 71-0088 PERCEPTION (See alsoBEHAVIOR; COGNITION) OPIUM SMOKING effect of carbon monoxide, 71 -0321 (See alsoSMOKING) smokers vs. nonsmokers, 71-0321 chronic bronchopulmonary disease and, 71-1158 in lung disease etiology, 71.1158 Pedestal mortalitySeeINFANT MORTALITY

OPSONINS PERIODONTAL DISEASES effect of tobacco smoke, 71-0360 (See also MOUTH DISEASES) areca chewing and, 71-123 1 ORAL HYGIENE preventive medicine, 71 -1231 areca chewing and, 71-1231 smoking and, 71-1063, 71-1231 effect of smoking, 71-1063, 71-1070, 71-1231 smokers vs. nonsmokers, 71-0691 PERSONALITY (See alsoBEHAVIOR) ORGANS cigarette sales and, 71.1240 effect of tobacco fermentationproducts, 71-0357, coronary disease and, 71 -0338, 71-0706, 71-1202 71-0550 effect of cannabis, 71-0576 smoking and, 71-0717 effect on cessation of smoking, 71-1090, 71.1262

(W.10 328 CUMULATIVE SUBJECT INDEX

effect on smoking characteristics, 71-0165, 71 -0328, coronary disease and, 71-0471, 71-1034 71-1 247 effect of nicotine, 71-1124 lung neoplasms and, 71 -1091 peptic ulcer and, 71-0785 PHYSICAL FITNESS projective technics, 71-0706 effect of alkaloids, 71-0188 smokers vs. nonsmokers, 71-1090, 71-1233, 71-1246 effect of cessation of smoking, 71-1025 smokinghabitand,71-0325,71-0340,71 -0518, effect of cigarette smoke, 71-0675 71-0785,71-0939,71-1084,71-1090,71-1091, effect of nicotine, 71-0188 71-1237,71 -1240,71-1245,71.1247,71-1248, effect of smoking, 71-0861 71-1 251 in military service, 71-0499 stress and, 71-0328 oxygen consumption and, 71 -0152 typology of smokers and, 71-1240 smokers vs. nonsmokers, 71-0152, 71-0499 PESTICIDE RESIDUES degradation in tobacco, 71-0365 PIGMENTS, TOBACCO determination in tobacco , 71-0383 as cocarcinogens, 71-0425 determination in tobacco leaf, 71-1117 tobacco variety and, 71-0425 determination in tobacco smoke, 71-0365, 71-0383 determination in tobacco tars, 71-0383, 71-1117 Pipe smokingSeeSMOKING, PIPE

PHAGOCYTOSIS Pipe tobacco smokeSeeSMOKE, TOBACCO effect of cigarette smoke, 71-0458 effect of tobacco smoke, 71-0360 PLACENTA lung diseases and, 71 -0612 effect of smoking, 71-0812 smokers vs. nonsmokers, 71-0612 enzymes in, 71-0812

PHARYNGEAL NEOPLASMS PNEUMOCONIOSIS (See alsoRESPIRATORY TRACT NEOPLASMS) (See also LUNG DISEASES; OCCUPATIONAL DI- cigar smoking and, 71-0998 epidemiology, 71-0058, 71-0247 SEASES) in Appalachia, 71-0279 etiology, 71-1001 bronchitis and, 71-0078 in India, 71 -0247 heart diseases and, 71-0299 pathogenesis, 71-0058 in Israel, 71.1009 sex as a factor, 71-0058, 71-0998 in nonsmokers, 71-1185 smoking and, 71-0058, 71-0588 occupation as a factor, 71-0078, 71-0079, 71-0091, smoking in etiology of, 71-0247, 71-0854 in Thailand, 71-0998 71-0093,71-0298,71-0629,71-0760,71-0764, therapy, 71-0058 71-0868,71-0871,71-1009,71-1015,71-1173, tobacco and, 71-0590 71-1174,71-1175, 71-1185 in Pennsylvania, 71-1174 tobacco chewing in etiology of, 71-0247 in Poland, 71-0078 smokers vs. nonsmokers, 71-0078, 71-0079, 71-0081, PHARYNGITIS 71-0091 (See alsoRESPIRATORY TRACT INFECTIONS) allergy and, 71-0504 smoking and, 71-0093, 71:0099, 71-0441, 71-0760, tobacco and, 71-0504 71-0764,71-0871,71-1009,71-1014,71-1015, 71-1133, 71-1173, 71-1175 smoking characteristics and, 71-0084, 71-0279 PHARYNX effect of smoking, 71-1171 smoking in etiology of, 71 -0868 fungi in, 71-1171 PneumoniaSeeRESPIRATORY TRACT INFECTIONS PHENOL CONTENT in cigarette smoke, 71-0822, 71.1126 PNEUMOTHORAX effect of cigarette paper, 71-1118 age as a factor, 71-1030 effect of filling density, 71-0018 emphysema and, 71-0286 effect of processing methods, 71-0240,71-1116 etiology, 71-1030 passive smoking and, 71-0286 PHENOLS smoking characteristics and, 71-0286, 71-1030 in cigarette smoke, 71-0837 smoking in etiology of, 71-1014 in cigarette tars, 71-0810 cocarcinogenicity, 71-0415, 71-0810, 71-1127 POLONIUM-210 determination in cigarette smoke, 71-0034, 71-1116, (See alsoMETALS) 71-0731 effect of smoking, 71-0565 in neoplasm induction, 71-0415 lung neoplasms and, 71 -0565 in tobacco leaf, 71-0191 in tobacco leaf, 71-0565 tobacco mosaic virus and, 71-0191 ZolycyclicaromatichydrocarbonsSeeAROMATIC PHYSICAL ACTIVITY HYDROCARBONS cardiovascular diseases and, 71-1192 cerebrovascular disoriien and. 71-1192 PolyphenolsSeePHENOLS

329 CUMULATIVE SUBJECT INDEX

Potassium cyanideSeeCYANIDES effectofsmoking,71-0075,71.0452,71-0606, 71-0607,71-0620,71.1008,71-1022,71-1156, PREGNANCY 71-1182 (See alsoFETUS; NEONATE; PREMATURITY) mucociliaryactivity,71-0452,71-0606,71-0607, cravings and aversions in, 71-1066 71-0620,71-0720,71.1007,71-1008,71-1015, diet and, 71-0508 71-1022, 71.1026, 71-1189 effect of aromatic hydrocarbons, 71-0584 particulatematter, 71-0363,71-1008,71-1026, effect of carbon monoxide, 71-0833 71.1175 effectofmaternalsmoking,71-0139,71-0I54, 71-0155,71-0156,71-0491,71-0508,71-0509, Pulmonary emphysemaSeeEMPHYSEMA 71-0595,71-0686,71-0688,71-0696,71-0717, 71-0737,71-0788,71-0792,71-0910,71-0984, PULMONARY FIBROSIS 71-1066,71-1134,71-1217,71-1219,71.1227, (See alsoLUNG DISEASES) 71-1228 air pollution as cause, 71-0877 effect of nicotine, 71-0394, 71-0790, 71-0910 asbestos and, 71-1029, 71.1187 effect of nitrosamines, 71-0729 experimentally induced in dogs, 71-0863 occupation as a factor, 71-0764, 71.1187 PREMATURITY smoking and, 71-0764, 71.1173 (See alsoFETUS; NEONATE; PREGNANCY) smokine as cause, 71-0863, 71-0877 effectofmaternalsmoking,71-0155,71-0156, smoking in etiology of, 71-1172, 71.1187 71-0305,71-0509,71-0686,71 -0717,71-0788, tobacco additives in etiology of, 71.1172 71.1064, 71-1227 Pulmonary functionSeeLUNG FUNCTION PROJECTIVE TECHNICS figure-drawing test, 71-070S PULMONARY HEART DISEASE smokers vs. nonsmokers, 71-0706 (See alsoHEART DISEASES) air pollution and, 71-0901 PROSTATIC NEOPLASMS bronchitis in etiology of, 71-0136 (See alsoUROGENITAL NEOPLASMS) electrocardiographic effects, 71.0136 epidemiology, 71-0759 epidemiology in India, 71-0136 race as a factor, 71-0759 lung diseases and, 71-0901 smoking and, 71-0242, 71-0759 smoking and, 71-0136, 71-0244, 71-0901

PSYCHOMOTOR PERFORMANCE PULMONARY SURFACTANT effect of cannabis, 71-0549, 71-0576 analysis, 71.0545 effectofcarbonmonoxide,71-0321,71-0366, effect of cigarette smoke, 71.0186, 71-0545, 71-0864 71-0379,71-0398,71-0403,71-0412,71-0416, effect of gaseous environment, 71-0624 71-0831, 71-0839, 71-0970, 71-1071 effect of nitrogen dioxide, 71.1160 effect of cigarette smoke, 71 -0924 effect on lung function, 71-0545 effect of smoking, 71-0321, 71-1 239 physiology, 71-0624 respiratory tract diseases and, 71.0624 PULMONARY ALVEOLAR MACROPHAGES bronchitis and, 71-1156 effect of cannabis, 71-0828 PYRIDINES effect of cigarette smoke, 71-0458, 71-0825, 71-1018, (See also HETEROCYCLIC NITROGENCOM- 71:1023, 71.1175, 71-1180 POUNDS) effectofsmoking,71-0627,71-0828,71-0863, in cigarette smoke, 71-0837 71-1156 in tobacco smoke, 71.0030, 71-0823 effect of tobacco smoke, 71-0828 metabolism in, 71-0211 Pyrolysis temperatureSeeCOMBUSTION TEMPERA - oxygen consumption and, 71-0211 1VRE

PULMONARY ALVEOLI chromium in, 71-0458 effect of nitrogen dioxide, 71-1160 effectof smoking,71-0146,71-1086,71-0465, RADIUM-226 71-0899 (See alsoMETALS) effect of surfactants, 71-0186, 71-0545, 71-0624 in tobacco leaf, 71-0565 macrophages in, 71-0146, 71-0612, 71 -0621, 71.1015 nickel in, 71-0458 RECTAL NEOPLASMS physiology, 71-0146 (SeealsoCOLONIC NEOPLASMS; INTESTINAL NEOPLASMS) PULMONARY CLEARANCE smoking and, 71-0310 (See alsoCILIARY ACTIVITY; LUNG FUNCTION) bronchitis and, 71.0606 RECTUM effect of cigarette smoke, 71-0452, 71-1007, 71-1022, (See alsoCOLON) 71-1 026, 71-1189 effect of smoking, 71-0310

3:32 330 CUMULATIVE SUBJECT INDEX

REDUCTION OF SMOKING in Sweden, 71 -0448 (See alsoCESSATION OF SMOKING; WITHDRAWAL tuberculosis and, 71-0089 CLINICS) antismokingcampaigns and,71 -0524, 71-0802, RESPIRATORY LNSUFFICIENCY 71-0937, 71.1100 (Sec alsoRESPIRATORY TRACT DISEASES) attitudes, 71.1084, 71-1100 in Canada, 71-0615 aversive therapy, 71-1261 smoking and, 71-0436, 71-0615, 71-0879, 71-1010 behavior therapy,71-0345, 71-0519, 71-0521, in women in Bordeaux, France, 71-0436, 71-1010 71 -0522, 71-0704, 71-1084, 71 -1263 belief in smoking hazards and, 71-0516, 71-1080 RESPIRATORY MUCOSA cognitive dissonance and, 71-1084, 7 1-126 1 effect of nicotine, 71-0438, 71-1003 conditioning (psychology) in, 71-1 263, 71 -1266 effect of smoking, 71.0465 drug therapy, 71-0330, 71-0950, 71-1096 emphysema and, 71-0438 effect of familial smoking, 71 -1080 effect of mecamybmine, 71-0815 RESPIRATORY SYSTEM effect of nicotine, 71-0815 (See alsoLARYNX; LUNGS; TRACHEA) effect on morbidity, 71-0854 effect of air pollutants, 71-0267, 71-0363 effect on stomach neoplasms, 71-0605 effect of cannabis, 71-0576 follow-up studies, 71-1267 effect of cessation of smoking, 71-1025 hypnosis in, 71-0532, 71-1267 effect of cigarette smoke, 71-0306 methods,71-0519,71-0521,71-0522,71-0922, effect of cigar smoking, 71-0630, 71-0870 71-0935, 71-0949, 71-1255, 71 -1264 effect of exercise, 71 -0152 motivation in, 71-0935 effectofsmoking,71-0104,71-0152,71-0250, peer group influences, 71-1080 71-0465, 71 -0629, 71-0870, 71-0913 as preventive medicine, 71-0750 effect of tobacco smoke, 71.0817 psychotherapy, 71-0330 reasons for, 71-0516 RESPIRATORY TRACT DISEASES roleof government,71-0179,71-0516,71-0528, (See alsoASTHMA; BRONCHIECTASIS; CHRONIC 71-0952 BRONCHOPULMONARY DISEASE;DYSPNEA; role of physicians, 71-0711 LUNG DISEASES; RESPIRATORY INSUFFI- role of teachers, 71-0524 CIENCY; TUBERCULOSIS) statistics, 71-1100 air pollution as a factor, 71-0228, 71-0266, 71-0363, stimulus saturation, 71-0521, 71 -0522 71-1178 in United Kingdom, 71-0179, 71 -0527, 71-0952 asbestos in etiology of, 71-0421 in children, 71 -0266 RESPIRATION. in college students, 71-0613 (See alsoDYSPNEA; LUNG FUNCTION; RESPIRA- in Colorado, 71-0278 TORY FUNCTION TESTS) drug abuse as a factor, 71-1011 effect of acetaldehyde, 71-1013 in Egypt, 71-0084 effect of carbon monoxide, 71 -0972 epidemiology in Germany, 71-1178 effect of carboxyhemoglobin levels, 71-0288 in Guyana, 71 -0622 effect of cigarette. smoke, 71 -0768, 71-1114 in Israel, 71-1009 effect of hypnosis, 71-0800 in lung neoplasm etiology, 71-0061 effectofsmoking,71-0104,71-0283,71-0288, morbidity, 71-0061 71-0800 mortality, 71-0615 nitrogen dioxide and, 71-0551 occupation as a factor, 71-0061, 71-0084, 71-0093, RESPIRATORY FUNCTION TESTS 71-0454, 71-0871, 71-1009 LUNG FUNCTION; RESPIRATION) (See also predisposing factors, 71-0454 asbestos and, 71-1029 psychosocial aspects, 71-0266 blood antitrypsin levels and, 71-0275 race as a factor, 71-0622 chronicbronchopulmonarydiseaseand,71-0098, smokers vs. nonrmokers, 71-0093, 71-0094, 71-0278, 71-0608 71-0453, 71-0770, 71-0871 effect of isoproterenol, 71-0269 smoking and, 71.0084, 71-0087, 71-0617, 71-0739, effect of metaproterenol, 71-1028 71-1009, 71-1178, 71-1182, 71-1257 effectofsmoking,71.0097,71-0099,71-0447, smoking in etiology of, 71-0266, 71-0454, 71-0613, 71-0626, 71-0764 71-0995 emphysema and, 71-0275 surfactants and, 71 -0624 in nonsmokers, 71-1185 therapy, 71-1166 occupation as a factor, 71-0084,71-0093,71-0764, in United Kingdom, 71-0266 71-0871, 71-1028, 71 -1185 pneumoconiosis and, 71-1028 RESPIRATORY TRACT INFECTIONS smokers vs. nonsmokers, 71-0079, 71-0088, 71-0093, (See alsoPHARYNGITIS) 71-0095,71-0269,71-0608,71-0633,71-0770, bronchial secretion and, 71.1159 71 C/871, 71-0879 cough and, 71-1159 smoking characteristics and, 71-0084, 71-0089 pathogenesis, 71-0769

3.73 331 CUMULATIVE SUBJECT INDEX

smoking and, 71-0244, 71-0465, 71-0769, 71.1159 aromatic hydrocarbons and, 71-0584 smoking in etiology of, 71-1172 benz(a)anthracenes and, 71-1136 therapy, 71-0769 benzo(a)pyrcne and, 71-0258 tobacco additives in etiology, 71-1172 cigarette tars and, 71-0253, 71-0258 experimentally induced in hamsters, 71-1142 RESPIRATORY TRACT NEOPLASMS experimentally inducedinmice, 71-0239, 71-0253, (See alsoBRONCHIAL' NEOPLASMS; CARCINOMA, 71-0258, 71-0431, 71-0584, 71 -0602, 71-0852 BRONCHOGENIC; LARYNGEAL NEOPLASMS; experimentally induced in rats, 71-1136 LUNG NEOPLASMS; NASOPHARYNGEAL NEO- PLASMS; PHARYNGEAL NEOPLASMS) SLEEP asbestos in etiology of, 71-0421 effect of carbon monoxide, 71 -0831, 71-0970 benzo(a)pyrene in etiology of, 71-1005 epidemiology, 71-0852, 71-0986, 71-114b SMOKE, BIDI experimentally induced in hamsters, 71.1005 ammonia in, 71.1109 nitrosamines and, 71-0564 occupation as a factor, 71-0852 SMOKE, CIGAR smoking and, 71-0986, 71-1148 (See alsoSMOKING; SMOKING, CIGAR) effect on lung function, 71-0630 REVERSE SMOKING effect on respiratory tract, 7 1-06 30 effect on mucous membrane, 71-0855 inhalation, 71-0630 mouth diseases and, 71-0681, 71-0690 particulate matter, 71-0150, 71-0966 in mouth neoplasm etiology, 71-0857 reducing properties of, 71-1110, 71-1111 mouth neoplasms and, 71-0855, 71-1150 stomatitis and, 71 -0855, 71-1150 SMOKE, CIGARETTE (See alsoSMOKING) acrolein in, 71-0844 aflatoxins in, 71-0209 alicyclic hydrocarbons in, 71-0187 aliphatic hydrocarbons in, 71-0002, 11-0187, 71-0217, SALIVARY GLANDS 71-0387 (See alsoPAROTID GLANDS) alkaloid content, 71-0001 effect of smoking, 71-0369, 71-0566 alklyphenols in, 71-0731 nicotine absorption and, 71-0734 amines in, 71.1121 nicotine content, 71 -0734 ammonia in, 71-1109 analysis, 71-0037, 71-0187, 71-0200,71-0385, SEMI-VOLATILE COMPOUNDS 71-0556,71-0563, 71-0731,71-0822,71-0846, (See alsoVOLATILE COMPOUNDS) 71-1115, 71-1121, 71-1128, 7 1-1129, 71-1269 in cigarette tars, 71-1123 aromatic hydrocarbons in, 71-0547 in tobacco tars, 71-0200, 71-0374, 71-0417 arylnitriles in, 71-0731 cadmium in, 71-1169 SEROTONIN carbohydrates in, 71-0813 effect of nicotine, 71-0216, 71-0225 carbon monoxide in, 71-0377 metabolism in intestines, 71-0225 carcinogenicity, 71-0201, 71-0738, 71-0838 metabolism in muscles, 71-0225 as cause of hypoxia, 71-0609 chemical properties of, 71-0201 SEX BEHAVIOR collection, 71-0202 effectofsmoking,71-0798,71-0923,71-0925, cyanides in, 71-0726 71-1227 distribution in respiratory tract, 71-0193, 71-0960 typology of smokers and, 71-0925 effect of filling density, 71-0018 effect of nitrates, 71-0402 SEX RATIO effect of ozone, 71-0836 effect of hypoxia, 71-0543 effect of processing methods, 71 -1116 effect of maternal smoking, 71-0686, 71-0807 effect of tobacco additives, 71-0388 effect of nicotine, 71-0543 effect on air pollution, 71-0267 effect on asparaginase, 71 -0718 SKIN effect on autonomic nervous system, 71-0306

effect of enzymes, 71-0623 . effect on avoidance learning in rats. 71-0700 effect of smoking, 71-0113, 71-0453, 71-1065 effect on behavior, 71-0306 effect of tobacco, 71-0498 effect on blood, 71-0571, 71-0890 effect of tobacco extracts, 71-0453 effect on blood antitrypsin levels, 71-0198 effect on blood circulation, 71-0115 SKIN DISEASES effect on blood coagulation, 71-0121, 71-0649 occupation as a factor, 71-0498 effect on blood pressure, 71-0129, 71-0883 tobacco and, 71-0498 effect on body temperature, 71-0469 effect on cardiovascular system, 71-0609, 71-1061 SKIN NEOPLASMS effect on cardiovascular system in dogs, 71-0883 (See alsoCARCINOMA, EPIDERMOID) effect on cells, 71-0198, 71-0254, 71-0629, 71-1019 age as a factor, 71-0253 effect on ciliary activity, 71-1175 3711 332 CUMULATIVE SUBJECT INDEX

effect on ciliary activity in cats, 71-0959 Smoke condensatesSeeTARS, CIGARETTES; TARS, effect on ciliary activity in rabbits, 71-1116 TOBACCO effect on diuresis, 71 -0842 effect on DNA, 71-1019 Smoke, particulatephaseSeeTARS, CIGARETTE; effect on eyes, 71 -0147 TARS, TOBACCO effect on gastric secretion, 71-0309 effect on heart function, 71-0306 Smoke, pipe tobaccoSeeSMOKE, TOBACCO effect on heart rate, 71-0129 effect on hemodynamics, 71-1042 SMOKERS VS. NONSMOKERS effect on hydroxylase activity, 71-0226 angina pectoris and, 71-0783 effect on lung epithelioid cells, 71.1019 antigen-antibody reactions, 71-0316, 71-0505, 71-0513 effect on lung function, 71-0599 antitrypsin deficiency and, 71-0440, 71-1164 effect on lung function in guinea pigs, 71.1026 arterial diseases and, 71-0479 effect on lungs, 71-0198, 71-0545, 71-0571, 71-0768 arteriosclerosis and, 71-0886 effect on lungs in dogs, 71-0864 asbestos and, 71-0129 effect on lungs in mice, 71-0758 ascorbic acid levels, 71-0474 effect on macrophages, 71-0458, 71-0825, 71.1018, behavior and, 71-0699, 71.1088 71.1175 bladder neoplanns and, 71-0604, 71-0992 effect on macrophages in guinea pigs, 71.1180 blood chemical analysis. 71.0472 effecton mucociliaryactivity, 71-0452, 71-0606, blood cholesterol, 71-0482, 71-1054 71.0720, 71.1007 blood cyanide levels, 71.0210 effect on mucociliary activity in rabbits, 71-1022 blood thiocyanate levels, 71-0210 effecton mucous membrane, 71-0147, 71-0254, body weight, 71-0912, 71-1044, 71-1229 71-0629 breast feeding and, 71-0712 effect on myocardial lactate extraction, 71-1061 bronchial epithelium, 71-1155 effect on nasal mucosa, 71-0268 bronchial mucous glands and, 71-0876 effect on nonsmokers, 71-0129, 71-0193, 71-0437, bronchial neoplasms and, 71 -0589, 71-0750, 71-0993 71-0838, 71-0960 bronchitis and, 71-0434, 71-0451, 71-0763, 71-1012 effect on olfaction, 71 -0147 bronchogenic carcinoma and, 71-0745 effect on pepsin levels, 71-0309 cannabis and, 71-0920, 71.1081 effect on physical fitness in rats, 71-0675 carboxyhemoglobin levels, 71-0116, 71-0390, 71-0482, effect on psychomotor performance, 71-0924 71-0489,71.0553,71.0569,71 -0662,71.0733, effect on pulmonary alveoli, 71-0545 71-0819, 71.1020, 71-1120 effect on pulmonary clearance, 71-0452, 71-0606 cardiovascular system, 71-0637 effect on pulmonary clearance in guinea pigs, 71-1026 chronicbroncholpulmonarydiseaseand,71-0440, effect on pulmonary clearance in rabbits, 71.1022 71-0460, 71.1012, 71.1293 effect on respiration, 71-0469, 71-0768 coronary diseaseand, 71-0120, 71-0289, 71-0473, effect on respiratory tract, 71-0591 71-0833, 71.0886, 71-1044, 71-1193 effect on surfactants, 71-0545, 71-0864 dyspnea and, 71.0446 filtration,71-0001,71-0028,71-0428,71-0675, effect of altitude, 71-0647 71.0700, 71-1114, 71-1128 effect of carbon monoxide, 71-0358, 71 -0668 fomuldehyde in, 71-1128, 71-1129 electrocardiographic effects, 71-0105, 71-0773 hydrogen ion concentration, 71-0254 emphysema and, 71-0621, 71-0876, 71-1184 hypoxia and, 71-0185 erythrocytes, 71-0662, 71-1047 inhalation,71-0201,71-0263,71-0286,71-0437, exercise and, 71-0152 71-0469, 71-0593, 71 -0600 extraversion and, 71-1248 inlungneoplasm induction,71-0067,71-0585, eye diseases and, 7143795 71-0593 feeding behavior and, 71-0933 in lung neoplasm induction in dogs, 71.0433 fertility, 71-0154 in lung neoplasm induction in laboratory animals, ferruginous bodies and, 71.0424 71-0999, 71.1148 fetal death and, 7143743 in lung neoplasm induction in mice, 71-0997, 71.1018 gastric secretion, 71-0918, 71-1218 maltol in, 71-1115 gastrointestinal diseases and, 71-0514 mechanism of action, 71-0254 hearing and, 71-0317 menthol in, 71-0388 hematocrit, 71.0894 metal-ion binding and, 71-0563 hemoglobin levels, 71-0470, 71-0662, 71-1047 nicotine content, 71-0001, 71-0032, 71-0202, 71.1126 immunity, 71.0888 nitrogen oxides in, 71 -0574 intermittent claudication and, 71-1037 particulate phase separation, 71.0202 knowledge of health facts and, 71-0934 phenol content, 71-0822, 71-1126 laryngeal neoplasms and, 71-0752 reducing properties of, 71-1110, 71.1111 lead levels, 71-0577 reflex action and, 71-0306 leukocytes, 71-0887, 71-1191 sulfur compounds in, 71-0201, 71.0556 life insurance in United States, 71-1103 tar and nicotine content, 71-0559, 71.0560 lung function, 71-0283, 71-0445, 71-0459, 71-0608, tar content, 71-0032, 71-0578 71-0610,71-0620,71-0628,71 -0862,71-0866, toxicity,71-0185, 71-0591,71-0629,71-0738, 71-0899, 71-1161, 71-1163, 71-1165, 71-1174 71-1116 lungneoplasms and,71-0245,71 -0432,71-0434, volatile compounds in, 71-0556, 71.0822 71-0745, 71.0849 CUMULATIVE SUBJECT INDEX macrophages and, 71.0627, 71.0828 arsenic content, 71-0066 in military service, 71-0499 carbon monoxide in, 71-0416 morbidity, 71.0297, 71.0580, 71.0742, 71-1237 carcinogenicity, 71-0070, 71-0750, 71-0817, 71-0834 mortality,71-0423,71.0580,71.0581,71-1103, effect on agglutinins, 71-0370 71-1139 effect on antibodies, 71-0370 mortality in Belfast, Northern Ireland, 71.0848 effect on digestive system, 71.0506 mouth diseases and, 71-0311, 71.0691, 71 -1223 effect on gastrointestinal system, 71-0808 mouth neoplasms and, 71-0692, 71-1152 effect on lungs, 71-0875 mucociliary activity, 71-0607 effect on mucociliary activity, 71-0875 myocardial infarct and, 71-0480, 71.0656, 71.0660, effect on nonsmokers, 71-0562, 71-0737 71-0669, 71.0884 effect on opsonins, 71-0360 neuroses and, 71.0917, 71-1248 effect on phagocytosis, 71-0360 nicotine absorption and, 71-0362, 71.0733, 71-0819, effect on respiratory tract, 71-1182 71.0838 effect on trichloroethylene, 71-0392 nicotine metabolism, 71-1108 effect on vision, 71 -0679 obesity and, 71-0912 filtration, 71-0738 oral hygiene and, 71-0691, 71-1070 hydrogen ion concentration, 71-0254 oxygen consumption and, 71-0152 inhalation, 71-0070, 71-0640 parkinsonism and, 71-0682 nitrogen dioxide and, 71-0551 pernicious anemia and, 71-1215 pesticide residues in, 71-0365, 71-0383 pneumoconiosis and, 71-1174 pharmacology, 71-1134 post-operative complications and, 71-0715, 71-1069 poisoning, 71-0360 projective technics and, 71-0706 polonium-210 content, 71-0565 pulmonary clearance, 71-0607, 71-0620 pyridines in, 71-0823 respiratory function tests, 71-0074, 71-0090, 71-0269, radium-226 content, 71-0565 71-0274,71-0279,71-0437,71-04461,71-0460, reducing properties of, 71-1110, 71-1111 71-0608, 71-0626, 71-0633, 71-0636, 71-0767 tobacco mosaic virus in, 71-0191 respiratorytractdiseasesand,71 -0278,71-0442, toxicity, 71.0370, 71-0737, 71-0817 71-0453, 71-0613, 71-0622, 71-0770, 71-0865 volatile compounds in, 71-0821 sickle-cell anemia and, 71-0899 skin-fold thickness, 71-0891 SMOKING sputum analysis, 71-0104, 71-0153, 71-0434, 71-0621, (Seealso OPIUM SMOKING; SMOKE, CIGAR; 71-0625, 71-0749 SMOKE,CIGARETTE; SMOKE, TOBACCO; stress and, 71-0933, 71-1252 SNUFF-DIPPING; TOBACCO CHEWING) sugar intake, 71-0914, 71-1203 alcohol consumption and, 71-0982, 71-0996 thiocyanate content in body fluids, 71-0847 antitrypsin deficiency and, 71-0616 thiocyanate content in saliva, 71-0369 arterial diseases and, 71-0898 thorium-232 in, 71-0207 arteriosclerosisand,71-0478,71-0898,71-0908, thromboangiitis obliterans and, 71-0479 71-1046 thrombosis and, 71-1213 in arteriosclerosis etiology, 71-0474, 71-0490, 71-1212 tongue diseases and, 71-0693 asthma and, 71-0102 urinalysis,71-0040,71-0041,71-0210,71-0827, in asthma etiology, 71-0262 71-0976, 71-1108 inbladderneoplasmetiology,71-0242, 71-0261, vascular diseases and, 71-0479, 71-1213 71-1143 wrinkling and, 71.1065 blood pressure and, 71-0666 in bronchial neoplasm etiology, 71-0057, 71-0592 SMOKE STREAMS bronchitis and, 71-0622, 71-1177 acrolein in, 71-0004 inbronchitis etiology, 71-0438, 71-0451, 71-0456, aliphatic hydrocarbons in, 71-0002, 71-0387 71-1162 analysis, 71-0036, 71-0037, 71-0846, 71-1126 in bronchogenic carcinoma etiology, 71-0257 aromatic hydrocarbons in, 71-0036 cannabis and, 71-0151 cannabinoids in, 71-1106 carbon monoxide and, 71-0719 carbon monoxide in, 71-0733 cardiovascular diseases and, 71-0659, 71-1048 cyanides in, 71-0004 as cause of bronchitis, 71-0076 effect on hemoglobin levels, 71-1114 as cause of coronary disease, 71-0648 effect on nonsmokers, 71-0129, 71-0733, 71-0838 as cause of heartburn, 71-0500 effect on respiration, 71-1114 as cause of hypoxemia, 71-0470 menthol in, 71-0388 ascauseoflungneoplasms,71-0746, 71-0751, pesticide residues in, 71-0383 71-0849 tar content, 71-0578 cerebrovascular disorders and, 71-0655, 71-1209 toxicity, 71-0129 chronicbronchopulmonarydiseaseand,71-0098, 71-0444, 71-0457, 71-0880, 71-1024 SMOKE, TOBACCO in chronic bronchopulmonarydisease etiology, (See alsoSMOKING; SMOKING, PIPE) 71-0456, 71-0869 in air pollution, 71-0737, 71-0738 in colonic neoplasm etiology, 71-0310 allergy, 71-0738, 71-1157 coronary disease and, 71-0127, 71-0484, 71- 0494;71- analysis, 71-0030, 71-0817, 71-0829 0496, 71-0643, 71-0646,71-0651, 71-0781, antitrypsin deficiency and, 71-1017 71-0895,71-0900,71-1034,71-1046,71-1196, 3 ?6 334 CUMULATIVE SUBJECT INDEX

71-1197, 71-1211, 71-1214 effect on physical fitness, 71-0152, 71-0861 incoronarydiseaseetiology,71-0137,71-0653, effect on placenta, 71 -0812 71-0908, 71-0909, 71-1040, 71-1192 effect on platelets, 71-0889 diet and, 71-0133 effect on prostate, 71-0242 effect on anesthetics, 71-0389, 71-033,2, 71-1132 effect on psychomotor performance, 71-1239 effect on antibodies, 71-0888 effect on pulmonary alveoli, 71-0146 effect on ascorbic acid levels, 71-0474 effect on Pulmonary clearance, 71-0452, 71-1008 effect on blood, 71-0128, 71-0472, 71-0496 effect on pulmonary clearance in rabbits, 71-1022 effect on blood cells, 71-0316 effect on respiration, 71-0104, 71-0152, 71-0283, effect on blood cholesterol, 71-0405, 71-1194 71-0800 effect on blood circulation, 71-0482, 71-0887 effect on respiratory tract, 71-0465 effect on blood coagulation, 71-0488 effect on respiratory tract in rats, 71-0870 effect on blood lipids, 71-0292, 71-0405, 71-1194 effect on salivation, 71-0566 effect on blood pressure, 71-0141, 71-0338 effect on sexual behavior, 71-0158, 71-1227 effect on blood vessels, 71-0106, 71-0487 effect on skin, 71-1065 effect on body temperature, 71-0113 effect on sterility, 71-0144, 71.0154 effect on body weight, 71-0405, 71-0912 effect on surfactants, 71-0186 effect on brain, 71-0510 effect on taste, 71-0793, 71-1066 effect on bronchial epithelium, 71-0849, 71-1155 effect on thrombus formation, 71-0889 effect on calculi formation, 71-0311 effect on urinalysis, 71-0041, 71-0148 effect on carboxyhemoglobin levels, 71-0489 effect on urine, 71-0148, 71-0842 effect on cardiovascular system, 71-0617, 71-0637, effect on urogenital system, 71-0154 71-0652, 71-0727, 71-0800, 71-0895 effect on uterus, 71-0144 effect on catecholamine levels, 71-1239 effect on vision, 71-0501, 71-0566 effect on cells, 71-0142, 71-0625 effect on wrinkling, 71-1065 effect on cravings and aversions, 71-1066 electrocardiographic effects, 71-0287, 71.491, effect on enzyme activity, 71-0060, 71-00 5, 71-0812, 71-0872 71-1132 electroencephalographic effects, 71-0502, 71-0510 effect on epithelial cells, 71-0791 emphysema and, 71-0463 effect on equilibrium, 71-0801 in emphysema etiology, 71-0438 effect on esophagus, 71-0500 gastrointestinal neoplasms and, 71-0596, 71-0860 effect on eustachian tube, 71-0911 habituation, 71-1270 effect on eyes, 71-0557 heart diseases and, 71-0672, 714200 effect on fertility, 71-0154 hypoxia and, 71-0775 effect on gastric secretion, 71-0918, 71-1218, 71-1225, lschemia and, 71-0774, 71-0780 71 -1226 in kidney neoplasm etiology, 71.1154 effect on gastrointestinal system, 71-1069 laryngeal neoplasms and, 71-0594, 71-0994 effect on hearing, 71-0317, 71-1072 in lung neoplasm etiology, 71-0053, 71-0063, 71-0252, effect on heart, 71-0106 71-0259, 71-0585 effect on heart rate, 71-0113, 71-0475, 71-1239 in lung neoplasm induction, 71-0250, 71-0428 effect on hemodynamics, 71-1042 lung neoplasmsand,71-0045, 71-0586, 71-0749, effect on hormones, 71-0013, 71-0154 71-0755, 71-0757, 71-0851, 71-0859 effect on immunity, 71-0888 in mouth disease induction, 71-0311 effect on kidneys, 71-0128, 71-0842 mouth diseases and, 71-0681, 71-0915 effect on larynx, 71-0069 in mouth neoplasm etiology, 71-0247, 71-1152 effect on lecithin levels, 71-0186 mouth neoplasms and, 71-0748 effect on leukocytes, 71-0513, 71-0673 myocardial infarct and, 71-0118, 71-0133, 71-0138, effect on liver cells, 71-0812 71-0665,71-0667,71-0777,71.0885,71-0893, effect on lung function, 71-0075, 71-0099, 71-0101, 71-1032, 71-1196 71-0104,71-0277,71-0283,71-0437,71-0444, inmyocardialinfarctetiology,71-0302, 71-0492, 71-0445,71-0447,71-0449,71-0861,71-0874, 71-1212 71-1162 myxoedemaand, 71-0111 effect on lungs, 71-0167 in neoplasm etiology, 71-0590, 71-1138 effect on macrophages, 71-0146, 71-0828, 71-1156 oral contraceptives and, 71-0906 effect on morbidity, 71-0235 oral hygiene and, 71-1231 effect on morbidity and mortality, 71-0940 in pancreatic neoplasm etiology, 71-0249 effectonmortality,71-0045, 71-0233,71-0235, parkinsonism and, 71-0682 71-0648, 71-0983 peptic ulcer and, 71-0680, 71-0918, 71-1216, 71-1225, effect on mortality in Japan, 71-0982 71-1226 effect on mouth mucosa, 71-0060, 71-0791 periodontal diseases and, 71-1231 effecton mucociliaryactivity, 71-0452, 71-1008, in pharyngeal neoplasm etiology, 71-0247 71.1156 pneumoconiosis and, 71-0868, 71-1173, 71-1175 effect on mucociliary activity in rabbits, 71.1022 polyps and, 71-0310 effect on mucous membrane, 71-0145 prohibition,71-0319,71-0320,71.0515, 71-0528, effect on oxygen consumption, 71-0874 71-1235 effect on parotid glands, 71-0566 prostatic neoplasms and, 71-0759 effect on pentazocine metabolkim, 71-0389 in pulmonary fibrosis etiology, 71-1187 effect on pharynx, 71-1171 in rectal neoplasm etiology, 71-0310 CUMULATIVE SUBJECT INDEX

research programs, 71-0540 leukoplakia and, 71-1223 respiratory tract diseases and, 71-0617 lung function and, 71-0894 rheumatoid factor and, 71-0619 lung neoplasms and, 71-0879, 71-0995, 71.1147 stress and, 71-1197 myocardial infarct and, 71-0114, 71-0902, 71-1053, sudden death and, 71-0651 71-1060, 71-1199, 71.1210 sugar intake and, 71-1032 in myocardial infarct etiology, 71-0302 thromboangiitis obliterans and, 71-1208 neoplasms and, 71-1139 thromboembolism and, 71-0906 neuroticism and, 71-0917 tobacco amblyopia and, 71 -0786 personality as a factor, 71-0165, 71 -0347, 71-1246, urogenital neoplasms and, 71-0850 71-1247, 71-1251 vascular diseases and, 71-0892, 71-1052 pharyngeal fungi and, 71.1171 pharyngeal neoplasms and, 71-0588 SMOKING AND HEALTH 71 -0182, 71-0237, 71-0342, pneumothorax and, 71-0286, 71.1030 71-0420, 71-0422, 71-0530, 71-0541, 71-1268 psychosocial aspects, 71.0939 American Cancer Society, 71-0985 respiratory tract diseases and, 71-0769 bibliography, 71-0739 stress and, 71.1036 in Connecticut, 71-0348 tuberculosis and, 71-1021 educational programs, 71-0326, 71-0932 in women, 71-0611, 71-0925 evaluation,71-0232,71-0235,71-0581,71-0955, 71-1075, 71-1134 SMOKING, CIGAR research programs, 71-0413, 71-0713, 71-1075 (See alsoSMOKE, CIGAR) statistics,71-0229,71 -0580,71-0617,71.1075, bronchial neoplasms and, 71-0944, 71-1140 71-1076, 71-1082, 71-1083, 71-1100, 71-1134 effect on respiratory tract in rats, 71-0870 in United Kingdom, 71-0714, 71-0955, 71-1134 laryngeal neoplasms and, 71-0998 in United States, 71-0984 in leukoplakia etiology, 71-0856 lung neoplasms and, 71-1140 Smoking behaviorSeeBEHAVIOR; SMOKING CHAR- in mouth neoplasm etiology, 71-0991, 71-1150 ACTERISTICS pharyngeal neoplasms and, 71-0998 stomatitis and, 71.1150 SMOKING, BIDI in arterial disease etiology, 71-0298 SMOKING HABIT bronchial neoplasms and, 71-0944 academic achievement and, 71-0169, 71 -1085 effect on mouth, 71-0690 adolescents,71-0074,71-0157,71-0164,71.0169, in leukoplakia etiology, 71-0856 71-0171,71-0329,71-0333,71 -0347,71-0459, lung neoplasms and, 71-0432 71-0796,71-0797,71.0929,71-0931,71-0939, mouth diseases and, 71-0681 71-0945,71-1079,71.1088,71-1236,71-1244, in neoplasm etiology, 71-0590 71-1250 adolescents in Bern, Switzerland, 71-0920 SMOKING CHARACTERISTICS adolescents in Dublin, Ireland, 71-1086 (See alsoBEHAVIOR) adolescents in Izmir, Turkey, 71-1232 adolescents, 71-0939 adolescents in New England, 71.1238 arterial diseases and, 71-1 036, 71-1055 in adults in Bordeaux, France, 71-0376 arteriosclerosis and, 71-1055 age as a factor, 71-0907, 71-1241 belief in smoking hazards and, 71-0934 alcohol consumption and, 71-0051, 71-0798, 71-0909, bronchial neoplasms and, 71-0057, 71-0993 71-0921, 71-1233, 71-1256 bronchitis and, 71-0077, 71-0450, 71-0611, 71.0763, in American Indians, 71-0520 71-1012, 71-1181 in the Americas, 71-0937 cannabis and, 71-1081 antismokingcampaignsand,71-0159,71-0172, cardiovascular diseases and, 71-1035 71-0174,71-0179,71-0341,71 -0343,71-0539, as cause of emphysema, 71-0286 71-0802,71-0804,71-0805,71-0936,71-1099, chronicbronchopuhnonarydiseaseand,71-0096, 71-1102, 71-1236, 71-1254, 71-1258 71-0873, 71-0879, 71-1012 attitudes,71-0159,71-0322,71-0337,71 -0347, coronary disease and, 71-1052 71-1075,71-1076,71-1088,71-1232,71-1234, effect of nicotine, 71-0327, 71-1077 71-1242, 71-1244 effect of parental smoking, 71-0698, 71-1086 aversive therapy, 71-0948 effect on enzyme activity, 71-0086 behavior and, 71-0172, 71-0176, 71-0328, 71-0518, effect on leukocytes, 71-0887 71-0699,71-0798,71-1077,71-1084,71-1088, effect on lung function, 71-0089, 71-0866, 71-0873 71-1099, 71-1242 effect on morbidity, 71 -0742, 71-0995 behavior therapy, 71-0166, 71-0170, 71-0533, 71-0704 effect on mortality, 71-0068, 71-0981 belief in smoking hazards and, 71-0337, 71-0526, effect on urinalysis, 71-0040 71-0698,71-0919,71-0926,71-1075,71-1232, emphysema and, 71-0463 71-1245, 71-1257 erythrocytes and, 71-1047 blood lipids and, 71-0907 gastrointestinal neoplasms and, 71-0860 body constitution and, 71-0801, 71-0907, 71-1227 hematocrit and, 71-0894 body weight and, 71-0912 hemoglobin levels and, 71-0894, 71-1047 in Canada, 71-0231 knowledge of health facts and, 71-0934 in Ceylon, 71-0944 laryngeal neoplasms and, 71-0588, 71-0858 children, 71-0171,71-0266, 71 -0329,71-0334,

3:78 336 CUMULATIVE SUBJECT INDEX

71-0796, 71-0931, 71-0936 71-0925,71-0939,71-1084, 71.1245,71-1259, children in Dublin, Ireland, 71-1086 71-1264 cognitive dissonance and, 71-0919, 71-0934 religion as a factor, 71-0520, 71-0798 incollegestudents,71-0159,71-0172,71-0173, research programs, 71-0494, 71-0540 71-0323,71-0698,71-0699,71-0705,71-1246, role playing and, 71-1084 71.1255 in Rumania, 71-1241 in Connecticut, 71-0341 in Russia, 71-0174 coronary disease and, 71-0338, 71-0663, 71-0779 in Saint-Etienne, France, 71-0921 defense of, 71-1091 in schools, 71-0161, 71-0171, 71-0329, 71-0333 diet and, 71 -0118, 71-0921 in schools in Dallas, Texas, 71-1079 drug abuse and, 71-1256 in schools in New York, 71-0936 economic loss in, 71-0231, 71-0422 sex as a factor, 71-0077, 71-0104, 71-0154, 71-0158, education as a factor, 71-0944 71-0164,71-0168,71-0169,71-0171,71-0328, effectof advertising,71-0339, 71-0343, 71-0538, 71-0334,71-0339,71-0340, 71-0518,71-0657, 71-1101, 71.1234, 71.1237, 71-1254, 71-1258 71 -0938,71-0944,71-1090,71-1241,71-1246, effect of carbon dioxide, 71-0922 71-1250, 71-1257 effect of hypnosis, 71-0532 sex behavior and, 71-0923, 71-0945 effect of nicotine, 71-0328, 71-0815 socioeconomiceffects,71-0537, 71-0580, 71-0919, effectofparentalsmoking,71-0163,71-0164, 71-0945, 71-1085, 71-1229, 71-1240 71-0698, 71-0919, 71-0945, 71-1250 in South Dakota, 71-0161 effect on aging, 71-0308 statistics, 71 -0376, 71-0928, 71-1076 effect on behavior, 71-0525 stress and, 71-0176, 71-1092, 71-1252 effect on blood circulation, 71-0634 sugar intake and, 71-1203 effect on lung function, 71-0634 in Sweden, 71-0580, 71-1234, 71.1247, 71 -1251 in France, 71-0376, 71-0954 systems analysis of, 71-0537 in Germany, 71-0157, 71-0173 toxicity, 71-0027 history, 71-0027, 71-0520, 71-0538, 71-0581 typology of smokers and, 71-0347, 71-0525, 71-1240 hypertension and, 71-0338 inUnitedKingdom, 71-0179, 71-0266,71-1102, in Indianapolis, 71-0329 71.1134 in Italy, 71-0797 in United States, 71-0231, 71-1100 in Japan, 71-0858 in women, 71-0517, 71-0526, 71-0925, 71-0928 knowledge of health facts and, 71-0929 longevity and, 71-0230 SMOKING MACHINES, 71-0147 lung neoplasms and, 71-1091 in cigarette smokeanalysis,71-0201,71-1126, in Magdeburg, East Germany, 71-0337 71-1269 mass media and, 71-1235 in pipe smoke analysis, 71-0351 medical students, 71-0338, 71-0938 modification, 71-0125, 71 -0162, 71-0166, 71-0170, SMOKING, MATERNAL 71-0175,71-0534,71-0540,71-0955,71-1166, breast feeding and, 71-0712 71-1255, 71-1261, 71-1264, 71-1265, 71-1266 congenital heart defects and, 71-0674, 71-1207 neuroses and, 71-0325, 71-0917, 71-1227, 71-1248, diet and, 71-0305 71.1252 effect on abortion, 71-0688, 71-1064 effect on antigen-antibody reactions, 71-0505 in nonmetropolitan areas, 71-1076 effect on birth weight, 71-0305, 71-0313, 71-0509, in Norway, 71-1256 71-0811,71-0830,71-0910, 71.1219,71-1228, obesity and, 71-0912, 71-1229 71-1230 occupation as a factor, 71-0069, 71-0337, 71-0340, effect on body height, 71-1219 71-1033, 71-1087 effect on enzyme levels, 71-0503 peer group influences, 71-0164, 71-0333, 71-0334, effect on fetal death, 71-0743 71-0939, 71-1085, 71-1244 effeut on fetus, 71-0006, 71 -0155, 71-0156, 71-0391, personality as a factor, 71-0165, 71-0325, 71-0336, 71-0505, 71-0688, 71-0910 71-0338,71-0347,71-0518,71-1089,71-1090, effect on hormone levels, 71-0503 71-1091,71-1227,71 -1233,71-1237,71-1240, effect on infant mortality, 71-0811 71-1245, 71.1246, 71-1247, 71-1251 effect on maternal-fetal exchange, 71-0788 physicians,71-0045,71-0319,71-0320,71-0322, effectonneonate,71-0006,71-0155,71-0313, 71-0337, 71-0340, 71-0928, 71-1243 71-0595, 71-0717, 71-0735, 71-1068 physicians in Canida, 71-1087 effect on prematurity, 71 -0155, 71-0156, 71-0305, physicians in Denmark, 71 -0926 71-0509, 71-1064 physicians in Finland, 71-1257 effects during pregnancy, 71-0006, 71-0155, 71-0156, physicians in Israel, 71-1259 71-0391,71-0422,71-0503, 71-0508,71-0526, psychosocialaspects,71-0065,71-0336,71-0518, 71-0686,71-0688,71-0696,71-0717,71-0735, 71-0525,71-0533,71-0538,71-0705,71-0803, 71-0788,71-0807,71-0910, 71-1217,71-1227, 71-0925,71-0929,71-0939,71-1089,71-1242, 71-1228 71-1247 eye diseases and, 71-0792 public attitudes and, 71-0799, 71-0955, 71-1235 noeplasms and, 71-0595 reasonsfor, 71-0173,71-0329,71-0330,71-0334, oral contraceptives and, 71-0684 71-0336,71-0347,71-0413,71-0525,71-0526, teratogenesis and, 71-1207 71-0533,71-0701,71-0705,71-07%,71-0803, teratogenic effects, 71-0674 3 )9 CUMULATIVE SUBJECT INDEX

SMOKING, PARENTAL teachers in Canada, 71-1087 effectonchildren,71-0163, 71-0164,71-0334, in twins, 71.1193 71-0698, 71-0919, 71-1238 in United Kingdom, 7143319, 71-0444 in United States, 71-0168, 71-0332, 71-0516 SMOKING, PIPE in West Germany, 71 -0350, 71-0352 (See alsoSMOKE, TOBACCO) bronchial neoplasms and, 71.1140 SNUFF in lip neoplasm etiology, 71-0238 effect on mouth in hamsters, 71-1142 lung neoplasms and, 71-1140 effect on mucous membrane in hamsters, 71-1142 in mouth neoplasm etiology, 71-0991 effect on skin in hamsters, 71-1142 tobacco amblyopia and, 71-0784 metals in, 71-0583

SMOKING SURVEYS SNI.;17F-DIPPING adolescents,71-0797,71-0939, 71-0945,71-1085, (See alsoSMOKING) 71-1088, 71-1236, 71-1253 coronary disease and, 71-1196 adolescents in Dublin, Ireland, 71.1086 effect on mucous membrane, 71.0145 adolescents in Izmir, Turkey, 71-1232 legislation, 71-0178 adolescents in New England, 71.1B8 in leukoplakia etiology. 71-0856 adolescents in New Zealand, 71-1250 in mouth neoplasm etiology, 71-0991, 71-1152 adolescents in Portsmouth, England, 71-0930 myocardial infarct and, 71-1196 adolescents in United States, 71.1250 nasopharyngeal neoplasms and, 71.0583 in the Americas, 71-0937 in United Kingdom, 71-0178 antismoking campaigns and, 71-0936 bank clerks in Brussels, Belgium, 71-1204 Sodium arsenateSeeARSENICALS in Ceylon, 71-0944 children, 71-0936, 71-1253 Sodium cyanideSeeCYANWES children in Dublin, Ireland, 71-1086 in colleges, 71-0323 SPERMATOZOA college students in Ohio, 71-0919 effect of nicotine, 71-0835 college students in Zurich, Switzerland, 71-1233 in Cralova, Rumania, 71-0763, 71-1241 SPINAL CORD in Czechoslovakia, 71-0251 (See alsoCENTRAL NERVOUS SYSTEM) in Dublin, Ireland, 71-0334 effect of nicotine, 71-0196, 71-0221 evaluation, 71-1242 in Finland, 71-0517 SPLEEN follow-up studies, 71-0446 effect of carbon monoxide, 71-0826 in Germany, 71-1249 effect of nicotine, 71-0196 in Glamorgan, South Wales, 71-0917 in Glostrup, Denmark, 71-0866 in hospitals, 71-0094 Spirometric measurementsSeeRESPIRATORY FUNC- in India, 71-0690 TION TESTS in Iowa, 71-1075, 71-1076, 71-1082, 71-1083 in Ireland, 71-0171, 71-0653 SPUTUM ANALYSIS in Italy, 71-0094, 71-0797 bronchial neoplasms and, 71-0592 in London, England, 71-0940 in Madrid, Spain, 71-0938 STATISTICAL ANALYSIS in medical centers, 71-0319 lung neoplasms, 71-0048 medical students, 71-0938 methodology, 71-0638 in New Zealand, 71-0169 neoplasms, 71-0048 in nonmetropolitan areas, 71-1075, 71-1076, 71-1082, smokers vs. nonsmokers, 71-0582 71-1083 nurses in Canada, 71-1087 STEROIDS physicians, 71-0332, 71-0928, 71-1243 metabolism in placenta, 71-0503, 71-0812 physicians in Canada, 71-1087 physicians in Denmark, 71-0926 STEROLS physicians in Finland, 71-1257 arteriosclerosis and, 71-0481 physicians in Israel, 71-1259 determination in tobacco, 71-0009, 71-0019 inschools,71-0164, 71-0169, 71-0171,71-0334, 71-1085 STOMACH NEOPLASMS in schools in Illinois, 71-1236 (See alsoINTESTINAL NEOPLASMS) in schools in New England, 71-1238 areca chewing and, 71-0596 in schools in New York, 71-0936 benz(a)anthracenes and, 71-1153 in schools in Portsmouth, England, 71-0930 effect of cessation of smoking, 71-0605 in schools in Saskatoon, Canada, 71-1253 effect of reduction of smoking, 71-0605 smoking research personnel, 71-0934 effect on tobacco tolerance, 71-0605 in South Dakota, 71-0161 r. experimentally induced in rats, 71-1153 in South Wales, 71-0912 pernicious anemia and, 71-1215 in Sweden, 71-0669 smoking and, 71-0596, 71-0982

340 338 CUMULATIVE SUBJECT INDEX

STOMATITIS cyanides in, 71-0726 (See alsoMOUTH DISEASES) effect of processing methods, 71-1116 cigar smoking and, 71-1150 effect of tobacco additives, 71-0837 reverse smoking and, 71-0855, 71-1150 effect on cell division, 71 -0726 effect on cells, 71-1145 STRESS effect on lung cells, 71-1146 adolescents and, 71 -0933 effect on macrophages, 71-0825 arterial diseases and, 71-1036 fluorescence, 71-0372, 71.0417 coronary disease and, 71-1197 in lung neoplasm induction in hamsters, 71.1146 effect on catecholamine levels, 71-1078 pesticide residues in, 71-0203, 71-1117 endocrine system and, 71-1092 physical properties, 71-0372 oral contraceptives and, 71-1092 preparation, 71-0374, 71-0375, 71-0380, 71-0417 peptic ulcer and, '1-0785 research programs, 71.0431 smokers vs. nonsmokers, 71-0933, 71.1252 semi-volatile compounds in, 71-0374, 7 1-1123 smoking and, 71 -0785, 71-1036, 71-1092,71-1197 inskinneoplasminduction,71-0253,71-0258, 71-0431 Stroke volume SeeHEART FUNCTION sterol content, 71-0019 volatile compounds, 71-0375, 71 -0380 STUDENTS, COLLEGE alcohol consumption and, 71-1233 TARS, TOBACCO behavior, 71 -0699 analysis, 71-0558, 71-0563, 71-1117 cannabis and, 71-0697, 71-1081 carcinogenicity, 71-0413, 71 -0602 lung function, 71-1 163 cocarcinogenicity, 71-1127 smokinghabitand,71-0323,71-0698, 71-0699, effect of cigarette paper, 71-1118 71-0705, 71-0919, 71-1 233, 71-1246 effect of processing methods, 71 -1116 metal ion binding and, 71-0563 Students,high schoolSeeADOLESCENTS in neoplasm induction, 71 -0066 norbomene content. 71 -0558 Staants, grade schoolSeeCHILDREN pesticide residues in, 71 -0383, 71-1117 reducing properties of, 71.1110, 71-1111 STUDENTS, MEDICAL terpenoids in, 71-0558 cardiovascular diseases and, 71-0642 TASTE SUGAR INTAKE effect of smoking, 71-1066 coronary disease and, 71-1203 heredity as a factor, 71-0793 ex-smokers, 71-0914 smokers vs. nonsmokers, 7,1-0793 myocardial infarct and, 71-1032 smokers vs. nonsmokers, 71-0914 TERATOGENESIS smoking and, 71-1 03 2, 71-1203 effect of nicotine, 71-0221 maternal smoking and, 71-1207 SULFUR COMPOUNDS mechanism of action, 71 -0221 in cigarette smoke, 71-0556 prevention, 71-1144 effect on fertility in rats, 71-0968 THIOCYANATES (See alsoCYANIDES) determination in blood, 71-0210, 71-0786, 71-0795 TAR CONTENT determinationin urine, 71-0040, 71-0041, 71-0210, brand differences, 71-0529 71-0847 in cigarette butt, 71 -0352 in saliva, 71-0153, 71 -0369 in cigarettes, 71 -0352 determination in cigarette smoke, 71-0032, 71 -0042, THORIUM-232 CONTENT 71-0529, 71 -0559, 71-0560, 71-0578 determination in cigarettes, 71 -0207 effect of filling density, 71-0018 determination in lungs, 71-0207 effect of processing methods, 71-0578 labeling, 71 -0529 THROMBOANGUTIS OBLITERANS tobacco variety and, 71-0578 (See alsoARTERIAL DISEASES; THROMBOSIS) age as a factor, 71.1208 TARS, CIGARETTE carboxyhemoglobin levels in, 71-0640 alkylating effect, 71-0373, 71-0417 smoking and, 71-0115, 71-0479, 71-1208 analysis, 71 -0028, 71-0202, 71-0203,71-1117, 71.1123 THROMBOEMBOLISM aromatic hydrocarbons in, 71-0547 epidemiology,71-0664 benzo(a)pyrene content, 71-0028 oral contraceptives and, 71-0664, 71-0906 carcinogenicity, 71-0203, 71-1145 smoking and, 71-0906 carcinogens in, 71-0810 in women, 71-0664 chemical properties, 71-0373 cocarcinogens in, 71-0810 THROMBOSIS consumption in Germany, 71-1249 (See alsoCARDIOVASCULAR DISEASES; CERE-

339 341:1 CUMULATIVE SUBJECT INDEX

BRAL EMBOLISM AND THROMBOSIS; CORO- effect on epithelial cells, 71-0789, 71-0791 NARY DISEASE; THROMBOANGHTIS OB- effect on mouth, 71-0676, 71.0690, 71 -1074 LITERANS) effect on mouth mucosa, 71-0789, 71 -0791 arteriosclerosis and, 71-0481, 71-0889 effectonmucousmembrane,71-014 3,71 -0145, in coronary disease etiology, 71-0301 71-014 9 pathological factors, 71-0486 in esophageal neoplasm etiology, 71-0590 physical activity and, 71-0486 in laryngeal neoplasm etiology, 71-0590 predisposing factors, 71.0486 in leukoplakia etiology, 71.1074 smoking in etiology of, 71 -1213 mouth diseases and, 71-0789 stress and, 71-0486 inmouthneoplasmetiology,71 -0247,71 -0590, 71 -0859, 71-0987, 71-1152 TISSUES in pharyngeal neoplasm etiology, 71 -0247, 71 -0590 effect of antitrypsin deficiency, 71-1073 effect of carbon monoxide, 71 -0722 TOBACCO EXTRACTS analysis, 71-0837 TOBACCO as cocarcinogen, 71-0425, 71-0435 advertising, 71-0339 aflatoxins in, 71-0209 TOBACCO FERMENTATION PRODUCTS alkaloid content, 71-0003 effect on adrenal glands, 71-0724 allergy, 71-0236, 71 -0498, 71 -0504, 71.1157 effect on catccholamine metabolism, 71 -0724 consumption, 71-1260 effect on central nervous system in rabbits, 71 -0357 effect of processing methods, 71-0755, 71-0971 effect on enzyme activity in rabbits, 71-05 5 0 effect on antigen-antibody reactions, 71-0505 effect on organophosphorus compounds, 71 -0550 effect on ascorbic acid deficiency, 71-0794 effect on organs in rabbits, 71-0357 effect on eyes, 71-0677 effect on gastrointestinal tract, 71-0504 TOBACCO INDUSTRY effect on mouth, 71-0504 advertising and, 71-0339, 71-0529, 71 -0530, 71-0538, effect on skin, 71-0498 71-1094, 71-1095 fungi in, 71-0716 antismokingcampaigns and,71 -0952, 71-1094, labeling, 71-0515 71-1095 mouth neoplasms and, 71-0692 in Bulgaria, 71-0003, 71-0331 nicotine content, 71-0003 cigarette sales and, 71-0527 nitrates in, 71-0402 in Connecticut, 71-0341 pesticide residues in, 71 -0365, 71-0383 economics, 71.1260 statistics, 71-0341 _ in Greece, 71-0408 sterol content, 71-0019 history, 71-0538 tar and nicotine content, 71-0971 in Hungary, 71-0026 taxation, 71-0515 research findings and, 71-0433, 71-0746, 7 1-075 1 tcratogenic effects in swine, 71 -0790 research programs, 71-0713 toxicity, 71-0017, 71-0236 . in Russia, 71-0794 statistics, 71-0530 TOBACCO ADDITIVES in United States, 71-0177 (See alsoGLYCERIN; GLYCOLS; HUMECTANTS; MENTHOL) TOBACCO LEAF COMPONENTS analysis, 71-0845 analysis, 71-0837 cannabii derivatives, 71 -1106 aliphatic amines, 71-0010, 71-0361 carbohydrates, 71-0813, 71-0814 alkaloids in, 71-0409 in cigarette smoke, 71-0813 analysis, 71-0829 in cigar smoke, 71-0966 aromatic hydrocarbons, 71-0354 in cigar wrappers, 71-0966 carbohydrates in, 71-0409 effect on aromatic hydrocarbons, 71-0547 cocarcinogenicity, 71-0415 effect on ciliary activity in cats, 71-0959 cocarcinogens in, 71-0425 effect on combustion temperature, 71-0837 effect of processing methods, 71 -0414 effect on lungs, 71-1172 effect on smoke, 71-0578 effect on nicotine content, 71 -0219 effect on tar content, 71-0578 effect on smoke, 71-0837 fatty acids, 71-0725 glycerin, 71-0219 in neoplasm induction, 71-0415 glycols, 71-0219, 71-0845 pesticide residues in, 71-1117 lipids, 71-1172 pheno.71-0191 menthol, 71-1223 pigme...9, 71-0425 pyrolysis products, 71-0388, 71-0814 sterols, 71-0009 sugar content, 71-0009, 71-0409 Tobacco alkaloidsSeeALKALOIDS, TOBACCO tobacco mosaic virus, 71-0191 tobacco variety and, 71-0354 Tobacco amblyopiaSeeAMBLYOPIA, TOBACCO volatile compounds, 71-0725

TOBACCO CHEWING TOBACCO MOSAIC VIRUS (See alsoARECA CHEWING; SMOKING) carcinogenicity, 71-0240 coronary disease and, 71-1211 effect of processing methods, 71 -0240

342 340 CUMULATIVE SUBJECT INDEX

passive smoking and, 71 -0240 bronchitis and, 71.1162 phenols and, 71-0191 chronic bronchopulmonary disease and, 71.0460 in tobacco, 71-0191 cough and, 71-1021 in tobacco smoke, 71-0191 effect on lung function, 71-0089 heart diseases and, 71-0299 TOBACCO PYROLYSIS PRODUCTS in Krakow, Poland, 71-1021 aliphatic hydrocarbons, 71-0002, 71-0217, 71-0387 in lung neoplasm etiology, 71-0052 analysis, 71-0042, 71-0556, 71-0578, 71-0813, occupation as a factor, 71-0299 71-0814 smokers vs. nonsmokers, 71-0095, 71.0460 carboxylic acids, 71-0821 smoking and, 71-0052, 71-0083, 71-0089, 71-10 2 1, carcinogenicity, 71-0201 71-1134, 71 -1162 cocarcinogenicity, 71-0415 therapy, 71 -0052 effect of nitrates, 71-0402 effect of processing methods, 71-0556 Tumor initiating agentsSeeCARCINOGENS effect of tobacco additives, 7 1-0 3 88, 71-0837 heterocyclic compounds, 71 -0385 Tumor promoting agentsSeeCOCARCINOGENS in neoplasm induction, 71-0415 phenols, 7I-0240 TWINS pyridines, 71-0823 cardiovascular diseases and, 71-1193 semi-volatile compounds, 71-0 20 0, 71-0374, 71-0417 chronic bronchopulmonary diseases and, 71-1193 tobacco variety and, 71-0201 coronary disease and, 71-0484, 71-0657 volatilecompounds,71-0375, 71-0380,71-041.7, smoking and, 71 -0484, 71-1193 71-0821

Tobacco smoke SeeSMOKE, TOBACCO

Tobaccosmoke,particulate phase See TARS, TOBACCO ULCER, PEPTIC (See alsoGASTROINTESTINAL DISEASES) TOBACCO VARIETIES antitrypsin deficiency and, 71-1170 alkaloidcontent, 71-0414 in Calcutta, India, 71-0507 analysis, 71-0026 epidemiology, 71-0507 aromatic hydrocarbons, 71-0354 experimentally induced in rats, 71-0974 blackfat tobacco, 71-1172 myocardial infarct and, 71.0114 carcinogenicity reduction and, 71 -0971 nicotine and, 71-0683, 71-0974, 71-1221 effect of irrigation, 71-0408 personality as a factor, 71-0785 effect of processing methods, 71-0870 predisposing factors, 71-0680 effect on respiratory tract, 71-0 87 0 smoking and, 71-0114, 71-0244, 71-0507,71-0680, effect on tobacco pyrolysis, 71 -0201 71-0785, 71-0901,71.0913,71-0918,71-0974. in Hungary, 71-0026 71-0982,71-0984,71-1133,71-1134,71-1216. lipids in, 71.1172 71-1225, 71-1226 nicotine content, 71-0408, 71 -0414 smoking in etiology of, 71-0514 nomicotine content, 71-0414 in South Australia, 71-1216 tar content, 71-0578 stress and, 7 1-0785

TONGUE DISEASES Urinary bladder cancerSeeBLADDER NEOPLASMS (See alsoMOUTH DISEASES) age as a factor, 71-0693 UlUNE sex as a factor, 71-0693 amines in, 71-0976 smoking and, 71-0693 analysis, 71-1107, 71.1108 aromatic hydrocarbons in, 71-0827 TonsMar neoplasmsSeePHARYNGEAL NEOPLASMS lead levels in, 71-0577 TRACHEA (See alsoRESPIRATORY SYSTEM) UROGENITAL NEOPLASMS effect of aldehydes, 71-0192 (See also BLADDER NEOPLASMS; KIDNEY NEO- effect of nitrosamines, 71-0744 PLASMS; PROSTATIC NEOPLASMS) age as a factor, 71-0054 TRIGLYCERIDE LEVELS coffee-drinking and, 71-0850 age as a factor, 71-0907 sex as a factor, 71-0054, 71-0850 arteriosclerosis and, 71-1201 smoking and, 71-0054, 71-0144, 71-0850 body constitution and, 71-0907 smoking and, 71-0907 UROGENITAL SYSTEM (See alsoKIDNEYS) TUBERCULOSIS effect of smoking, 71-0144, 71-0154 (See alsoLUNG DISEASES; RESPIRATORY TRACT DISEASES) UTERUS in Australia, 71-0052 effect of smoking, 71-0144, 71-1064 CUMULATIVE SUBJECT INDEX

VAGOTOMY VOLATILE COMPOUNDS effect on nicotine pharmacology, 714.1511, 71-0512 (See alsoSEMI-VOLATILE COMPOUNDS) analysis, 71-0829 VASCULAR DISEASES in cigarette smoke, 71-0556, 71-0822 (,See also ARTERIAL DISEASES; CARDIO- in cigarette tars, 71-0810 VASCULAR DISEASES) as cocarcinogens, 71-0810 age as a factor, 71-0892, 71.1062 determination in tobacco leaf, 71-0725 Framingham study, 71-1043 formation in tobacco pyrolysis, 71-0821 nicotine and, 71-0115, 71-0652 in tobacco smoke, 71-0821 pathogenesis, 71-0652 in tobacco tars, 71-0375, 71-0380, 71-0417 screening, 71-0892 sex as a factor, 71.1062 smoking and, 71-0115, 71-0479, 71-0892, 71.1037, 71-1062, 71-1208, 71-1213 Water contentSeeMOISTURE CONTENT smoking in etiology of, 71-1043 WITHDRAWAL CLINICS Ventilatory function testsSeeRESPIRATORY FUNC- (See alsoCESSATION OF SMOKING; REDUCTION TION TESTS OF SMOKING) behavior therapy, 71-0345, 71-0349 in cessation of smoking, 71-0951 VISION in Connecticut, 71-0539 (See alsoEYES) in Copenhagen, Denmark, 71-0708 effect of air pollution, 71-0965 drug therapy, 71-0330, 71-0536, 71-0708, 71.1262 effect of alcohol, 71-0501 evaluation, 71-1025, 71-1099, 71.1267 71-0358,71-0366, effectofcarbonmonoxide, follow-up studies, 71-1098, 71.1267 71-0395, 71-0965, 71-0970 in Germany, 71-0717 effect of environment, 71-0679 in Goteborg, Sweden, 714)709 effect of nutrition, 71-0679 71-0501,71-0566, group therapy, 71-1262 effectofsmoking,71-0307, hypnosis in, 71-1267 71-0679 methods, 71-0346,71-0347,71-0531,71-0540, tobacco amblyopia and, 71 -0307 71-0708, 71-0709, 71-0935 psychotherapy, 71-0330 Visual perceptionSeeVISION research programs, 714)540 role of physicians, 714)337 VitalcapacitymeasurementsSee RESPIRATORY in Salers, France, 71-1097 FUNCTION TESTS scopolamine in, 71-0536 stimulus saturation, 71-0346, 71-0349 VITAMIN B13 DEFICIENCY in Sweden, 714)531, 71-0536 tobacco amblyopia and, 71-0312 in United Kingdom, 71-1102

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