Relationship of altitude mountain sickness and smoking: a Catalan traveller's cohort study.

OBJECTIVES: The aim of this study is to analyse the relationship between smoking and altitude mountain sickness in a cohort of travellers to 2500 metres above sea level (masl) or higher. SETTING: Travel Health Clinic at the Hospital Universitari de Bellvitge, in Barcelona, Spain. PARTICIPANTS: A total of 302 adults seeking medical advice at the travel clinic, between July 2012 and August 2014, before travelling to 2500 masl or above, who agreed to participate in the study and to be contacted after the trip were included. Individuals who met the following criteria were excluded: younger than 18 years old, taking carbonic anhydrase inhibitors for chronic use, undergoing treatment with systemic corticosteroids and taking any medication that might prevent or treat altitude mountain sickness (AMS) prior to or during the trip. The majority of participants were women (n=156, 51.7%). The mean age was 37.7 years (SD 12.3). The studied cohort included 74 smokers (24.5%), 158 (52.3%) non-smokers and 70 (23.2%) ex-smokers. No statistical differences were observed between different sociodemographic characteristics, constitutional symptoms or drug use and smoking status. OUTCOMES: The main outcome was the development of AMS, which was defined according to the Lake Louise AMS criteria. RESULTS: AMS, according to the Lake Louise score, was significantly lower in smokers; the value was 14.9%, 95% CI (6.8 to 23.0%) in smokers and 29.4%, 95% CI (23.5 to 35.3%) in non-smokers with an adjusted OR of 0.54, 95% CI (0.31 to 0.97) independent of gender, age and maximum altitude reached. CONCLUSIONS: These results suggest that smoking could reduce the risk of AMS in non-acclimated individuals. Further studies should be performed in larger cohorts of travellers to confirm these results. Despite the results, smoking must be strongly discouraged because it greatly increases the risk of cardiorespiratory diseases, cancer and other diseases.

Brief smoking cessation intervention in hospitalized patients with cardiovascular disease.

The objective of this study was to determine the smoking abstinence rate after hospital discharge in cardiovascular patients who had undergone a brief smoking cessation intervention during hospitalization. The prospective cohort study involved 252 smokers who were admitted to the Hospital Universitari de Bellvitge in Catalonia, Spain. Twenty-four hours after hospital discharge, 76.6% of patients were still abstaining from smoking. At 1, 3, 9 and 12 months, the abstinence rate diminished to 71.4%, 67.2%, 64.1% and 62.2%, respectively. Patients diagnosed with ischemic cardiopathy had a significantly lower probability of a smoking relapse: hazard ratio=0.56 (95% confidence interval, 0.36-0.87). At our center, a brief smoking cessation intervention in cardiovascular patients during hospital admission was found unlikely to result in smoking abstinence following discharge.

Breve intervención de cesación tabáquica en enfermos cardiovasculares hospitalizados / Brief smoking cessation intervention in hospitalized patients with cardiovascular disease

El objetivo del estudio es estimar la tasa de abstinencia tabáquica posterior al alta hospitalaria en enfermos cardiovasculares que recibieron una intervención mínima de cesación tabáquica durante el ingreso. Se realizó un estudio prospectivo de una cohorte de 252 fumadores ingresados en el Hospital Universitari de Bellvitge. A las 24 h del alta hospitalaria se mantenía en abstinencia tabáquica el 76,6% de los pacientes. Tras 1, 3, 9 y 12 meses, las tasas de abstinencia habían disminuido al 71,4, el 67,2, el 64,1 y el 62,2%, respectivamente. Los pacientes diagnosticados de cardiopatía isquémica tenían menor probabilidad de recaída tabáquica: hazard ratio = 0,56 (intervalo de confianza del 95%, 0,36-0,87). En nuestro centro, una intervención mínima de cesación tabáquica durante la hospitalización en los enfermos cardiovasculares probablemente no sea suficiente para mantener la abstinencia tabáquica al alta (AU)

The objective of this study was to determine the smoking abstinence rate after hospital discharge in cardiovascular patients who had undergone a brief smoking cessation intervention during hospitalization. The prospective cohort study involved 252 smokers who were admitted to the Hospital Universitari de Bellvitge in Catalonia, Spain. Twenty-four hours after hospital discharge, 76.6% of patients were still abstaining from smoking. At 1, 3, 9, and 12 months, the abstinence rate diminished to 71.4%, 67.2%, 64.1%, and 62.2%, respectively. Patients diagnosed with ischemic cardiopathy had a significantly lower probability of a smoking relapse: hazard ratio =0.56 (95% confidence interval, 0.36-0.87). At our center, a brief smoking cessation intervention in cardiovascular patients during hospital admission was found unlikely to result in smoking abstinence following discharge (AU)