What are the Differences Between Smoker and Non-smoker COPD Cases? Is it a Different Phenotype?

OBJECTIVE: The most important risk factor for chronic obstructive pulmonary disease (COPD) is smoking. However, more than 25% of patients do not have a history of smoking. The intent of this study is to identify characteristics of COPD patients that are non-smokers. MATERIAL AND METHODS: The records of patients with COPD were retrospectively reviewed. Smoking history, comorbidities, exacerbations, biomass, and environmental tobacco smoke (ETS) exposures were identified. Also, age, gender, pulmonary function test (PFT) values, modified Medical Research Council (mMRC) dyspnea scores were recorded. Non-smokers exposed to any of the COPD risk factors above were grouped and the data were analyzed to determine the specific characteristics of COPD that applied to them. RESULTS: A total of 706 COPD patients were analyzed with a mean age of 67.2 ± 9.4. Of these patients, 93 (13.2%) were female and 613 (86.8%) were male. Of the 706 patients, 128 (18.1%) were non-smokers. The percentage of male patients having COPD was significantly lower in the non-smoker group (P < .001). However, biomass, ETS exposure in childhood, and a history of previous respiratory infection were significantly higher in the non-smoker group (P < .001). The mean body mass index (BMI) was greater in non-smokers than smokers. CONCLUSION: Non-smokers with COPD have more biomass, ETS exposure, and infection history in childhood. They also have less impairment of airflow limitation, better symptom scores, and greater BMIs. Smoking history can be used to determine a different phenotype.

Body surface area: a new anthropometric measurement for obstructive sleep apnea syndrome.

INTRODUCTION: We aimed to explore the possibility of using body surface area (BSA) as a new anthropometric measurement in evaluation of OSAS. MATERIALS AND METHODS: Obesity was defined as having a BMI ≥ 30 kg/m2. BSA were calculated using the Mosteller and Boyd formulas. Totaly 426 (306 male) cases were included in this study. RESULT: The mean BMI was 33.0 kg/m2. The mean BSA was 2.06 m2 and 2.11 m2 respectively. BMI, AHI, oxygen desaturation, ODI and oxygen saturation were found different between the groups. Both BMI and BSA correlated positively with AHI, oxygen desaturation and ODI and negatively with oxygen saturation. There was no difference between BMI and BSA in mild cases in both gender. However, in moderate and severe cases, BMI and BSA were higher in males. We dedected that BSA and BMI display similar sensitivity and specificity values for the prediction of severe OSAS. CONCLUSIONS: To the best of our knowledge, this is the first study to examine the potential association between BSA and the severity of OSAS. As a result, we determined that BSA correlated with polisomnographic parameters as BMI. In severe OSAS BSA can be used as a predictor parameter like BMI.

Predictive value of platelet-to-lymphocyte ratio in exacerbation of chronic obstructive pulmonary disease.

AIM: We aimed to assess the platelet-to-lymphocyte ratio (PLR) and platelet parameters in patients with chronic obstructive pulmonary disease (COPD). METHODS: A total of 60 stable COPD patients, 50 acute exacerbation COPD patients and 50 healthy controls were enrolled in this study. RESULTS: The platelet distribution width and PLR were higher and the mean platelet volume was lower in the COPD patients during acute exacerbation compared with the stable patients and controls. The PLR was negatively correlated with the forced expiratory volume in 1 s. CONCLUSION: The PLR may be used as a useful and easily accessible tool for evaluating the ongoing inflammation during stable period and the disease severity during acute exacerbations in COPD patients.

Effect of obstructive sleep apnea syndrome on corneal thickness.

Obstructive sleep apnea syndrome (OSAS) might be a risk factor for the development of eye disorders. The aim of the study was to evaluate the effect of OSAS on central corneal thickness (CCT). A total of 195 patients were enrolled in the study, and underwent polysomnography. Patients were divided according to their apnea-hypopnea index (AHI) scores into control group (AHI < 5), mild (AHI, 5-15), moderate (AHI, 15-30), and severe OSAS (AHI > 30) groups. In ophthalmological examinations, CCT, auto refractometer measurement, tear break-up time, and Schrimer's test results were evaluated. Central corneal thickness was significantly decreased in patients with OSAS compared to the control group (542.14 ± 31.21 vs. 569.92 ± 13.46, p < 0.001). As the severity of OSAS increased, CCT decreased (mild OSAS = 567.48 ± 23 mm, moderate OSAS = 530.21 ± 30.2 mm, and severe OSAS = 557.97 ± 16.52 mm, respectively, p < 0.001). The mean values of auto refractometer, tear break-up time, and Schrimer's test were similar between the groups (p > 0.05). CCT was negatively correlated with AHI, oxygen desaturation index, desaturation percentages, and positively correlated with minimum oxygen saturation values (p < 0.05). This study showed that central corneal thickness is inversely correlated with the severity of OSAS. OSAS affects all organ systems particularly cardiovascular and neurological mechanisms. Further studies are warranted to evaluate the effect of OSAS treatment on CCT.

Platelet-lymphocyte ratio is an independent predictor for cardiovascular disease in obstructive sleep apnea syndrome.

There is a strong relationship between obstructive sleep apnea syndrome (OSAS) and cardiovascular disease (CVD). Chronic intermittent hypoxia, inflammation, oxidative stress, and endothelial dysfunction may constitute etiologic mechanisms, linking OSAS to CVD. Inflammation play an important role in the development of CVD. Platelet-lymphocyte ratio (PLR) is a new biomarker showing inflammation. No previous study has ever investigated the association between PLR, CVD and OSAS severity in patients with OSAS. This study was designed to investigate the association between PLR and CVD in patients with OSAS, and relationship between severity of OSAS, polysomnographic parameters and PLR. This was a cohort study in which patients who had undergone a full night polysomnoraphy for diagnosis of OSA were recruited. Patients were divided according to their apnea-hypopnea index (AHI) scores into OSAS negative (Group 1: AHI < 5), mild (Group 2: AHI, 5-15), moderate (Group 3:AHI,15-30), and severe OSAS (Group 4: AHI > 30) groups. The presence of heart failure, coronary artery disease or arrhythmia was defined as CVD. A total of 424 patients were included in this study. There were 57, 93, 82, and 192 patients in Groups 1, 2, 3, and 4, respectively. PLR were significantly different between groups (Group 1: 87.38; Group 2: 95.07; Group 3: 97.01, Group 4: 126.9, P < 0.05). PLR were significantly correlated with AHI, oxygen desaturation index, average and minimum O2 saturation values (P < 0.05). Values of PLR were significantly higher in patients with CVD compared with those without. Multiple regression analysis demonstrated that PLR is an independent predictor of CVD. PLR cut-off value for demonstrating the presence of CVD is higher than 108.56. In the light oh findings, PLR is strongly associated with the severity of OSAS and cardiovascular disease in OSAS patients. PLR might be used as a biomarker to predict CVD in OSAS patients.

The opinion of catering sector about the smoking ban and the evaluation of establishments.

INTRODUCTION: We aimed to evaluate the knowledge and perspective of employees/employers in the catering sector in our city regarding the smoking ban, as well as to determine the changes in the number of customers and income after the bans implementation. MATERIALS AND METHODS: In this two phased cross-sectional study 337 and 310 adults were evaluated respectively. Before the smoking ban was implemented we visited 84 workplaces in city center, after 18 months later 97 workplaces were visited in the same region. In both phases, the participants' opinions about the necessity/applicability of the ban were evaluated. In the second phase, they were also asked whether they had any changes in their income. RESULTS: In both phases, participants' general characteristics were similar. When all participants were evaluated, we determined that their knowledge and belief in the necessity/applicability of the ban did not change over time. It was determined that non-smokers more strongly believed in the necessity/applicability of the ban. Thirty-eight participants were included in both phases; 44.7% of them reported a decrease in the number of customers, and 60% of employers reported an increase in their income. CONCLUSION: The smokers were less convinced about the applicability/necessity of this ban than non-smokers. According to our results it could be said that smoking can also adversely affect implementation of the related ban. Employers should be informed that the ban will not affect their income.

The effect of personality disorders on asthma severity and quality of life.

Assesment of health related quality of life (HRQL) is increasingly recognized as an important part of the patient care in asthma. We aimed to evaluate the effect of personality disorders (PDs) on HRQL and the severity of disease in asthmatic patients. Ninety seven consecutive patients with asthma and ninety healthy controls were included. All patients completed a Short Form-36 health survey (SF-36) and Structured Clinical Interview Form for DSM-III-R Axis-II Disorders (SCID-II). All SF-36 questionnaire scores of asthmatic patients were significantly lower than the controls. There were statistical differences between the asthma severity and the mean scores of vitality and emotional role difficulties of HRQL's subdomains (p=0.03, p=0.014, respectively). There was a weak but statistically significant correlation between the scores of pain and emotional role difficulties, and forced expiratory volume in 1 second (FEV1) (r=0.27, p=0.007; r=0.24, p=0.01, respectively). When compared to healthy controls, patients with asthma had higher prevalence of PDs (p=0.0001). The most common PDs found in asthmatic patients were obsessive-compulsive and avoidant PDs. HRQL values of asthma patients with PDs were significantly lower than patients without PDs except for the physical functioning subscores on HRQL. We conclude that patients with asthma have higher prevalence of PDs, which is associated with their poor quality of life. A psychiatric evaluation may be beneficial in patients with asthma if a concomitant PD is suspected.

Cysteinyl leukotrienes in exhaled breath condensate of smoking asthmatics.

BACKGROUND: Cysteinyl leukotrienes (CysLTs) are among important inflammatory mediators in asthma pathogenesis. In this study, we aimed to determine leukotriene D4 (LTD4) and leukotriene E4 (LTE4) levels in exhaled breath condensate (EBC) in asthmatics and to evaluate the effect of smoking upon CysLTs levels and to speculate the importance of adding leukotriene receptor antagonists in smoking asthmatics. METHODS: A total of 88 participants were included in the study. Of them, 59 were asthmatics; 30 of the 59 asthmatics were smokers (Group I) and the others were non-smokers (Group II). As a control group (Group III), 29 healthy non-smokers were enrolled. EBC samples were collected (EcoScreen, Jaeger, Hoechberg, Germany) and pulmonary function tests (PFTs) were performed in each case, and an asthma control questionnaire (ACQ) was completed by the asthmatics. LTD4 and LTE4 levels in EBC samples were analyzed by using ELISA. RESULTS: LTD4 levels were found to be higher in Group I than other groups and similar in Group II and Group III. LTE4 levels were lower in Group III than other groups and similar in Group I and Group II. PFTs were different between Group I and Group III and there was a significant negative correlation between LTE4 levels and forced expiratory volume in one second and forced vital capacity ratio in Group I. CONCLUSIONS: LTD4, but not LTE4, concentrations in EBC were higher in asthmatic smokers than asthmatic nonsmokers. LTE4 concentrations in EBC were higher in asthmatics than healthy non-smokers. In smoking asthmatics usage of agents that block the effects of LTD4 can be beneficial; however, new clinical studies are required.

The role of molds in the relation between indoor environment and atopy in asthma patients.

BACKGROUND: The effect of mold fungi to allergic sensitization is not well-known. We aimed to evaluate the role of molds in the relation between indoor environment and atopy in asthmatics. MATERIALS AND METHODS: The air samples obtained from 66 stable asthmatics and 35 control subject's houses were sprayed into Sabouraud dextrose agar. Allergy skin testing were performed in both groups. The temperature and humidity of each house were measured. RESULTS: The incidence of atopy was similar in cases (59.1%) and controls (51.4%). The average amount of mold was 35.9 CFU/m(3) and 34.3 CFU/m(3), respectively. The number of household residents was positively correlated with the amount of molds. There was no difference in the amount of mold with respect to dosage of inhaler corticosteroids as well as symptom levels in asthmatics. The most frequently encountered allergens were Dermatophagoides farinae/Dermatophagoides pteronyssinus, grass/weeds and molds. Spending childhood in a village was more common among atopics. CONCLUSION: Living environment during the childhood might affect atopy and asthma. Based on the identification of molds as the second most frequent allergen after mites in our study population, assessment of mold sensitization as well as in forming patients about ways to avoid them seem likely to contribute to the effective management of uncontrolled asthma.

Serum levels of gamma-glutamyl transferase are associated with cardiovascular disease in obstructive sleep apnea syndrome.

BACKGROUND AND OBJECTIVES: Obstructive sleep apnea syndrome (OSAS) significantly increases the risk of cardiovascular disease (CVD). Gamma-glutamyl transferase (GGT) is a new marker for predicting CVD. The aim of this study was to evaluate the relationship of serum GGT levels with cardiovascular event, severity of OSAS, and polysomnographic parameters in patients with OSAS. DESIGN AND SETTINGS: This was a retrospective, cross-sectional study conducted between January 2011 and March 2013 (Gaziosmanpasa University, Faculty of Medicine, Tokat, Turkey). METHODS: We performed a retrospective study. Patients were divided according to their apnea-hypopnea index (AHI) scores into OSAS negative (AHI < 5, Group 1), mild OSAS (AHI: 5-15, Group 2), moderate OSAS (AHI=15.30, Group 3), and severe OSAS (AHI > 30, Group 4) groups. The presence of heart failure, coronary artery disease, or arrhythmia was defined as CVD. RESULTS: A total of 320 patients, with a mean age of 50.2 (10.8) years, were included in this study. There were 47, 68, 58, and 147 patients in Groups 1, 2, 3, and 4, respectively. Serum GGT levels were significantly different between groups (Group 1: 25.24 [14.95]; Group 2: 28.03 [11.92]; Group 3: 32.82 [18.18], and Group 4: 40.41 [31.90] mg/dL , P < .001). Besides, serum GGT levels were significantly correlated with AHI, oxygen desaturation index, and average and minimum O2 saturation values (P < .05). Serum GGT levels were significantly higher in patients with CVD compared with those without (P < .05). Multiple regression analysis demonstrated that independent predictors of CVD were serum GGT and low-density lipoprotein-cholesterol levels, age, and body mass index in patients with OSAS. CONCLUSION: GGT level is an important predictor for CVD in patients with OSAS. The effectiveness of continuous positive airway pressure therapy on CVD and GGT levels should be investigated.

Evaluation of visual field parameters in patients with chronic obstructive pulmonary disease.

PURPOSE: To evaluate the effects of chronic obstructive pulmonary disease (COPD) on retina and optic nerve. METHODS: Thirty-eight patients with COPD and 29 healthy controls, totally 67 subjects, were included in the study. Visual evoked potentials (VEP) and visual field assessment (both standard achromatic perimetry (SAP) and short-wavelength automated perimetry (SWAP)) were performed on each subject after ophthalmological, neurological and pulmonary examinations. RESULTS: Mean deviation (MD), pattern standard deviation (PSD) and corrected pattern standard deviation (CPSD) were significantly different between patient and control groups as for both SAP and SWAP measurements (p = 0.001, 0.019, 0.009 and p = 0.004,0.019, 0.031, respectively). Short-term fluctuation (SF) was not statistically different between the study and the control groups (p = 0.874 and 0.694, respectively). VEP P100 latencies were significantly different between patients with COPD and the controls (p = 0.019). CONCLUSION: Chronic obstructive pulmonary disease is a systemic disease, and hypoxia in COPD seems to affect the retina and the optic nerve.

The value of the computed tomographic obstruction index in the identification of massive pulmonary thromboembolism.

PURPOSE: In this study, the pulmonary arterial computed tomography obstruction index ratio, which indicates the degree and extent of thrombotic arterial occlusion, was calculated in cases with pulmonary thromboembolism. Our objectives were to investigate the value of this index for the identification of cases with massive pulmonary thromboembolism and to search for correlations between this index and clinical parameters. MATERIALS AND METHODS: Data from 68 patients were evaluated retrospectively. For the clinical evaluation, the Wells scoring system was used. Pulmonary computed tomographic angiography examinations were acquired using an eight-channel multidetector computed tomography. The presence of arterial filling defects was recorded, and the clot burden was quantified based on the degree and extent of thrombotic arterial occlusion. RESULTS: According to the Wells scoring system, the patients were assigned to low (n = 14), moderate (n = 34), and high clinical (n = 20) possibility groups, and the difference among the mean pulmonary arterial computed tomography obstruction index ratios of the three groups was significant (P = 0.001). A positive correlation was observed between the pulmonary arterial computed tomography obstruction index ratio and the Wells score (r = 0.470, P < 0.001). The pulmonary arterial computed tomography obstruction index ratio cut-off point was determined to be 40% for the discrimination of massive and nonmassive cases (sensitivity, 72.7%; specificity, 91.4%). CONCLUSION: We found that in cases where the pulmonary arterial computed tomography obstruction index ratio was above 40%, a diagnosis of massive pulmonary thromboembolism was demonstrated. Furthermore, a positive correlation between the obstruction index and the Wells score suggested the use of a clinical evaluation as a means of developing a recommendation regarding the thrombotic load.

The trends of relevance about telling lung cancer diagnosis: social constraints, medical practice in several clinics.

INTRODUCTION: The aim of this study is to assess the opinions of relatives about telling the lung cancer diagnosis to the patient and evaluate the implementation in our hospital. MATERIALS AND METHODS: A survey questionnaire was designed, and applied on nurses and physicians working in oncology care units, 4th-6th grade medical students, and relatives of cancer and non-cancer patients. RESULTS: Totally 347 (228 males, 119 females) participants (64 physicians, 100 nurses, 61 medical students, and 122 relatives of patients) with a mean age of 28 were enrolled in the study. 62.5% of doctors, 53.2% of nurses, 59.5% of medical students and 45.9% of relatives of lung cancer patients thought that the patient should be informed about his/her cancer diagnosis. 29.5% of the physicians told their patients about their diagnosis of cancer. Gender, age, abroad experience, academic career, speciality, and period of professional experience were not determined to have any impact on physician's opinion and clinical practices. CONCLUSION: It was determined that physicians care more about patients' right to be informed than other participating groups. Generally, although physicians agree that the diagnosis of cancer should be told to the patient, their routine clinical practices do not reflect this viewpoint.

Procalcitonin: Is it a predictor of noninvasive positive pressure ventilation necessity in acute chronic obstructive pulmonary disease exacerbation?

BACKGROUND: Acute exacerbations of chronic obstructive pulmonary disease (AeCOPD) are important causes of morbidity and mortality. In this study, we analyzed procalcitonin (PCT) levels in AeCOPD and stable period of COPD in order to evaluate usage of PCT in the prediction of the severity of AeCOPD, and its value on the planing of noninvasive positive pressure ventilation (NPPV). MATERIALS AND METHODS: In this cross sectional study (2009-2010) 118 COPD patients were enrolled, 68 of them (58%) were in acute exacerbations (case group). The others had stabile COPD and they were defined as control group. RESULTS: In case group the mean levels of PCT (0.19 ± 0.02) C-Reactive Protein (44.7 ± 5.92), erythrocyte sedimentation rate (28.4 ± 2.65), white blood cell (9.4 ± 0.43) and %neutrophils (69.9 ± 1.22) were significantly higher than controls (P = 0.0001). There was no difference between PCT levels based on stages of COPD. There were significiant differences in mean PCT levels according to type and severity of AeCOPD. Mean PCT level in hospitalized patients receiving NPPV was 0.36 ng/ml, while it was 0.15 ng/ml for those treated without NPPV (P = 0.0001). PCT cut-off value for NPPV indication was determined to be 0.10 ng/ml. CONCLUSIONS: PCT levels were found to be higher in AeCOPD patients than in stable COPD patients, as expected. Also mean PCT levels increased especially in cases with severe AeCOPD and those receiving NPPV among them. In the present study, we determined a cut off value of PCT as 0.10 ng/ml as a predictor of necessity of NPPV in AeCOPD.

Oxidative stress levels in exhaled breath condensate associated with COPD and smoking.

BACKGROUND: COPD is characterized by chronic air-flow limitation. Smoking is the most important factor in the pathogenesis of COPD. Smoking is associated with increased oxidative stress in the lungs. In this study our aim was to evaluate the differences in the burden of oxidative stress in patients with COPD, smokers, and non-smokers by measuring hydrogen peroxide (H(2)O(2)), malondialdehyde (MDA), and 8-isoprostane levels in the exhaled breath condensate (EBC) samples. METHODS: Eighty subjects were included in the study. Group I (no. = 25) had COPD, Group II (no. = 26) was smokers, and Group III (no. = 29) was nonsmokers. The severity of the COPD and dyspnea was assessed according to the results of pulmonary function tests (PFTs) and Medical Research Council (MRC) scale. RESULTS: The mean age of the subjects was 58 ± 8.9 years. While 8-isoprostane and H(2)O(2) levels were significantly higher in subjects with COPD (44.8 ± 40.2 pg/mL and 1.9 ± 0.8 µmol/L) and smokers (41.3 ± 26 pg/mL and 1.7 ± 0.7 µmol/L) than non-smokers (15.8 ± 6.9 pg/mL and 0.8 ± 0.4 µmol/L), levels were similar between smokers and COPD subjects. MDA levels were similar between the 3 groups (P = .31). There was no correlation between 8-isoprostane and H(2)O(2) levels and PFT parameters. There was a significant positive correlation between dyspnea grade on the MRC scale and 8-isoprostane levels (r = 0.805, P < .001). CONCLUSIONS: Even if respiratory function tests are within normal limits, oxidant burden in lungs of smokers is equivalent to that in COPD patients. 8-isoprostane could be useful in assessing symptom severity and health status of COPD patients.

Oxidative status in the lungs associated with tobacco smoke exposure.

BACKGROUND: Oxidative stress has a critical role in inflammatory responce against tobacco smoke (TS). Testing exhaled breath condensate (EBC) samples is one of the methods used for assessment of airway inflammation caused by TS. We aimed to investigate oxidative stress in the lungs associated with TS and to evaluate the effect of this stress with pulmonary function tests (PFTs). METHODS: We included 69 subjects as three groups into the study (Group I; 26 smokers, Group II; 21 passive smokers, Group III; 22 non-smokers without TS exposure). Levels of malondialdehyde (MDA), 8-hydroxydeoxyguanosine (8-OHdG), nitrite/nitrate [index of nitric oxide (NO) production], vitamin C, superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) were measured in EBC samples collected using a condenser and PFTs were performed. RESULTS: The levels of MDA, 8-OHdG, SOD and GSH-Px were higher in smokers. NO levels gradually increased from Group I to Group III. MDA levels were lower in Group III than Group II. The levels of vitamin C were similar in all groups. We determined negative correlation between 8-OHdG levels and forced expiratory volume in one second (FEV1), and maximum mean expiratory flow (MMEF), and a positive correlation between SOD levels and FEV1. CONCLUSIONS: TS exposure affected the balance between oxidative stress and antioxidant capacity of lungs. Preventing environmental TS exposure might decrease oxidative damage. Increased levels of 8-OHdG and SOD levels could be assessed as an early sign of airway damage.

[Nicotine addiction and environmental tobacco smoke exposure]. / Nikotin bagimliligi ve çevresel tütün dumani maruziyeti.

In present study it was aimed to determine the general characteristics of cases who cause environmental tobacco smoke (ETS) exposure. One hundred and forty five cases (53/92, F/M) who admitted to smoking cessation clinic were asked about general demographic characteristics, the history of ETS exposure in childhood and whether they cause of ETS exposure or not. Also Fagernström test for nicotine dependence (FTND) and hospital anxiety depression test (HADT) were performed. The mean age of the cases was 42.2 years. It was determined that 71% of cases exposed ETS in childhood and 69% of cases cause ETS exposure. There was no effect of the number of cigarette smoked per day and the amount of packet/years on to cause ETS exposure. The cases who cause ETS exposure to be forced more than others in places that it is forbidden smoking (p= 0.045), FTND score was higher (mean= 5.9) than others (mean= 4.8) (p= 0.009). The FTND score was ≥ 5 in 72% of cases who cause ETS exposure and in 53.3% of others (p= 0.045). 117 of cases were performed HADT, symptoms related with anxiety and depression were detected in 45 and 54 of cases respectively. The mean anxiety score was higher in cases who cause ETS exposure (p= 0.025). The symptoms related with anxiety and depression were determined similar in cases who cause ETS exposure or not. It was identified that there was no effect of gender, education, business status, another smoker at home, history of ETS exposure in childhood, socioeconomic status and to have knowledge about passive smoking on to cause ETS exposure. Prevention of nicotine addiction to be developed by starting smoking precludes the onset of the diseases related to smoking, and also enables inhibition of ETS exposure especially at home.

[Evaluation of the knowledge and manner of workers of workplaces in Tokat about the ban on restriction of indoor smoking]. / Tokat'da kapali alanlarda sigara içiminin engellenmesine dair yasaya iliskin isletme çalisanlarinin bilgi ve tutumlarinin degerlendirilmesi.

To evaluate the knowledge and manner of cafe, pub and restaurant (with/without alcohol) workers in our city center about the ban on restriction of indoor smoking. To determine the preparation about the ban, smoking characteristics of workers, the knowledge on passive smoking. A questionnaire was performed to workers. The type of workplace, the number of workers, existence of a restriction of indoor smoking, any preparation about the ban were asked. The job of worker, whether the worker has a knowledge on the ban or not, the idea of the workers on the necessity and practicability of the ban were asked. Smoking history and the knowledge about passive smoking of workers were recorded. Fagerstrom nicotine dependent test (FNDT) was performed to smokers. Eighty four work places with 568 workers included in the study. The questionnaire was performed to 337 workers whose mean age was 29.1/years. 292 of workers were male. 190 of cases were current smokers. 166 of cases (49.3%) know the meaning of passive smoking. Alcohol offering was made at 8 of workplaces. Smoking was forbidden in 20 of workplaces. A preparation was performed about the ban in 30 of (46.9%) other workplaces. 88.4% of workers have knowledge on the ban, 64.7% of them know the punishment of the noncompliance of the ban. 81.3% of the workers believe the necessity and 45.7% of them believe the practicability of the ban. Smokers and especially who's FNBT > 5 have a stronger belief on the necessity and practicability of the ban. We determined that the preparation about the ban was inadequate although there was an little time for the put into practice the law. So we think that the controls of workplaces should be happened frequent.