Monday, January 23, 2023

Can Chewing Tobacco Cause Bladder Cancer

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The Effects Of Nicotine On Kidneys

Tobacco is harmful for health, causes mouth cancer

Nicotine can cause many health problems. It can temporarily raise blood pressure and heart rate because it causes blood vessels to narrow. Nicotine can also make the blood more likely to clot and block an artery, and it can cause damage to the lungs and make breathing difficult. Nicotine in the body is first processed by the liver and then excreted by the kidneys. Over time nicotine can have negative effects on the kidneys.

What Are The Health Risks

Chewing tobacco can cause many types of cancer, including cancer of the mouth, tongue, gums, stomach, oesophagus and bladder. Heavy users might also notice that their teeth can start to get worn down and stained by the chewing tobacco, which can also cause the gums to recede. Regular chewing tobacco use is linked to higher heart attack risks too, since it is known to raise blood pressure and cholesterol levels.

Adverse Outcomes Of Pregnancy

Numerous studies have shown a strong association between cigarette smoking and adverse pregnancy outcomes, particularly low birth weight, but relatively few have considered the relationship of these variables with ST use. Generalisability of these studies elsewhere may be problematic, not simply because of differences in ST types but also in access to health care, nutritional status, cigarette smoking, and alcohol consumption.

The only study included in the review was of women in Delhi who delivered single infants in 19712 . The stillbirth rate was increased among tobacco chewers . Birth weights were presented for chewers and non-chewers by maternal weight, gestation, and social class. Overall, there was a reduction in birth weight of about 100200 g in each stratum in chewers compared with non-chewers, and this was mainly attributed to the greater proportion of chewers who delivered at 36 weeks or earlier. Other potentially important confounders were not considered, although smoking was rare in this population.

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What Are The Health Risks Of Smokeless Tobacco

Using any kind of smokeless tobacco can expose you to health risks. These products contain cancer-causing chemicals, as well as addictive nicotine.

Some smokeless tobacco products may expose users to lower levels of harmful chemicals than cigarette smoke, but this doesnt mean they are safe.

No form of smokeless tobacco is a safe substitute for cigarettes. Still, tobacco companies often market these products as alternatives to smoking in places where smoking isnt allowed.

How Can I Quit

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Chewing tobacco is highly addictive. But just like smoking, it is possible to stop using chewing tobacco.

Many people who quit find it helpful to replace chewing tobacco with a healthier substitute, like sunflower seeds, beef jerky or chewing gum. These substitutes take the physical place of chew in the mouth and they can help keep you distracted.

Heavy users of chewing tobacco may also want to consider Nicotine Replacement Therapy to reduce their cravings and to lessen their withdrawal symptoms. NRT includes nicotine patches, gum, lozenges, inhalers and sprays that provide a cleaner dose of nicotine without the toxic and cancer-causing chemicals found in chewing tobacco.

Doctors can also prescribe medicines like Champix and Zyban to help you quit.

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Mouth Cancer From Chewing Tobacco How Does It Occur

Though the accurate cause of mouth cancer is unclear, there are assured lifestyle factors that can put someone at hazard for this grave disease. Tobacco of any kind cigarettes, pipes, cigars, as well as smokeless tobacco, can increase your risk for oral cancer. Heavy use of alcohol and chewing tobacco increases the risk of developing oral cancer. Moreover, when a person uses both tobacco and alcohol, the situation gets worse!

Tobacco smoke has a bunch of chemicals that cause cancer. Each time you inhale that smoke, its poisonous chemicals get into your body, which gets carried to all parts of your body. Many of these chemicals can damage your DNA, which controls and directs each kind of cell to do what it is made for. Damaged DNA can make cells which are unusual and these unusual cells can turn into cancer cells.

To know more about how Smoking is injurious to health follow the link.

Chemicals Which Causes Oral Cancer From Tobacco

The fully dried tobacco leaves are used to make cigars, cigarettes, and of course, the chewable tobacco also. The tobacco actually comes from the tobacco plant from genus Nicotiana. More than seventy different types of tobacco are found wherein the N.tabacum variety is the most coveted one in the commercial world of tobacco. Some other ingredients are also included to enhance the flavor of tobacco and to make it more enjoyable. The smoke produced from these kinds of stuff is a multifaceted combination of many chemicals twisted by burning tobacco. Tobacco smoke is made up of burning thousands of chemicals, and many of them are the main cause of increases the chances of oral cancer from chewing tobacco. Cancer-causing chemicals found in Tobacco smoke include:

  • Hydrogen cyanide
  • Nicotine
  • Formaldehyde
  • Some radioactive elements like uranium
  • Polycyclic aromatic hydrocarbons

Many of these chemicals cause mouth or oral cancer. Some can cause lung diseases, heart diseases, or other grave health issues, too.

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Mirna Sequencing And Data Analysis

The quality of the raw reads was checked using FASTQC for OKF6/TERT1-Parental, OKF6/TERT1-Tobacco and OKF6/TERT1-Smoke samples. Cutadapt was used to remove low quality bases with Phred score 30 and adaptor sequences from 5 and 3 end of the read. The adaptor trimmed reads were aligned against nc-RNA sequence databases ,,, using Bowtie . Remaining reads were used for known miRNA identification. These reads were first aligned to mature and precursor sequence from miRBase 21 miRNA database using Bowtie. Unaligned reads were further aligned against human genome hg19 using miRDeep2 . Known miRNA that are quantified with at least 10 reads in both samples of a pairs i.e. OKF6/TERT1-Tobacco vs. OKF6/TERT1-Parental and OKF6/TERT1-Smoke vs. OKF6/TERT1-Parental were further investigated for differential expression using DESeq.

Novel miRNAs were assessed for the genomic location using UCSC BLAT. They were also queried against database YM500V3 using genomic location search option. YM500V3 is a repository of novel miRNA built using > 8,000 smRNA data-sets pertaining to various cancers along with their CLIP-Seq results from different cell lines.

Limitations Of A Case

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  • The design, in general, is not useful to study rare exposures. It may be prudent to conduct a cohort study for rare exposures

  • We are not able to estimate the incidence or prevalence in a case-control study

  • Why cant we comment on the incidence or prevalence of the disease?

    Since the investigator chooses the number of cases and controls, the proportion of cases may not be representative of the proportion in the population. For instance if we choose 50 cases of psoriasis and 50 controls, the prevalence of proportion of psoriasis cases in our study will be 50%. This is not true prevalence. If we had chosen 50 cases of psoriasis and 100 controls, then the proportion of the cases will be 33%.

  • The design is not useful to study multiple outcomes. Since the cases are selected based on the outcome, we can only study the association between exposures and that particular outcome

  • Sometimes the temporality of the exposure and outcome may not be clearly established in case-control studies

  • The case-control studies are also prone to certain biases

    • In general, individuals may not be able to recall all exposures accurately. Furthermore, cases are more likely to remember detailed exposure history compared with controls particularly population based controls. Thus, this may lead to recall bias

      If the cases and controls are not selected similarly from the study base, then it will lead to selection bias.

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    Key Facts About Tobacco Use Among Older Adults

    • Todays generation of older Americans had smoking rates among the highest of any U.S. generation. In the mid-1960s, about 54 percent of adult males were current smokers and another 21 percent were former smokers in 2008, about 23 percent of adult males were smokers and another 24 percent were former smokers.
    • In 2008, over 17 million Americans over the age of 45 smoked, accounting for over 22 percent of all adult smokers. Nine percent of Americans over 65 years of age currently smoked.

    Secondhand Smoke And Bladder Cancer

    Secondhand smoke contains the same harsh chemicals smokers inhale. There’s no safe SHS level of exposure, and the American Cancer Society points to the link between SHS and cancer. When you’re a non-smoker exposed to SHS, it’s known as passive smoking or involuntary smoking. Non-smokers breathing in SHS take in toxic chemicals and nicotine the same way smokers do. And, the more secondhand smoke you breathe in, the higher the levels of harsh chemicals in your body.

    Evidence suggests SHS leads to lung cancer, even in individuals who have never smoked. Studies also suggest a link between SHS and bladder cancer. The Cancer Management Research journal recently published a study showing a statistically significant 22% increase in bladder cancer risk for lifetime SHS exposure in patients who don’t smoke versus those not exposed to SHS.

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    Criteria For Considering Studies For Review

    Types of studies

    Analytical epidemiological studies were reviewed, provided they included users of a form of ST and a group who used no tobacco products or smoked cigarettes only. Small studies were excluded as they may be subject to publication bias and are more likely to be published if they are positive, while larger studies are likely to be published regardless of their finding and may provide more power. Excluded studies are listed in the appropriate tables of excluded studies for each health outcome. All the studies meeting the inclusion criteria are described in detail in appendix 1 .

    Types of outcome measures

    Studies reporting one or more of the following health outcomes were included: oral/pharyngeal cancers, other cancers, all cause mortality, vascular diseases, dental health, complications of pregnancy, and surgery. Ideally, outcomes should be clearly defined according to International Classification of Disease system . The authors statement that the study considered one of these outcomes was accepted. Excluding studies with no clearly defined outcomes may bias against older studies. Studies reporting on one or more intermediate outcomes such as blood pressure or lipid levels, or oral lesions such as leukoplakia were excluded.

    Spot The Warning Signs

    Tobacco

    Usually, squamous cell carcinoma will start as something that seems harmless, like a little white or red bump in the mouth. Someone might not think much of it and expect it to go away after a few days. “The issue is when something doesn’t go away. If you remove the cause of the issue, whether it be chewing tobacco, cheek biting or a sharp tooth, and the lesion doesn’t go away, that’s a problem. That’s a warning sign for cancer,” says Dr. Manuballa. “Typically the area will be watched for about two weeks, and if it doesn’t go away, it needs to be biopsied. So for anything that’s in the mouth that isn’t healing, make sure you see your dentist or a head and neck specialist and have it looked at as soon as possible.”

    Another warning sign is developing a condition called oral submucous fibrosis, where the tissue in the jaw becomes inflamed and stiff over time, preventing a person from being able to open their mouth fully.

    “What ends up happening is you’ll have difficulty opening your mouth because the fibrosis prevents your jaw from stretching as far as it normally would. The condition is considered a premalignant lesion, meaning it can develop into cancer,” says Dr. Manuballa. “Someone with oral submucous fibrosis should be watched very carefully by their dentist or doctor.”

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    What Are The First Signs Of Mouth Cancer From Chewing Tobacco

    If you think chewing tobacco is a healthier alternative to smoking, think again. Unfortunately, that theory is misguided.

    While it’s not linked to lung cancer like smoking, chewing tobacco and other smokeless tobacco products put users at an increased risk for several head, neck and mouth cancers, including squamous cell carcinoma as well as esophageal and pancreatic cancer. “For some reason, some people think that chewing tobacco is not as risky as smoking, but in a lot of ways it’s actually even more risky because there is a heavy concentration of tobacco, nicotine and other additives that are highly carcinogenic, in one area of the mouth,” says Sunita Manuballa, DDS, Assistant Professor of Oncology, Roswell Park Comprehensive Cancer Center.

    Squamous cell carcinoma is the second most common form of skin cancer and can appear almost anywhere in the head and neck area. Chewing tobacco users are especially at risk for squamous cell carcinoma inside their mouths.

    Squamous cells make up the mucosa layer of tissue on the inside of the mouth, including the lips and cheeks. So when using chewing tobacco, the skin’s squamous cells are in direct contact with the tobacco and the various carcinogenic additives. “Typically, users will keep their chewing tobacco in the pocket under their bottom lip or back in the cheek, and the product just sits there and gets directly absorbed into the outermost layer of the mucosa,” says Dr. Manuballa.

    How Does Chewing Tobacco Compare To Smoking

    Chewing tobacco contains more nicotine than cigarettes and can be even more difficult to quit than smoking. Having a regular amount of chew in your mouth for 30 minutes will give you as much nicotine as three cigarettes. This means more nicotine gets into your bloodstream, which causes a buzz that regular chewing tobacco users can begin to crave. This buzz can momentarily change the way you think, feel and even act.

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    Health Risks Of Smokeless Tobacco

    Smokeless tobacco includes products such as chewing tobacco, moist snuff, snus , and other tobacco-containing products that are not smoked.

    Some smokeless tobacco products might expose people to lower levels of harmful chemicals than tobacco smoke, but that doesnt mean these products are a safe alternative to smoking.

    What Is Chewing Tobacco

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    Chewing tobacco is available in various forms. Its made from different dried parts of the tobacco plant. To use chewing tobacco, you typically place it between your cheek and gums or teeth. You can spit or swallow the juices. Some forms of chewing tobacco are spitless.

    When you put chewing tobacco in your mouth, the tissues in your oral cavity absorb the nicotine. Your bloods nicotine concentration slowly increases. Nicotine tends to make its way to and concentrate in certain organs like the liver, spleen, and kidneys. It also makes its way to the brain.

    Why do people use chewing tobacco? Here are a few possible reasons:

    • Some use it to help quit smoking, though theres no evidence that its useful for this purpose.
    • Some people like the taste.
    • Like cigarettes, smokeless tobacco products are highly addictive. People may return to chewing tobacco because they are addicted.
    • Flavored smokeless tobacco products may be more appealing and may attract new users.

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    How Quitting Smoke Lowers Your Cancer Risks

    Your chances of cancer rise with the number of cigarettes you smoke each day and how many years you do it. The reverse is true, too. The less you smoke and the sooner you quit, the lower your odds of getting any of the 12 cancers linked to smoking.

    Five years after you quit, your odds for mouth, throat, esophageal, and bladder cancer will drop by half. Your odds of getting cervical cancer will fall to the same level as someone who doesnât smoke.

    If you go 20 years without smoking, your risk of getting cancer of the mouth, throat, voice box, or pancreas will be about the same as if youâd never smoked.

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    How Is Cancer Treated

    The treatment for cancer depends on the type of cancer and the stage of the disease . Doctors may also consider the patients age and general health. Often, the goal of treatment is to cure the cancer. In other cases, the goal is to control the disease or to reduce symptoms for as long as possible. The treatment plan for a person may change over time.12

    Most treatment plans include surgery, radiation therapy, or chemotherapy. Other plans involve biological therapy .12

    Some cancers respond best to a single type of treatment. Other cancers may respond best to a combination of treatments.12

    For patients who get very high doses of chemotherapy or radiation therapy, a stem cell transplant, also known as a bone marrow transplant, may be recommended by their doctor. This is because high-dose therapies destroy both cancer cells and normal blood cells. A stem cell transplant can help the body to make healthy blood cells to replace the ones lost due to the cancer treatment. Its a complicated procedure with many side effects and risks.12

    Quitting smoking improves the outlook for people with cancer. People who continue to smoke after diagnosis raise their risk for future cancers and death. They are more likely to die from cancer than nonsmokers and are more likely to develop a second tobacco-related cancer.5

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    Rna Isolation And Mirna Enrichment

    Total RNA, including small RNA, was isolated using the Qiagen RNAeasy isolation kit from OKF6-TERT1-Parental, OKF6/TERT1-Tobacco and OKF6/TERT1-Smoke cells. The quantity and quality of RNA was analyzed on denaturing agarose gel as well as on Bioanalyzer RNA 6000 Pico chip. RNA isolated from each condition was used to construct sequencing libraries with the Illumina TruSeq Small RNA Sample Prep Kit as per manufacturers instructions. Briefly, 3 and 5 adapters were sequentially ligated to small RNA molecules and ligation products were subjected to reverse transcription to create single stranded cDNA. To selectively enrich fragments with adapter molecules on both ends, the cDNA was amplified with 50 PCR cycles using a common primer and a primer containing an index tag to allow sample multiplexing. The amplified cDNA constructs were gel purified, and validated by checking the size, purity, and concentration of the amplicons on the Agilent Bioanalyzer High Sensitivity DNA chip . The libraries were pooled in equimolar amounts, and sequenced on an Illumina HiSeq 2500 instrument to generate 50-base pair reads.

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