tag:blogger.com,1999:blog-7068394429846282384.post2446794567418740513..comments2019-08-12T09:00:23.429-07:00Comments on Intro to Public Health student blog – Christopher Ng: The Smoker's WifeAnonymoushttp://www.blogger.com/profile/08308859463438101154noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-7068394429846282384.post-55823644039773858522013-02-11T19:35:02.620-08:002013-02-11T19:35:02.620-08:00Thanks for the post!
For decades, public health...Thanks for the post! <br /><br />For decades, public health advocates have attempted to link cigarette smoking and lung cancer. The attempt to make a causative link between smoking and lung cancer has been stymied by the long timespan prior to the development of lung cancer, the relative rarity of the disease and the numerous confounding factors that are concurrent in individuals who smoke. This landmark prospective cohort study sought to show an association between second-hand (aka side-stream) smoke exposure, lung cancer incidence, overall mortality and lung cancer attributable mortality. For more information about criteria of causation please see the Bradford Hill criteria: http://en.wikipedia.org/wiki/Bradford_Hill_criteria<br /><br />The study designers utilized a cohort design in order to analyze the risk associated with second hand smoke exposure (risk ratio = relative risk). Cohort studies are often difficult to accomplish due to the length of follow-up time, the overall cost of the study and the possibility of a large number of study participants to be lost to follow-up. In contrast, case-control studies identify cases (those with disease) and controls (those similar but without disease) and attempt to distinguish different rates of past exposure. This study sought to prove that smoke exposure was specifically related to an increase in lung cancer incidence, environment of residence is not a confounder of this relationship and that smoke exposure and lung cancer incidence has a dose response relationship (more smoke exposure causes more cancer). The authors further point out that considering their results, future comparisons of the health status between smokers and nonsmokers should control for the secondhand smoke exposure of nonsmokers.<br /><br />No study is perfect and you rightly discuss some other possible confounding factors that could be at play in the association of smoking, lung cancer and lung cancer related mortality. Other alternatives to a randomized control study (in this case would be unethical) would be to see if the lung cancer related mortality improves after a husband stops smoking. This study attempts to show a dose-response relationship between smoking, lung cancer and mortality, further supporting the lung cancer/smoking association. While this study followed conventional understanding, there were strong economic interests on behalf of tobacco companies to fight tooth and nail any association of their product with adverse outcomes. Here is some more on the topic:<br />http://cebp.aacrjournals.org/content/16/6/1070.longPublichealth_Weaver_Gregory(TA)https://www.blogger.com/profile/00362466103919673148noreply@blogger.comtag:blogger.com,1999:blog-7068394429846282384.post-17252653347429588892013-02-10T11:21:42.453-08:002013-02-10T11:21:42.453-08:00I especially liked reading your fourth paragraph o...I especially liked reading your fourth paragraph of your blog post. It was helpful to include concrete details and terms such as p value and Hill Criteria to thoroughly explain the results of and problems with the study. I also liked how you included various other options a smoker could do to have the same feelings of smoking but lessen the affects it has on others. Overall, nice job on this week's blog assignment. I really enjoyed reading it.Leslie MacManushttps://www.blogger.com/profile/04902431346339263007noreply@blogger.com