Factors associated with weight changes in successful quitters participating in a smoking cessation program.

OBJECTIVE: To identify possible predictors of post-cessation weight gain in smoking abstainers. PATIENTS AND METHODS: A sample of 607 successful abstainers seen at the Centre for Tobacco-Dependent in Prague, Czech Republic, between 2005 and 2010, was included in this analysis. This sample was followed up for 1year and included 47.9% women (N=291) with the mean age of 48years (18-85). FINDINGS: Post-cessation weight gain occurred in 88.6% of the 607 abstainers. The mean weight gain after one year post-quit was 5.1kg (95% confidence interval 4.7-5.5kg). Baseline characteristics associated with increased weight gain included a higher baseline smoking rate (p<0.001), more severe cigarette dependence (p=0.003), less physical activity (p=0.008), and a report of increased appetite on the baseline assessment of withdrawal symptoms (p<0.001). CONCLUSIONS: Smokers who are more dependent and have minimal physical activity are at increased risk for post-cessation weight gain. For these smokers, incorporating interventions targeting the weight issue into tobacco dependence treatment is recommended. Further research should be done to identify reasons for this important quitting complication.

Tobacco treatment outcomes in patients with and without a history of depression, Czech Republic, 2005-2010.

INTRODUCTION: Higher prevalence of smoking among depressed patients, as well as the risk of depression in smokers, is well documented. The proportion of patients with a history of depression among those seeking intensive treatment of tobacco dependence is also high. In contrast, evidence of treatment success in this subgroup of patients is controversial. The aim of this study was to compare smoking abstinence rates after tobacco treatment in smokers with and without a history of depression. METHODS: We reviewed retrospective data from 1,730 smokers seeking treatment in Prague, Czech Republic. History of depression was defined as past diagnosis of depression or current treatment of depression. After a 1-year, self-reported smoking status was validated by expired-air carbon monoxide. We used logistic regression to analyze associations between abstinence rates, history of depression, and other factors (eg, age, sex, tobacco dependence). RESULTS: Of 1,730 smokers treated, 289 (16.7%) had a history of depression. The smoking abstinence rate at 1 year was 32.5% for smokers with a history of depression and 38.7% for those with no history (P = .048). Among women, abstinence did not differ between groups (35.0% vs 35.7%; P = .86). However, among men, those with a history of depression had lower rates of abstinence (27.4% vs 41.3%; P = .009). After adjustment for baseline covariates, history of depression was not significantly associated with smoking abstinence in men or women. CONCLUSION: Intensive outpatient tobacco treatment programs can achieve abstinence rates among smokers with a history of depression similar to rates among the general population.

The role of a center for tobacco-dependent in cardiovascular prevention. A retrospective study.

OBJECTIVES: Smoking cessation is an essential part of cardiovascular disease (CVD) prevention. At the Center for Tobacco-Dependent (CTD), clients are screened to identify and reduce cardiovascular (CV) risk factors. In our study we have focused on the role of the CTD in reducing global CV risk. METHODS: 1,334 CTD patients aged 25-64 years (52.2% men, mean age 44±12 years, Fagerström Test for Cigarette Dependence 6±2) were included in a retrospective cross-sectional survey. Medical history, blood samples and physical examination were analysed. Blood pressure, weight and exhaled CO were measured at each visit (12-months-follow-up). Patients' CV risk was scored. CO-verified abstinence according to CV risk and prevalence of detected CV risk factors were examined. RESULTS: Among patients who had attended at least their first visit and a visit after one year, 37.9% (506/1,334) had stopped smoking. Among patients with a SCORE of <5%, the success rate was 44.3% (254/574) and 41.2% for patients at high CV risk (105/255, p=0.41). There was a trend towards a lower success rate among patients with CVD, but this difference was not significant. The smoking cessation rate among low and high CV risk patients at the baseline visit was identical (46.2%, resp. 47.3%, p=0.81). 3.1% (42/1,334) of patients were referred to a specialist for hypertension. 62.5% (223/357), without a prior history, were found to have dyslipidemia. CONCLUSIONS: High CV risk patients have the same chance to stop smoking as low risk patients.

Efficacious but insidious: a retrospective analysis of fludarabine-induced myelotoxicity using long-term culture-initiating cells in 100 follicular lymphoma patients.

OBJECTIVE: Fludarabine has been recognized as effective treatment in patients with follicular lymphoma (FL), but can induce myelotoxicity of unknown mechanism. MATERIALS AND METHODS: Myelotoxicity was assessed by cultivation of two types of hematopoietic progenitor cells: colony-forming units granulocyte-macrophage (CFU-GM) and long-term culture-initiating cells (LTC-IC). Pretreatment amounts of CFU-GM and LTC-IC were correlated to age, gender, stage of disease, bone marrow involvement, and previous therapy. Posttreatment comparison of CFU-GM and LTC-IC was performed after different regimens of chemotherapy: fludarabine-based (FND +/- R), procarbazine-based (COPP +/- R), and CHOP(cyclophosphamide, doxorubicin, vincristine, prednisone) +/- R(Rituximab). RESULTS: One-hundred patients (median age 55 years; 21 patients relapsed) treated for FL were analyzed. The total number of progenitor hematopoietic cells in both types of cultures varied in wide ranges; for LTC-IC between 0 and 874 cells/mL with a median of 77.71 cells/mL and for CFU-GM between 0 and 531 x 10(2) cells/mL with a median of 30.58 x 10(2) cells/mL. Bone marrow involvement, gender, stage of disease, or previous therapy had no influence on LTC-IC and CFU-GM counts. We identified an increase in LTC-IC, but not CFU-GM, associated with age (p = 0.01). Median figures for CFU-GM and LTC-IC were found to be significantly lower after FND +/- R and COPP +/- R than after CHOP +/- R therapy, compared to baseline values (p < 0.01). CONCLUSIONS: Fludarabine and procarbazine have a dramatic influence, especially on the most immature hematopoietic cells, mirrored in reduced numbers of LTC-IC. This finding is consistent with clinical observations (poor mobilization after fludarabine) and offers an insight into the mechanism of fludarabine-induced myelotoxicity.