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Pulmonary Langerhans cell histiocytosis (PLCH) belongs to the spectrum of diffuse interstitial cystic pneumonias; it affects young people of both sexes and occurs almost exclusively in tobacco smokers or co-users of tobacco and cannabis. The management of this severe chronic disease is undertaken in specialized centers. A better understanding of the pathogenic mechanisms of the disease has opened up prospects for targeted therapies. However, supporting the abstinence from inhaling noxious materials which determine its prognosis remains the cornerstone of treatment. Patients with PLCH who persist in smoking despite the diagnosis may be very dependent on tobacco, experience significant difficulties in stopping smoking, and must have access to specialist smoking cessation clinics., (Copyright © 2021 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Introduction: Binge drinking and continued alcohol use in large amounts are associated with many health problems but there are very few studies on the effects of alcohol intake on the function of lung, the effects of ethanol on lung diseases, and links between alcohol consumption and lung cancer. Therefore, our knowledge of these interactions from pathophysiological, clinical and epidemiological aspects is poor., Background: Acute alcohol exposure stimulates the beating of the cilia of mucociliary epithelium cells but the effects of chronic ethanol over-exposure are different, with a progressive desensitization of ciliary response: ethanol exposure reduces airway mucociliary clearance. As a result this important innate primary defense mechanism, which protects the lungs from the deleterious effects of different pollutants, allergens and pathogens, is weakened. Chronic alcohol exposure alters the adaptative immune response to pathogens (decreasing the phagocytic function of macrophages) and leads to an inflammatory response (pro-inflammatory cytokines). Respiratory function is impaired by alcohol misuse: asthma, chronic obstructive pulmonary disease, lung infections, and the acute respiratory distress syndrome are more frequent and severe. It is difficult to establish a causal link between alcohol and lung cancer as the lung cancer risk is likely confounded by the effect of smoking. Very few studies among never smokers have been conducted until now and the results are not consistent: they are therefore necessary to confirm or refute whether lung cancer is attributable to alcohol misuse., Conclusion: The pulmonary effects of alcohol misuse are many but further investigations into the mechanism by which alcohol might predispose to lung cancer are necessary., (Copyright © 2018 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Tobacco use is not just about manufactured cigarettes. Rolling tobacco, highly prized in the wake of price increases, is estimated to carry more toxic agents than its counterpart. This study shows that the use of cigar, pipe, cigarillos and narghile also leads to a cohort of pathologies similar to or more than what is known for smoking single cigarettes. Exotic, liquid or heated forms do just as much. The non-smoked tobacco, often fallen into disuse in France is very used in the United States and especially in Scandinavia. Denuded of inhaled products, it is often pointed as a form of reduction of smoking risks. Its use by athletes in all countries as a doping attitude, especially in ski disciplines, required a campaign of prevention within the federations concerned., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Smoking represents a major public health problem because of its high morbidity and mortality rates. Nearly half of the deaths in the lower class are caused by smoking. The socially deprived are physically and psychologically vulnerable. The instability of their situation increases the difficulty to invest in smoking cessation and certain time orientations linked to this social deprivation represent negative factors in the prognosis. Socially deprived populations do not understand the consequences of smoking unless they are in denial of the risks. The motivation to stop is essentially financial. The perception of smoking cessation is taken as a deprivation of pleasure. Independently of the social deprivation factors, taking into account the time perspective conveys necessary information of appropriate care.

To date, there has been little research into the relationship between violent behavior and the practice of sport in young adolescents (both girls and boys) in the general population. Indeed, sport is often recommended as a means of prevention and an alternative to violence in adolescence. For this reason, we studied this issue in a representative sample of 14-16 year-olds (ESPAD 99). Among this sample, boys practised some form of extra-curricular sport more than girls (75% vs. 57%), this practice being more intensive (13% boys vs. 4% girls practising sport more than 8 hours per week outside of school) and more "competitive" (14% vs. 4% taking part in national and/or international events). Boys also exhibited more violent behavior than girls, including stealing (mean 0.91 for boys vs. 0.49 in girls), fighting (mean 1.71 in boys vs. 0.49 in girls) or serious offences (mean 0.66 in boys vs. 0.34 in girls). Taking part in competitions was found to be highly associated with violent behavior. In particular, competition at a national or international level was associated (in decreasing order of significance) with fighting (OR=2.35), serious offences (OR=1.78) and stealing (OR=1.58), after adjustment for age, gender, father's educational level and type of school attended. The practical implications of this study are that it is important to moderate one's judgment about the positive effects of sport in reducing youth violence, to be attentive to violent acts perpetrated in stadiums and to better analyze the eventual beneficial effects of sports clubs.

Few studies have analyzed in the general population psychoactive substance use among athletes, especially among females. In fact, sporting activity is often promoted in prevention actions, as an alternative to addiction or alcohol, tobacco or other substance misuse. So, we propose an analysis of the ESPAD 1999 sample among students (16-18 years old), focused on the relationship between sporting activities and substance use. Boys play sport more frequently than girls (71.5% versus 49.5%) and report 8 hours and more a week 4 more times than girls (14% versus 3.5%). Sixty-eight percent of boys and 36% of girls have already participated in sport competitions, more often at a local, departmental or regional level; a minority of them (26% of boys and 20% of girls) have already participated in sport competitions at a national or international level. Sporting activity is decreasing with age among girls, students from general lycée play sport more frequently than others do (vocational lycée); the higher the father's education level, the more frequently the students play sport. Moderate sporting activity (1-8 hours a week) is a protective factor against regular smoking (OR=0.54 in boys and OR=0.60 in girls) and against regular cannabis use among boys (OR=0.64). Intensive sporting activity (>8 hours a week) is a risk factor for illicit drugs (except cannabis) use (OR=2.74) and sleeping drugs/tranquillizers (OR=1.82) only among girls. Competition level is the most important risk factor for substance misuse as well in boys (except sleeping drugs/tranquillizers) as in girls. Practical implications are: adjusting health policy concerning the beneficial effects of sporting activity, raising sports associations abilities and avoiding doping and addiction in high-level sporting activities.

Early February 1999, the French Ministère de la Jeunesse et des Sports (Youth and Sports Ministry) sponsored three different studies, aiming to prevent harmful behavior in the area of sport practices among youth. Two years earlier, our health care team working with drug users published reports on the meaningfulness of intensive sports activities in the history of our patients. The present work was performed to highlight the midterm results of one of these studies, to better understand and quantify the importance of physical training in the history of a group of outpatients seen for addictive disorders and comorbid pathologies. For 20 consecutive weeks, 3,040 self-administered questionnaires were available for persons consulting 20 health centers, 2 self-help groups and a general practitioner network working in the field of alcohol or heroine abuse. One thousand one hundred and eleven questionnaires were filled out (36.1%) and returned by mail for complete analysis: 86% of the answering persons had practiced at least one sports activity or participated in physical training, 10.5% had participated in a national or international level competition, and 10.6% reported stress fractures. In the intensive sports group, 36% had used illicit drugs intravenously and 16.4% said they had already used doping substances. Only 28.4% said they experienced dependence during their period of intensive sports activities compared with 15.2% before this time, and a majority (56.4%) thereafter. Intensive sports or physical training should not be seen as a protective factor nor as a way of improving addictive behaviors. More studies are needed to evaluate individual vulnerability factors and specific harm of overtraining and to determine the exact periods when men and women participating in sports activities are likely to abuse drugs, especially at the end of their career.

Using only ingested alcohol quantity, where individual erroneous values are counted and weigh a lot, alcohol consumption evaluation is biased. An original alcohol consumption evaluation is explained: ordinal factor analysis, and evaluation scales are described. This study shows several people groups, whose sensitivity about alcohol consumption safety varies greatly: from people whose alcohol consumption is low and have a bad picture of alcohol, to people whose consumption is high, have a good picture of alcohol, or think that their consumption is low or normal. In fact, for the last ones, alcohol consumption safety will never be effective.

We have developed a method for the assessment of auditive loss using a sample of 1794 Bekesy audiograms recorded in young military students. A rectangular digital filter was used to smooth rough audiogram signals so as to detect pathological patterns such as scotoms and recruitments. Three factors were extracted from principal component analysis. They were correlated with the usual auditory indices and explained 70% of the total observed variance. The first factor is a general indicator of deafness, while the second and third describe the shapes of the hearing threshold level (asymmetry and convexity). This method can be used for rapid identification of suspect audiograms and is thus of value for epidemiological surveillance of populations exposed to impulsive noise.