Abstract
Objective: The aim of the study was to determine if smoking is associated with cervical human papillomavirus infection (CHPI) independent of sexual risk factors. Setting: Two family planning clinics and one youth clinic in Sweden. Subjects: Human papillomavirus (HPV) DNA was found in cervical samples of 66 (6.8%) of 972 women attending for contraceptive advice, using Southern blot tests. Results: Among women with cervical human papillomavirus infection (CHPI), 33 (50%) were smokers, as compared to 307 (33.9%) among a comparison group of HPV-negative women (odds ratio = 2.0, 95% CI = 1.2–3.2). After stepwise adjustment for number of lifetime partners, number of partners last six months, age at first intercourse, alcohol use, drug abuse and history of or current sexually transmitted disease other than CHPI, the odds ratio decreased to 1.4 (95% CI = 0.8–2.4). Recent use of alcohol and ever use of narcotics were also significantly correlated to CHPI in crude analyses, but vanished in multifactorial analyses after adjustment for the mentioned sexual risk behavioral factors. Conclusions: The results of this study indicate that smoking, alcohol and drug abuse are risk markers, but not causal factors, for CHPI.
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Barton SE, Jenkins D, Cuzick J, Maddox PH, Edwards R, Singer A (1988) Effect of cigarette smoking on cervical epithelial immunity: a mechanism for neoplastic change? Lancet 2:652–654
Burger MPM, Hollema H, Gouw ASH, Pieters WJLM, Quint WGV (1993) Cigarette smoking and human papillomavirus in patients with reported cervical cytological abnormality. Br Med J 306:49–52
Burkett BJ, Peterson CM, Birch LM, Brennan C, Nuckols ML, Ward BE et al. (1992) The relationship between contraceptives, sexual practices, and cervical human papillomavirus infection among a college population. J Clin Epidemiol 45:1295–1302
Daling JR, Sherman KJ, Weiss NS (1986) Risk factors for condyloma acuminatum in women. Sex Transm Dis 13:16–18
Doornum GJJ, Hooykaas C, Juffermans LHJ, van der Lans SMGA, van der Linden MMD, Coutinho RA et al. (1992) Prevalence of human papillomavirus infections among heterosexual men and women with multiple partners. J Med Virol 37:13–21
Ericksen KP, Trocki KF (1992) Behavioral risk factors for sexually transmitted diseases in American households. Soc Sci Med 34:843–853
Ferson M, Edwards A, Lind A, Milton GW, Hersey P (1979) Low natural killer activities and immunoglobulin associated with smoking in human subjects. Int J Cancer 23:603–609
Fitzpatick C, McKenna P, Hone R (1992) Teenage girls attending a Dublin sexually transmitted disease clinic: A socio-sexual and diagnostic profile. Int J Med Sci 161:460–462
Hellberg D, Valentin J, Nilsson S (1986) Smoking and cervical intraepithelial neoplasia. Acta Obstet Gynecol Scand 65:625–631
Hellberg D, Nilsson S, Haley NJ, Hoffmann D, Wynder E (1988) Smoking and cervical intraepithelial neoplasia: nicotine and cotinine in serum and cervical mucus in smokers and nonsmokers. Am J Obstet Gynecol 158:910–913
Hildesheim A, Reeves WC, Brinton LA, Lavery C, Brenes M, Guardia De La ME et al. (1990) Association of oral contraceptive use and human papillomaviruses in invasive cervical cancers. Int J Cancer 45:860–864
Hjerpe A, Lindh E, Bistoletti P, George J, Groff D (1990) Use of cervical Cytobrush samples for dot-blot detection and Southern blot typing of human papillomaviruses using subgenomic probes. Anal Quant Cytol Histol 5:299–305
Kjaer SK, Engholm G, Teisen C, Haugaard BR, Lynge E, Christensen RB et al. (1990) Risk factors for cervical human papillomavirus and Herpes simplex in Greenland and Denmark: a population-based study. Am J Epidemiol 131:669–682
Ley C, Bauer HM, Reingold A, Schiffman MH, Chambers JC, Tashiro CJ et al. (1991) Determinants of genital human papillomavirus infection in young women. J Natl Cancer Inst 83:997–1003
Miller LG, Goldstein G, Murphy M, Ginns LC (1982) Reversible alterations in immunoregulatory T cells in smoking. Chest 5:527–529
Moscicki A-B, Palefsky J, Gonzales J, Schoolnick GK (1990) Human papillomavirus infection in sexually active adolescent females: prevalence and risk factors. Ped Res 28:507–513
Rahm VA, Odling V Pettersson R (1991) Chlamydia trachomatis in sexually active teenage girls. Factors related to genital chlamydial infection: a prospective study. Genitourin Med 67:317–312
Rasp FL, Clawson CC, Hoidal R, Repine JE (1978) Reversible impairment of the adherence of alveolar macrophages from cigarette smokers. Am Rev Respir Dis 118:979–986
Rohan T, Mann V, McLaughlin J, Harnish DG, Yu H, Smith D et al. (1991) PCR-detected genital papillomavirus infection: prevalence and association with risk factors for cervical cancer. Int J Cancer 49:856–860
SAS Institute Inc. (1994) JMP users guide. Cary, USA
Schneider A, Loutsky LA (1992) Natural history and epidemiological features of genital HPV infection. In: The epidemiology of cervical cancer and human papillomavirus. Munoz N, Bosch FX, Shah KV, Mebeus A (eds), IARC, Lyon p 25–52
Shafer M-A, Boyer CB (1991) Psychosocial and behavioral factors associated with risk of sexually transmitted diseases, including human immunodeficiency virus infection, among urban high school students. J Pediatr 119:826–833
Sikström B, Hellberg D, Nilsson S, Mårdh P-A (1995) Sexual risk behavior in women with cervical human papillomavirus infection. Arch Sex Behav
Vandenvelde C, Van Beers D (1992) Risk factors inducing the presistence of high-risk genital papillomaviruses in the normal cervix. J Med Virol 38:226–232
Villa LL, Franco LF (1989) Epidemiologic correlates of cervical neoplasia and risk of human papillomavirus infection in asymptomatic women in Brazil. J Natl Cancer Inst 81:332–340
Willmott FE (1992) Current smoking and genital infections in women. Int J STD AIDS 3:329–331
Winkelstein W (1990) Smoking and cervical cancer-current status: a review. Am J Epidemiol 131:945–957
Yarber WL, Parrillo AV (1992) Adolescents and sexually transmitted diseases. J Sch Health 62:331–338
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Correspondence to: D. Hellberg
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Sikström, B., Hellberg, D., Nilsson, S. et al. Smoking, alcohol, sexual behaviour and drug use in women with cervical human papillomavirus infection. Arch Gynecol Obstet 256, 131–137 (1995). https://doi.org/10.1007/BF01314641
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DOI: https://doi.org/10.1007/BF01314641