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Smoking and risk of giant cell arteritis
- Christian Dejaco, Christina Duftner, Michael Schirmer (9 March 2004)
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Smoking and blindness advertisements are effective in stimulating calls to a national quitline
- Nick A Wilson, Michele Grigg, Graham Cameron, Ramzan Afzal, and Helen Glasgow (18 March 2004)
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Christian Dejaco, Research Fellow A-6020 Innsbruck, Christina Duftner, Michael Schirmer
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Sir, In the editorial on smoking and blindness, Kelly et al. point out that patients attending eye clinics recognize many adverse health hazards of tobacco but remain largely unaware of the possible link between smoking and eye diseases.1 Smoking is an established risk factor for age related macular degeneration, and smoking is further associated with poorer outcome after photocoagulation with argon laser. Reading this article we also thought about smoking and its possible negative influence on immune- mediated diseases like rheumatoid arthritis and ankylosing spondylitis.2,3 Besides, it has been reported that smoking is an independent risk factor for giant cell arteritis (with an odds ratio of 2.3),4 and female smokers with more than 10 pack-years even have a 17-fold increased risk for GCA.5 Thus GCA is indeed relevant for smokers: GCA is the most frequent primary vasculitis in Western countries, and the annual incidence of GCA is between 15 and 25 per 100 000 people over the age of 50 years.6 Irreversible blindness, mainly due to anterior ischemic optic neuropathy and frequently preceded by amaurosis fugax, occurs in up to 14.9% of GCA patients, whereas less severe ischemic complications of the eye are seen in 26.1% of the patients.7 Taken together, tobacco smoking has to be considered as an important risk factor for blindness not only due to age related macular degeneration but also because of blindness due to GCA. Christian Dejaco, Research Fellow, Christina Duftner, Rsearch Fellow,
REFERENCES 1. Kelly SP, Thornton J, Lyratzopoulos G, Edwards R, Mitchell P. Smoking and blindness. BMJ 2004;328: 537-8. 2. Stolt P, Bengtsson C, Nordmark B, Lindblad S, Lundberg I, Klareskog L, et al. Quantification of the influence of cigarette smoking on rheumatoid arthritis: results from a population based case-control study, using incident cases. Ann Rheum Dis 2003;62: 835-41. 3. Averns HL, Oxtoby J, Taylor HG, Jones PW, Dziedzic K, Dawes PT. Smoking and outcome in ankylosing spondylitis. Scand J Rheumatol 1996;25:138-42. 4. Machado EB, Gabriel SE, Beard CM, Michet CJ, O’Fallon WM, Ballard DJ. A population- based case- control study of temporal arteritis and degenerative vascular disease? Int J Epidemiol 1989;18:168-72. 5. Duhaut P, Pinede L, Demolombe-Rague S, Loire R, Seydoux D, Ninet J, et al. Giant cell arteritis and cardiovascular risk factors: a multicenter, prospective case-control study. Groupe de Recherche sur l'Arterite a Cellules Geantes. Arthritis Rheum 1998;41: 1960-5. 6. Lawrence RC, Helmick CG, Arnett FC, Deyo RA, Felson DT, Giannini EH, et al. Estimates of the prevalence of arthritis and selected muscoloskeletal disorders in the United states. Arthritis Rheum 1998; 41: 778-99. 7. Gonzalez-Gay MA, Garcia-Porrua C, Llorca J, Hajeer AH, Branas F, Dababneh A, et al. Visual manifestations of giant cell arteritis. Trends and clinical spectrum in 161 patients. Medicine (Baltimore) 2000;79: 283- 92. Competing interests: None declared |
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Nick A Wilson, Senior Lecturer (Public Health) Wellington School of Medicine & Health Sciences, PO Box 7343, Wellington, New Zealand, Michele Grigg, Graham Cameron, Ramzan Afzal, and Helen Glasgow
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Editor – We can provide additional information on the effectiveness of television advertisements on smoking and blindness to that described by Kelly et al.[1] The Quit Group (funded by the New Zealand Ministry of Health) has shown “threat appeal” television commercials (TVCs) on national television channels in New Zealand since 1999. These TVCs were adapted from an Australian campaign and combine information on a threat to health along with a "call to action" via the Quitline number at the end. We analysed data for the years 2002 to 2003 and found that the most effective of these TVCs in generating calls to the national Quitline was the one on smoking and blindness (for calls within one hour of the commercial being shown). This TVC generated 97 calls per 100 target audience rating points (TARPs - a measure of the size of the audience exposure to the TVC) over this two-year period (n=1385 calls). The TVC on stroke and smoking generated 88 calls per 100 TARPs and the TVC on smoking and lung tumours generated 78 calls per 100 TARPs. Although the blindness TVC was the most effective of the three for generating calls from Maori callers, the differences between the three TVCs were not statistically significant. However, for non-Maori (mainly European) callers, the blindness TVC was significantly more effective than the tumour one (rate ratio (RR) = 1.45, 95% CI = 1.15, 1.84). The smoking and blindness TVCs were also far more effective in generating calls to the Quitline than the TVCs in two separate campaigns that focused on second-hand smoke during this two year period (RR = 19.57, 95% CI = 15.06, 25.46; and RR = 34.97, 95% CI = 27.20, 44.53). However, the TVCs in these campaigns also differed in that they did not include the Quitline number. The relative effectiveness of this particular smoking and blindness TVC has also been shown in the Australian setting.[2] Only one of these “health threat” TVCs shows a Maori person as the main participant (the tumour TVC) and so there is scope for further adapting these TVCs to better suit Maori who are a priority audience for smoking cessation support in New Zealand. Furthermore, the advent of a dedicated Maori television channel in the near future may provide a more cost-effective means to reach a Maori audience with these and other TVCs designed to stimulate smoking cessation. Nick Wilson, Senior Lecturer (Public Health), Wellington School of Medicine & Health Sciences, PO Box 7343 Wellington South (nick.wilson@wnmeds.ac.nz); Michele Grigg, Research Manager; Graham Cameron, Researcher; Ramzan Afzal, Researcher; Helen Glasgow, Executive Director, The Quit Group, PO Box 12 605, Wellington, New Zealand. Competing interests: None declared. 1 Kelly SP, Thornton J, Lyratzopoulos G, et al. Smoking and blindness. BMJ 2004;328:537-538 2 Carroll T, Rock B. Generating Quitline calls during Australia's National Tobacco Campaign: effects of television advertisement execution and programme placement. Tob Control 2003;12(Suppl 2):ii40-4. Competing interests: None declared |
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