Smoke Less America

Current Research Findings and Information

The Truth About "Light" Cigarettes: Questions and Answers


Many smokers choose "low-tar," "mild," or "light" cigarettes because they think that light cigarettes may be less harmful to their health than "regular" or "full-flavor" cigarettes.

After all, the smoke from light cigarettes feels smoother and lighter on the throat and chest - so lights must be healthier than regulars, right? Wrong.

The truth is that light cigarettes do not reduce the health risks of smoking. The only way to reduce your risk, and the risk to others around you, is to stop smoking completely.

What about the lower tar and nicotine numbers on light cigarette packs and in ads for lights?

How do light cigarettes trick the smoking machines?

What is the scientific evidence about the health effects of light cigarettes?

 

 

What do tobacco companies say about the health effects of light cigarettes?

What is the bottom line for smokers who want to protect their health?

·        Quitting also decreases your risk of lung cancer, heart attacks, stroke, and chronic lung disease.

Courtesy of the National Cancer Institute

Secondhand Smoke Can Hide in Your Home 

Secondhand tobacco smoke contaminants lurking in household dust and on furniture and other surfaces can expose children to levels that are equivalent to several hours of active smoking, says a study in the current issue of Tobacco Control.

The study also says that making adults smoke outside doesn't fully protect children from the harmful effects of tobacco smoke.

Researchers compared 49 homes that included children between 2 and 12 months old. Nonsmokers lived in 15 of the homes. Of the remaining 34 homes, 17 were occupied by smokers who tried to protect their children by smoking outdoors. The other 17 homes were occupied by smokers who made no attempt to protect their children from secondhand smoke.

Dust and surface wipe samples were collected from the living room and the child's bedroom in each of the homes. Urine and hair samples were taken from the children. Nicotine monitors were placed in the living room and the child's bedroom of each home.

Levels of tobacco contaminants in the dust, air and surface samples of homes where adults smoked outdoors were up to seven times higher than in homes of nonsmokers. Tobacco contaminant levels in the homes of indoor smokers were up to eight times higher than in the homes where adults went outside to smoke.

Infants are particularly at risk from these indoor tobacco contaminants because they spend most of their time indoors and are close to contaminated sources, the study authors say.

Courtesy of HealthDayNews

Smoking Damages Reproductive Health

Report finds pervasive effects on men, women and babies

 A new British report says cigarette smoking causes damage throughout a person's reproductive years and reduces the chance of having healthy children.

The report advises anyone planning to have kids to stamp out that cigarette butt once and for all.

The report, a comprehensive look at more than two decades of studies on smoking and reproduction, concludes that the damaging effects of smoking occur throughout a person's reproductive life, from puberty to young adulthood and into middle age. This was true of both men and women.

"There are so many aspects where smoking impacts our health -- 50 or 60 damaging aspects, of which there are many that can kill," says report author Dr. Sinead Jones, director of the British Medical Association's Tobacco Control Resource Centre. "So the evidence of fertility and conception -- for example, both male and female fertility -- was important for us to highlight."

It finds women who smoke take longer to conceive, and also will find their chances of conception reduced by up to 40 percent per cycle.

Also, both men and women may have less response to fertility treatments when they smoke, thereby jeopardizing the possibility of having a family.

"Men are twice as likely to be infertile and to have damaged DNA in their sperm," Jones says. "And with women, we found higher incidences of miscarriages."

The report says that between 3,000 and 5,000 miscarriages per year in the United Kingdom can be directly linked to smoking.

It also found that 120,000 men in England between the ages of 30 and 50 are impotent due to smoking. Moreover, every year smoking is implicated in around 1,200 cases of malignant cervical cancer in women.

According to the report, there is conclusive evidence that women smokers face a variety of ailments: a higher risk of heart disease when taking contraceptive pills; early menopause; and cervical cancer. The danger is passed on to the child, too: placental complications; premature membrane rupture; premature and low birth weight babies; and perinatal death.

Babies whose mothers smoked had a higher risk of SIDS, middle-ear disease, respiratory illnesses, developing asthma in those previously unaffected, and suffering asthma attacks in those already affected.

The more tobacco the person consumed the greater the adverse effect, the report notes, and stopping smoking dramatically reduced the effects.

"This report clearly shows the devastating impact of smoking on generations to come," says Deborah Arnott, director of the British anti-smoking organization Action on Smoking and Health. "Stopping smoking should be the number one priority for anyone who wants to have children."

"This is important not just to increase the chances of conception but also to give your child the best start in life," she continues. "More than 17,000 children are hospitalized every year [in the U.K.] because of respiratory problems caused by their exposure to parents' smoke. By stopping smoking, parents will not only improve their own health but will lessen the chances of their children developing illnesses such as asthma and pneumonia."

But the report finds good news in the growing trends towards eliminating tobacco advertising and promoting smoke-free legislation in many areas, such as in the United States and in many European cities.

"Our government has a long way to go," Jones says. "We find that they are very complacent on the issue."

Courtesy  Andrew Conaway HealthDay Reporter

Black Youths Likelier to Quit Smoking

Study cites parental disapproval, less exposure to peers who smoke

Most black teens try smoking cigarettes, but they're much less likely than whites and Hispanics to become regular smokers as adolescents and young adults, new research finds.

The Rand Corp. study, published in the February issue of the American Journal of Public Health, found 62 percent of black youths had lit up by age 13, compared with 69 percent of Hispanics, 52 percent of whites and 36 percent of Asian-Americans.

But by age 15, just 7 percent of blacks in the study had become regular smokers, compared with 20 percent of whites and Hispanics and 8 percent of Asian-Americans.

Rand researchers attribute the drop-off in smoking among blacks to factors including parental disapproval, communication with parents about personal problems, having fewer friends who smoke, and receiving fewer offers of cigarettes from peers.

"What we find really intriguing is that this parental disapproval of smoking really seems to have an impact that African-American kids really pay attention to," says study author Phyllis L. Ellickson.

Ellickson, director of the Rand Center for Research on Maternal, Child and Adolescent Health, says the results suggest steps such as getting parents to talk to their children about smoking, improving family bonds and dampening peer pressure to smoke might help keep youths from becoming regular smokers.

For the study, researchers tracked more than 6,000 blacks, whites, Hispanics and Asian-Americans for 10 years, from ages 13 to 23. Rand recruited the study participants from 30 California and Oregon middle schools for a study on substance abuse.

Students completed surveys about substance abuse, smoking and psychological, social and behavioral factors.

By age 23, the survey showed, 19 percent of blacks smoked regularly, compared with 32 percent of whites, 29 percent of Hispanics and 16 percent of Asian-Americans.

Along with influence of peers and parents, researchers looked at risk factors that could be related to decisions on whether to smoke, such as school grades and "problem behavior" such as rebelliousness and marijuana or alcohol use.

Asian-Americans did well in school and were less likely than others to drink alcohol, smoke marijuana, or be exposed to "pro-smoking influences," Ellickson says.

Blacks, by contrast, had significantly worse grades than whites throughout middle school and high school. "But," Ellickson adds, "it appears to be counteracted by positive influence from parents and less exposure to smoking."

For example, the proportion of black youths with a best friend who smokes dropped after age 13 or 14, the study says.

Edwin Fisher, a professor of psychology, medicine and pediatrics at Washington University in St. Louis, says parents play a crucial role in keeping kids from becoming smokers.

"An overlooked aspect of preventing smoking in adolescents is parental involvement and parental wisdom in treating smoking as a health problem, not a discipline problem," says Fisher, a spokesman for the American Lung Association.

"So it's not a matter of simply saying, 'You don't smoke because you're my child and it's my house.' It's a matter of explaining to young people why smoking is so dangerous, and providing them opportunities for showing independence in doing things their own way in healthy ways without needing to show their independence by doing things like smoking."

Preventing smoking during the teen years is critical. Tobacco use typically begins by age 16, and the first smoke almost always occurs before high school graduation, the American Lung Association says. At least 4.5 million American adolescents smoke, and each day 6,000 U.S. children under 18 smoke their first cigarette, the association says. Moreover, smoking-related diseases kill about 430,700 Americans each year.

Adolescent smoking has been linked not only to significant health problems, but also involvement in fights, carrying weapons, engaging in high-risk sexual behavior and using alcohol and other drugs.

Four decades after the landmark Surgeon General's Report on Smoking and Health provided the first official U.S. recognition that smoking causes cancer and other serious diseases, other new studies also have looked at the demographics of those who smoke.

The Dana-Farber Cancer Institute, a teaching affiliate of Harvard Medical School, found that occupation is a significant factor in determining which adults smoke. People in working-class, non-supervisory positions, including blue-collar and service jobs, had the highest smoking rates. The study also showed those with less education and lower income smoked more than others.

The findings appear in the same issue of the American Journal of Public Health, along with results of a separate Dana-Farber study on one of the first workplace programs to successfully reduce smoking rates among blue-collar workers. The study concluded that smoking cessation combined with broader occupational safety and health worked much better than smoking cessation offered alone.

Researchers tested the two approaches at 15 Massachusetts manufacturing firms for two years. Smoking quit rates for those who had smoking cessation as part of the broader health-promotion efforts were more than twice that of those who underwent only smoking cessation.

In an analysis of national survey data from 1999 to 2001, the U.S. Centers for Disease Control and Prevention found 8.2 percent of blacks aged 12 to 17 had smoked during the preceding month. That compares with 29.5 percent of American Indians and Alaska natives, 14.9 percent of white youths, 11.4 percent of Hispanics and 8.8 percent of those from Asian ethnic groups, according to the survey, which appears in the Jan. 30 issue of the CDC publication Morbidity and Mortality Weekly Report.

By Gary Gately (HealthDay Reporter)

Genes May Help You Quit Smoking

Those with two in particular have an easier time

Did you ever wonder why some people stop smoking cold turkey and never look back, while others struggle to quit again and again?

Researchers from the Tobacco Use Research Center at the University of Pennsylvania may have found at least part of the answer -- genetics.

Two genes in particular seem to help smokers quit successfully, and this same combination of genes also makes them less likely to start smoking again, report the researchers in the October issue of Health Psychology.

"This study provides the first evidence that genes that alter dopamine function may influence smoking cessation and relapse during treatment," study author Caryn Lerman, associate director for Cancer Control and Population Science at the University of Pennsylvania, says in a press release.

Dopamine is a neurotransmitter that acts as a messenger between nerve cells in the brain.

Lerman and her colleagues studied 418 people who were enrolled in a clinical trial to test the effectiveness of the antidepressant bupropion for smoking cessation. The study participants either received a placebo or bupropion for 10 weeks and behavioral counseling.

Blood samples were taken from all of the participants for genetic analysis. Smoking status was assessed at the end of the 10 weeks and then again after six months.

People who had particular variants of a dopamine transporter gene (SLC6A3) and a dopamine receptor gene (DRD2) were more successful at staying off cigarettes and avoiding relapse than people who didn't have those variants.

"One of the great mysteries in smoking cessation is why some people find it so easy and why it's so hard for others," says Robert Baker, director of the Ochsner Center for the Elimination of Smoking in New Orleans. "I hear about people who have smoked for 40 years and then just put them down one day. Others haven't smoked as long and seem to have a much harder time. I think genetic factors do play a role."

Dr. Marc K. Siegel, an internist at New York University Medical Center, agrees. "It's not surprising to hear that someone's genetic makeup influences their response to quitting smoking. Some patients respond to Zyban [a form of bupropion], some to the patch [nicotine replacement therapy]." Often, people who want to quit are encouraged by doctors to use Zyban and a patch.

What's exciting about this research, Siegel says, is the possibility that one day doctors could specifically target smoking cessation treatment to each patient based on their genetic makeup. But such a therapy is likely a long time away. "If you're waiting for a cure before you quit smoking," advises Baker, "you may not live that long."

Despite some compelling reasons to quit -- including an increased risk of many cancers, heart disease and a one in five chance of developing emphysema or chronic bronchitis, according to the American Cancer Society -- many people still smoke.

About 25 percent of all men and 21 percent of women in the United States are currently smokers, according to the U.S. Centers for Disease Control and Prevention.

The good news is that plenty of people -- with and without these genes -- have quit smoking. The American Cancer Society says that more than 44 million Americans have stopped smoking.

"You may have a more difficult time if you don't have these genes," says Baker, "but you can still get off cigarettes. I'm sure there are thousands upon thousands who have done just that."

By Serena Gordon HealthDay Reporter

Decades After Landmark Smoking Report, Some Issues Remain Clouded

Research finds misuse of tobacco funds 40 years later

Forty years to the day that a landmark Surgeon General's report found the health hazards of smoking warranted "appropriate remedial action," a new study says there is still a long way to go.

A series of public health measures large and small have been taken since the 1964 report declared that cigarette smoking causes cancer and other diseases. Perhaps the single largest came in 1998, when the Master Settlement Agreement (MSA) required four U.S. major U.S. tobacco companies to give $209 billion to 46 states in return for dropping lawsuits.

The original lawsuit, brought by state attorney generals, aimed to get funds for Medicaid to recover the cost of treating tobacco-related illness. The settlement, however, allowed the states to use the windfall primarily at their own discretion.

And while many states said that they planned to use the funds to defray Medicaid costs, few have actually done so, according to new research being released Sunday from the Jan. 15 issue of the New England Journal of Medicine.

The journal chose this date because of Jan. 11, 1964, when Surgeon General Dr. Luther Terry released his historic report linking smoking to health hazards. That report help jump-start the antismoking movement in this country.

For the most part, the researchers say, states have not used the funds to cover Medicaid costs or for tobacco control and education projects. Instead, they have been used to address budget deficits and ensure "no new taxes."

"We missed a big opportunity, and we certainly could have done a lot more and we didn't do it. That's a shame," says Dr. Steven A. Schroeder, author of the new study and a professor of health and health care at the University of California, San Francisco. "State politicians chose not to use [master settlement funds] for the intended purposes."

"[The tobacco industry] got out of it easy," adds Dr. Robert Giusti, chief of pediatric pulmonology and assistant chair of pediatrics at Long Island College Hospital in Brooklyn, N.Y. "It became apparent quite a while ago that this was not going to have an impact on changing smoking habits. It has been a frustration."

According to the New England Journal article, in fiscal year 2003, 47 percent of the MSA payments were funneled into state budgets, up from 29 percent the year before and from 16 percent in the three preceding fiscal years.

Perhaps most troubling, many states are mortgaging future MSA payments through bond issues. This gives states a direct and strong interest in keeping the tobacco companies afloat so they will continue to pay.

In addition, certain stipulations in the original settlement, such as stronger warnings on tobacco packages, have been abandoned.

Most of the funding for the American Legacy Foundation disappears after five years because the money depends on the tobacco companies' maintaining a 99.05 percent or greater share of the U.S. cigarette market.

The new findings coincide with the Jan. 6 release of the American Lung Association State of Tobacco Control: 2003, which concludes that most states are not doing what it takes to protect citizens from tobacco smoke. The report card gave an "F" to 38 states and the District of Columbia for funding tobacco prevention and control programs and an "F" to 35 states and D.C. for smoke-free air laws. Three states flunked in tobacco taxes while 23 states failed in laws limiting youth access to tobacco.

There have been some forward movement, however.

The article quotes Matt Myers, director of the Campaign for Tobacco-Free Kids, saying that MSA was responsible for "the most significant increase in spending on tobacco prevention and cessation in history. These funds have forever changed the debate about the appropriate level of funding for tobacco control."

The MSA-funded American Legacy Foundation, Schroeder writes, is "the most important national counter-marketing effort in 30 years."

And to pay for all this, tobacco companies had to raise the price of cigarettes, an action which in itself resulted in fewer smokers.

The innovation from here on, Schroeder says, "is going to have to be on the ground and a little bit at a time, and it's too bad."

Still, there are hopeful signs. The telephone "quit lines," for instance, have been "fantastic," Schroeder says. They just haven't been marketed very well. Fuel for the anti-tobacco movement is also coming from raising cigarette taxes, counter-marketing (such as the American Legacy Foundation), and the clean indoor air movement.

Meanwhile, Guisti, adds, getting people to quit smoking is still the primary responsibility of physicians.

"I think there are reasons for optimism," Schroeder says. "Smoking rates are going down and smoking is becoming less socially acceptable. Those are two wonderful trends, [but] the problem is a lot of people think the battle is over -- but it's not."

His argument is bolstered by another new body of research, released in Saturday's British Medical Journal, that found low-tar cigarettes are no less damaging to health than any other form of filtered cigarettes.

The American Cancer Society estimates that before the 1964 Surgeon General's report, about half of all American adults smoked; today, the organization says, it's down to about 22 percent.

Smoking kills 440,000 American men and women each year, which is almost one person a minute, the ACS says. And cigarette smoking causes approximately 30 percent of all cancer deaths in the country, it adds.

(Courtesy of Amanda Gardner, HealthDay Reporter)

Smokers: Consider Your Legs

Blocked arteries can lead to amputation

If you're a smoker, you should worry about your legs, the Society of Interventional Radiology warns.

What with lung cancer, heart attack, stroke and the like, smokers have plenty to worry about, the society acknowledges. But legs -- specifically, blood vessels in legs -- often get ignored.

Just as smoking accelerates the buildup of the fatty deposits in heart and brain arteries that result in heart attacks and strokes, it has the same effect in legs. The result is a condition called peripheral vascular disease (PVD), which can lead to gangrene or amputation.

And it's not only smokers who are at risk, says Dr. Ziv J. Haskal, a professor of radiology and surgery at Columbia University and a spokesman for the Society of Interventional Radiology. Other risk factors for PVD are identical to those for heart attack and stroke -- diabetes, high blood pressure, high cholesterol, obesity and lack of exercise.

"It is an accepted belief that PVD is vastly under-diagnosed," Haskal says. "It affects perhaps 10 million Americans. But it is often mistaken for other conditions, such as arthritis."

The classic symptom of PVD is intermittent claudication, leg pain that occurs when walking or exercising and disappears when the activity stops. But many people with PVD have other symptoms, such as numbness and tingling of the legs and feet, ulcers or sores that don't heal, or coldness of the legs or feet.

Such symptoms should send a person to a radiologist for a simple screening test called an ankle brachial index, which compares blood pressure in the leg with blood pressure in the arm, Haskal says. It is "an excellent diagnostic test," he adds.

"Detecting PVD doesn't mean that you can reverse it," Haskal says. "But its progression can be stopped by a supervised exercise program and medication. Such a program has been shown to improve walking distance."

For severe cases, he says, an interventional radiologist can apply the same techniques used for heart artery blockage -- angioplasty to widen the blood vessel followed by implantation of a stent, a flexible tube, to prevent it from closing.

And, of course, a smoker should stop smoking if possible, Haskal says, because "there are a thousand other reasons why someone should stop smoking."

(Courtesy of Ed Edelson HealthDay Reporter)

Heart Patients Gain by Quitting Smoking

Study finds it's never too late to break habit

 You have heart disease and chest pain -- a heart attack waiting to happen. Quitting smoking is the least of your worries, right?

Think again. Heart disease patients who quit smoking can reduce their risk of premature death by about 36 percent, regardless the severity of their illness or their age, says a new study by British researchers.

"It seems that it's always worth quitting," says study leader Julia Critchley, an epidemiologist at the Liverpool School of Tropical Medicine in England. The only time it's ever too late is, well, when it's too late.

Critchley and a colleague, Simon Capewell of the University of Liverpool, reviewed 20 previous studies of smoking cessation among heart patients. Of those, six were considered "higher quality," being relatively free of errors in methodology and other potential hitches that might skew the results.

The 20 studies included more than 12,000 people, of whom nearly 5,700 were smokers. Taken together, they showed that people who stopped smoking reduced their risk of death by 36 percent compared with those who continued lighting up. The so-called "relative risk" of suffering non-deadly heart attacks was also lower, by 32 percent, in the groups that quit smoking. Follow-up periods in the studies ranged from two years to 26 years. However, the risk of death didn't fall with time, suggesting that most of the drop in risk associated with quitting smoking occurs within two years or so of cessation.

A report on the new study appears in the latest issue of the Cochrane Library, an international medical publication.

Dr. Richard Stein, a cardiologist at Beth Israel Medical Center in New York City and a spokesman for the American Heart Association, says people who quit smoking often take up other heart-friendly behaviors, too. They're more likely to exercise, use medications to lower their cholesterol and blood pressure, and eat a low-fat diet high in fruits and vegetables. As a result, it's often difficult for researchers to tease out the precise impact of smoking cessation on reducing the risk of future heart problems.

Still, Stein adds, the latest study sounds "reasonable" given what researchers have found previously. The link, he says, is probably related to the way tobacco smoke exacerbates trouble spots, or plaques, in narrowed blood vessels. Smoking damages the cells that line vessel walls. When these cells are the only thing keeping a "vulnerable" plaque from breaking loose into the bloodstream, the added weakening can be devastating.

When people stop smoking, they snuff out a major source of instability for their vulnerable plaques -- and thus avoid future heart attacks and strokes, Stein says.

If you do quit smoking, ask for a raise. Michigan researchers have found that employees who quit smoking save their company money by boosting their productivity and reducing their medical expenses. However, the expenses for workers with chronic ailments such as arthritis, back pain or allergies take twice as long -- 10 years versus five -- to reach the level of employees who never smoked. That study appears in the latest issue of the American Journal of Health Promotion.

Courtesy of Adam Marcus (HealthDay Reporter )

Smoking and Bladder Cancer in Women

A new study shows smoking puts women at significantly higher risk for urinary bladder cancer.

University of Minnesota investigators report up to 25 percent of bladder cancer cases seen in their analysis of postmenopausal women could be attributed to smoking.

Bladder cancer strikes nearly 55,000 people in the United States every year. Men are more affected than women, and most studies gauging bladder cancer risks have been conducted among men. These researchers evaluated a large population of women past menopause to assess risk factors for this group.

The study involved more than 27,000 women who were participating in the Iowa Women's Health Study. All completed a study questionnaire on various health-related factors in 1988 and then were followed for the next 13 years to assess for bladder cancer incidence.

Results show current smokers had about a 5.5-fold higher risk of developing bladder cancer than nonsmokers. After adjusting for other factors that could increase the risk, smokers still had about a 4.25-increased risk. Quitting smoking helped. Women who had kicked the habit for longer than 15 years had a relative risk approaching that of nonsmokers.

The study also linked bladder cancer in women to several other risk factors, including diabetes, lack of physical activity, being unmarried, and having a smaller body mass index. However, these risks were not as significant as the smoking risk.

SOURCE: Cancer, 2002;95:2316-2323

Courtesy of Ivanhoe Newswire

Smokers Raise Risk of MS

Study finds they're twice as likely to develop disease

Smokers face twice the risk of developing multiple sclerosis (MS), a crippling disease that destroys the lining of nerve cells, new research shows.

Norwegian and American scientists have found people smoked -- including those who've quit the habit -- have nearly double the risk of MS as those who never used tobacco. The effect wasn't quite as great as the long-established impact of smoking on the risk of cardiovascular trouble, such as heart attacks and chest pain, but it was larger than the increased risk of asthma associated with tobacco use.

"We found this rather strong relationship between smoking and MS. It's almost comparable with cardiovascular disease" and smoking, says study leader Trond Riise, an epidemiologist at the University of Bergen in Norway.

Multiple sclerosis involves the destruction of a protein called myelin that covers nerve fibers -- probably by the body's own immune system. Myelin both protects nerves and lets them function properly. People with MS suffer a wide range of symptoms with varying severity. These include difficulty walking and swallowing, fatigue and vision problems. The disease, which affects 400,000 Americans, usually sets in between the 20s and 50s.

Scientists aren't sure why smoking might heighten the risk of developing MS. One explanation, Riise says, is that smoking saps the immune system and makes people vulnerable to infections, particularly of the throat, that trigger the nervous system disease. "We believe that it's most likely that the factor that initiates this disease is an infection," Riise says, though he admits that the mechanism remains "speculation." A report on the findings appears in the Oct. 28 issue of Neurology.

A 2001 study by Harvard University study turned up a similar link between smoking and MS in female nurses. That study, reported in the American Journal of Epidemiology in 2001, found the risk of MS diminished, though not entirely, in people who'd quit smoking compared with those who still smoked. However, the risk increased the longer a woman smoked.

Riise's group looked at the risk of MS and smoking in 22,240 Norwegian men and women living in Hordaland County in 1997. Of those, 8,239 never smoked, while 7,892 smoked and 6,109 had given up the habit.

The researchers identified 86 cases of MS. The risk of developing the disease was 80 percent greater among smokers or former smokers than among people who'd never smoked.

The association between smoking and the nerve disorder was greater for men than women. It didn't appear to wane significantly in former smokers, although most people had quit relatively recently before being diagnosed with MS, Riise says. The average duration of smoking before diagnosis was about 15 years.

In addition to raising the odds of developing MS and perhaps other autoimmune diseases, previous research suggests smoking also appears to worsen flare-ups of symptoms.

However, Stephen Reingold, vice president of research programs at the National Multiple Sclerosis Society, says the newest findings don't address that effect. "It does not tell us anything about the impact of smoking for people who have MS," he says.

Reingold says smoking, infections and other environmental exposures or behaviors probably interact with a genetic susceptibility to MS.

Courtesy of By Adam Marcus (HealthDay Reporter)

Smokers: Beware Bad Air

Pollution can triple heart attack risk, study finds

If you're unwise enough to smoke, you'd better keep a close eye on local air pollution levels, a French study indicates.

"We clearly showed that the heart attack rate was increased by 161 percent when the ambient air pollution index was high," says Dr. Yves Cottin, a professor of cardiology at the University Hospital of Dijon, who presented the findings Nov. 9 at the American Heart Association's annual conference in Orlando, Fla. "Smokers are particularly sensitive to air pollution, since we found a threefold increase risk in heart attack in the smoking population when the pollution is high."

The risk is closely associated with levels of fine particles, which mainly are generated by diesel engines, the study finds.

Cottin and his colleagues collected data on 322 Dijon area residents hospitalized for heart attacks in 2001 and 2002, looking at the relationship between incidence and levels of air pollution summarized in the ATMO index, which rates pollution on a scale of 1 to 10.

The pollution level rose to 6 or higher only 18 days of each year, but those days had the greatest incidence of heart attacks, especially for smokers, Cottin says.

Smokers "should reduce or stop cigarette smoking during poor air quality days," he says. "Smokers are also recommended to stay at home during those days."

And high pollution levels also call for special attention to the symptoms of a heart attack on high-pollution days, in case immediate emergency care is needed, Cottin says.

The French report is the latest addition to "a host of short-term and epidemiological studies that show an association between cardiovascular events and air pollution," says Dr. Robert D. Brook, an assistant professor of medicine at the University of Michigan and a member of an expert panel that is writing a position paper on the subject for the American Heart Association.

"Certain individuals are at especially high risk," Brook says. "They include smokers, the elderly, people with diabetes and children, in relation to asthma. This finding has been replicated all over the world, and an association has also been found with the risk of stroke."

Cottin says his group is studying the mechanism by which air pollution causes heart attacks and other cardiovascular problems. There is evidence that pollutants can contribute to an inflammatory process that leads to rupture of fatty deposits called plaques, releasing clots that block blood vessels, he says.

Some newspapers publish information on local air pollution levels on a regular basis, Brook says. Air pollution readings for communities across the country also are available daily on the Web site of the U.S. Environmental Protection Agency.

Courtesty of  Ed Edelson (HealthDay Reporter)

COPD: The Unnoticed Epidemic

Jump in cases fueled by women getting lung disease

Most people have never heard of it, and have no idea what the acronym means. But it's the fourth leading cause of death in the United States and the sixth in the world, and it costs $32 billion a year in this country alone.

COPD, short for chronic obstructive pulmonary disease, is essentially an umbrella term that refers to irreversible airflow obstructing and which includes chronic bronchitis and emphysema. Patients often say that they feel "hungry for air." The disease has no cure.

While death rates for other diseases include stroke and heart disease were decreasing, the mortality for COPD jumped 163 percent from 1968 to 1998. By 2020, experts say, it will be the third biggest killer in the world.

"It's a common disease that has reached epidemic proportions," says Dr. Richard S. Irwin, president of the American College of Chest Physicians, who moderated an American Medical Association panel on COPD Thursday.

Women are driving that trend, adds Dr. A. Sonia Buist, a professor of medicine at Oregon Health & Science University in Portland. In 2000, for the first time, deaths among women were higher than those among men from COPD.

About 24 million Americans are estimated to suffer from COPD, only 10 million of whom are diagnosed and only 6 million of whom are being treated. Those numbers help explain why November has been designated COPD Awareness Month, and why medical professionals are pushing for doctors and patients alike to recognize the disease in its own right.

Why the increase? Buist attributed it mostly to increases in smoking and in exposures to other risk factors, especially in developing countries, as well as to the changing age structure of the population. "More people are living into the COPD years," she says.

Smoking is, in fact, the number one cause of COPD, in the United States accounting for some 80 percent to 90 percent of cases. That number is probably less in developing countries where other exposures (for example, certain cooking fuels) are more common.

Why are women increasingly affected? Because they started smoking and joining the workforce in the 1940s and are now seeing the result of those exposures.

The disease is grossly under diagnosed, even though diagnosis can be as simple as spirometry, a classic breathing test that some argue should become the fifth vital sign. "Only 15 percent of people with COPD in the U.S. have had a breathing test," Buist says. Half of COPD patients are being treated by family doctors without spirometry.

One of the problems is that we all lose lung function as we get older, and the symptoms of COPD too often are confused with those of normal aging. Those symptoms include shortness of breath, increased effort to breathe, chronic cough, increased mucus production and frequently clearing of the throat.

Once lung damage has happened, it can't be reversed. The best you can do is to stop the damage in its tracks, and the best way to do that is to (you guessed it) stop smoking. In fact, the only two things that have been shown to improve mortality are oxygen supplementation in people with low blood oxygen and quitting smoking.

Drugs such as bronchodilators and inhaled steroids can control various symptoms but right now, that's it as far as pharmacotherapies go. "The prospect of something novel soon is not particularly good," says Dr. Alan R. Leff, a professor of medicine, pediatrics, anesthesia and critical care and the University of Chicago.

Exercise, however, does have benefits. It "doesn't change the lung but it allows you to do more with the lungs you have," says Dr. Mark J. Rosen, a professor of medicine at Albert Einstein College of Medicine in New York City.

Courtesy of Amanda Gardner HealthDay Reporter

Vitamin C May Ward Off Stroke
A study finds an added benefit for smokers.

People who eat a diet rich in vitamin C may be at lower risk of suffering strokes, and smokers who do so may benefit the most.

A new Dutch study finds people with the lowest amount of vitamin C in their diets were 30 percent more likely to have a stroke than people with the highest amount of it.

People with the highest amount of vitamin C in their diets consumed more than 133 milligrams of vitamin C per day. People with the lowest amount in their diets got less than 95 milligrams per day. The recommended daily amount is 60 milligrams a day.

Smokers with diets high in vitamin C were more than 70 percent less likely to have a stroke than smokers with diets low in vitamin C.

Antioxidants such as vitamin C may protect cells from oxidative stress, which plays a role in stroke, the researchers say.

"The lower third will have a higher risk of stroke and those with higher intake will be at lower risk," says study author Dr. Monique Breteler of Erasmus Medical Center in Rotterdam. "Vitamins don't react so differently within populations -- so this fits for general populations."

The research "confirms that the healthy diet is good for you, one that is rich in antioxidants and vegetables, as we have seen over the last several years," she adds.

Researchers studied 5,197 people aged 55 and older living in Rotterdam, all of the whom had no cognitive problems, were living independently, and had never had a stroke.

Participants were then tracked for an average of 6.4 years, and during that time, 253 of them suffered strokes.

The study also found smokers benefited from high levels of vitamin E in their diets. They were more than 20 percent less likely to have a stroke than those with diets low in vitamin E. Ironically, nonsmokers with high vitamin E levels didn't enjoy similar protection.

"This is not an excuse to continue smoking. There is more than enough medical evidence to show that smoking is extremely bad for you," Breteler cautions. "The effects of anti-oxidation are more than outweighed by other factors."

"But we looked at that because smoking causes damage due to increased oxidative stress. Then vitamin C has anti-oxidative properties, so we looked at [that] connection and saw that it was indeed the case," she says.

However, the use of dietary supplements containing vitamins C and E and other antioxidants didn't seem lower the risk of stroke more, but Breteler says this finding doesn't mean supplements have no potential benefit.

"I think it's important for the public to keep hearing the message about our diet and reducing stroke risk, and this study shows this quite very nicely," says Dr. Philip B. Gorelick, head of the cerebrovascular disease and neurological critical care department at Rush University Medical Center in Chicago.

The results appear in the Nov. 11 issue of Neurology.

This seems to confirm similar findings from a 2002 Finnish study, which showed a relationship between low vitamin C levels and an increased risk of stroke. The study of 2,419 men between the ages of 42 and 60 also showed a relationship between high levels of vitamin C and reduced stroke risk, especially in overweight and hypertensive men.

One possible explanation is that vitamin C enhances endothelial function, which inhibits artery clogging and lowers blood pressure. But the link could also simply be that people who take vitamin supplements or eat vitamin-rich fruits and vegetables may be more health-conscious than those who don't.

So the study cautions that vitamin C alone may not be responsible for the results of the study.

Rich sources of vitamin C include oranges and other citrus fruits, strawberries, red and green peppers, broccoli, and brussels sprouts. Good sources of vitamin E are vegetable oils such as sunflower seed, cottonseed, safflower, palm and wheat germ oils, margarine and nuts.

Vitamin C has had a much heralded history, ever since the 18th century British explorer James Cook was credited with being the first captain to use diet as a cure for scurvy, the disease caused by lack of ascorbic acids. After making his crew eat cress, sauerkraut and an orange extract, he lost no men to the ailment on several months-long voyages.

It has, it also seems, even reached a sort of cult status. One such example is the efforts of the former Nobel-prize winner Linus Pauling, who advocated, against medical evidence some say, megadoses of vitamin C to protect against cancer and many other ailments. Pauling died in 1994 at age 93.

But studies have shown that, since vitamin C passes out of the body via urine, amounts in excess of what the body can use are simply eliminated.

Courtesty of Drew Conaway HealthDay Reporter

What's in Cigarette Smoke?

Cigarette smoke contains over 4,000 chemicals, including 43 known cancer-causing (carcinogenic) compounds and 400 other toxins. These include nicotine, tar, and carbon monoxide, as well as formaldehyde, ammonia, hydrogen cyanide, arsenic, and DDT.

Nicotine is highly addictive. Smoke containing nicotine is inhaled into the lungs, and the nicotine reaches your brain in just six seconds.

Nicotine in small doses acts as a stimulant to the brain. In large doses, it's a depressant, inhibiting the flow of signals between nerve cells. In even larger doses, it's a lethal poison, affecting the heart, blood vessels, and hormones. Nicotine in the bloodstream acts to make the smoker feel calm.

As a cigarette is smoked, the amount of tar inhaled into the lungs increases, and the last puff contains more than twice as much tar as the first puff. Carbon monoxide makes it harder for red blood cells to carry oxygen throughout the body. Tar is a mixture of substances that together form a sticky mass in the lungs.

Most of the chemicals inhaled in cigarette smoke stay in the lungs. The more you inhale, the better it feels—and the greater the damage to your lungs.

Listed here are 109 of the more toxic chemicals. Those proven to cause cancer are in boldface type.

 

A
Acetaldehyde
Acetic Acid
Acetone
Acetylene
Acrolein
Acrylonitrile
Aluminum
Aminobiphenyl
Ammonia
Anabasine
Anatabine
Aniline
Anthracenes
Argon
Arsenic
 
B
Benz(a)anthracene
Benzene
Benzo(a)pyrene
Benzo(b)fluoranthene
Benzo(j)fluoranthene
Butadiene
Butane
 
C
Cadmium
Campesterol
Carbon Monoxide
Carbon Sulfide
Catechol
Chromium
Chrysene
Copper
Crotonaldehyde
Cyclotenes
 
D
DDT/Dieldrin
Dibenz(a,h)acridine
Dibenz(a,h)anthracene
Dibenz(a,j)acridine
Dibenzo(a,l)pyrene
Dibenzo(c,g)carbazole
Dimenthylhydrazine

E
Ethanol
Ethylcarbamate

F
Fluoranthenes
Fluorenes
Formaldehyde
Formic Acid
Furan
 
G
Glycerol
 
H
Hexamine
Hydrazine
Hydrogen cyanide
Hydrogen sulfide
 
I
Indeno(1,2,3-c,d)pyrene
Indole
Isoprene
 
L
Lead
Limonine
Linoleic Acid
Linolenic Acid
 
M
Magnesium
Mercury
Methane
Methanol
Methyl formate
Methylamineethylchrysene
Methylamine
Methylnitrosamino
Methylpyrrolidine
 
N
n-Nitrosoanabasine
n-Nitrosodiethanolamine
n-Nitrosodiethylamine
n-nitrosodimethylamine
n-Nitrosoethyl methylamine
n-Nitrosomorpholine

n-Nitrosopyrrolidine
Naphthalene
Naphthylamine
Neophytadienes
Nickel
Nicotine
Nitric Oxide
Nitrobenzene
Nitropropane
Nitrosamines
Nitrosonomicotine
Nitrous oxide phenols
Nomicotine
 
P
Palmitic acid
Phenanthrenes
Phenol
Picolines
Polonium-210
Propionic acid
Pyrenes
Pyrrolidine
 
Q
Quinoline
Quinones
 
S
Scopoletin
Sitosterol
Skatole
Solanesol
Stearic acid
Stigmasterol
Styrene
 
T
Titanium
Toluene
Toluidine
 
U
Urethane
 
V
Vinyl Chloride
Vinylpyridine

 

*Courtesy of QuitingSmokingSupport.com

Smoking Rate Dips Among U.S. Adults - CDC Study

 

The percentage of American adults who regularly smoke cigarettes fell slightly in 2001, according to a federal study. The numbers cast doubt on the nation's ability to meet a targeted reduction of the habit by 2010.

About 440,000 Americans die each year from lung cancer and other diseases related to tobacco use, making smoking the leading preventable cause of death in the United States, according to the federal government.

 

In 2001, an estimated 46.2 million adults, or 22.8 percent of those 18 years and over, reported that they were current smokers, according to an annual survey published on Thursday by the Centers for Disease Control and Prevention.

 

That compared to an estimated 23.3 percent of adults who smoked the previous year and 25 percent who did in 1993. Blacks in particular registered sharp declines in smoking in 2001, according to the survey.

 

CDC officials welcomed the findings, attributing them in part to the impact of anti-tobacco control programs at the state level, but they also warned that not enough money was being invested in such efforts.

 

Tobacco companies agreed in 1997 and 1998 to pay $206 billion as part of a landmark legal settlement with a number of states that had sued the industry to recoup the health-care costs of treating sick smokers.

 

"The states were starting to fund some comprehensive tobacco-prevention and control programs, but unfortunately with the budget crises those funds are being lost and put into general revenues," said Dr. Corinne Husten, medical officer in the CDC's office of smoking and health.

 

UNLIKELY TO MEET TARGET

 

"We do have a lot of concern that we may not be able to maintain these (smoking) declines," said Husten, who added that the United States was unlikely to meet a federal goal of reducing the adult smoking rate to 12 percent or less by 2010.

 

To hit that target, adult smoking would have to fall more than four times the rate of decline between 1994 and 2001.

 

The CDC is advocating that states increase the funding and implementation of comprehensive anti-tobacco programs that target different ethnic communities, adolescents and rich and poor Americans alike.

 

Anti-tobacco activists contend that the human and economic costs of smoking could be dramatically reduced if authorities at both the state and federal levels clamped down on tobacco advertising and raised taxes on cigarettes to make them less affordable, particularly to teenagers and young people.

 

In the past two years about half the state governments in the nation have increased excise taxes on cigarettes and other tobacco products. A number of others have passed legislation further restricting smoking in restaurants and public areas.

 

Earlier this year, an advisory committee to the U.S. Department of Health and Human Services recommended increasing the federal cigarette tax by $2 a pack and using at least half the revenue to help people kick the habit.

 

The Bush administration rejected the idea.

 

"We urge the White House to reconsider its position in light of the clear need for bold and aggressive efforts at all levels," Matthew Myers, president of the Campaign for Tobacco-Free Kids, a Washington-based anti-tobacco group, said on Thursday.

 

SOURCE: Morbidity and Mortality Weekly Report October 10, 2003

Magnetic Field May Help Smokers to Quit

Smokers exposed to repeated pulses of magnetic energy via a coil-shaped stimulator placed on the head apparently smoke less afterwards, German doctors report.  This technique, called high-frequency repetitive transcranial magnetic stimulation (TMS) may eventually be used to reduce cigarette smoking among individuals who want to quit.

 

Repetitive TMS, sometimes used to treat depression, "is a novel approach that has never been tried before" for smoking cessation, lead author Dr. Peter Eichhammer told Reuters Health.  Drugs, such as bupropion or nicotine replacement, are commonly prescribed for patients when they decide to stop smoking. Eichhammer explained that his team studied TMS because it specifically "targets areas related to the brain's reward system." Hence, TMS avoids side effects caused by drugs that affect other areas of the brain not involved in cravings.

 

The research team at the University of Regensburg, Germany, conducted a trial in a group of 14 smokers who wished to stop smoking. According to their report in the Journal of Clinical Psychiatry, each subject underwent two trials of active stimulation and two trials of "sham" stimulation on 4 consecutive days, without knowing which was which.

 

On average, the subjects smoked significantly fewer cigarettes during the 6-hour period immediately following active treatment compared with placebo treatment. No adverse effects other than two cases of mild headache after active stimulation were reported.

 

The German research team has initiated a larger trial of repetitive TMS as treatment for smoking cessation. In addition, Eichhammer said, "We want to optimize high-frequency repetitive TMS as an effective method for treating other addictions as alternatives to conventional drug-related treatment approaches."

 

SOURCE: Journal of Clinical Psychiatry, August 2003.

Smoking and Litter

A frequently overlooked aspect of smoking is the ever-growing problem of litter.  The following is an excerpt from www.cigarettelitter.org a non-profit organization dedicated to reducing cigarette-related litter.  Please check out their site and you might find out some new information about the multiple dangers of the use of tobacco products!

 

There is a lot of misinformation out there regarding cigarette butt litter. The biggest myth is that cigarette filters are biodegradable. In fact, cigarette butts are not biodegradable in the sense that most people think of the word. The acetate (plastic) filters can take many years to decompose. Smokers may not realize that their actions have such a lasting, negative impact on the environment.

This myth has been perpetuated not just by the wishful thinking of many smokers, but also by the cigarette companies, who have taken great pains to keep their customers in the dark on this issue. It is very common for highly littered items such as soda cans, snack wrappers, and fast food containers to have a simple "Please Don't Litter" message. You won't find such a message on cigarette packs. Although our contacts in the industry are at a loss as to why they can't take this simple step, our best guess is that they would prefer to leave their customers blissfully ignorant. Maybe they think that people will smoke fewer cigarettes if they have to be responsible for disposing of them. We think they ought to give their customers the benefit of the doubt. Smoking and littering do not have to be synonymous, as many smokers have proven by example.

What happens after that butt gets casually flicked onto the street, nature trail, or beach? Typically wind and rain carry the cigarette into the water supply, where the toxic chemicals the cigarette filter was designed to trap leak out into aquatic ecosystems, threatening the quality of the water and many aquatic lifeforms. Cigarette butts may seem small, but with several trillion butts littered every year, the toxic chemicals add up!

 

Study Affirms Safety of The Pill

 

But news isn't so good for smokers who took the early versions of oral contraceptive

There's good news for women who were early users of birth control pills in the 1970s and 1980s as well as for women now taking newer versions of oral contraceptives.

A large, decades-long study confirms that nonsmoking women on the pill do not have higher overall death rates. Although mortality rates from cervical cancer were higher, these were balanced out by decreased death rates from ovarian and other uterine cancers.

Smokers have a much more grim prognosis, however. The study, appearing in the July 19 issue of The Lancet, found that overall death rates were more than twice as high for women who took the pill and who smoked at least 15 cigarettes a day as compared to nonsmokers.

Two other large studies had already published similar results. "This is a pretty solid finding with these big studies in agreement," says Dr. Martin Vessey, lead author of the latest study. "The sound statistical conclusion is that there is no harmful effect to taking oral contraceptives. That's a very important result." Vessey, an emeritus professor of public health at the University of Oxford in Britain, has been involved in the study since it began 35 years ago.

The study started by recruiting 17,032 British women between 1968 and 1974. At the time, the women were aged 25 to 39 and were white and married. All used oral contraceptives, a contraceptive diaphragm, or an intrauterine device (IUD). Many of the women ended up being on the pill for at least eight years, Vessey says.

"In common with a number of studies, we did find an increase in deaths from cancer of the cervix in pill users," Vessey says. "That was compensated for by fewer deaths from cancers of the other parts of the uterus and from cancers of the ovary. If you put those three reproductive cancers together, the net effects of the pill on the three is beneficial."

"Their findings are consistent with previous studies, and that is a slight increase in cervical cancer and a decrease in particular in ovarian cancer. We've pretty much known this for many years now," adds Dr. Sanjay Agarwal, director of the Center for Reproductive Medicine at Cedars-Sinai Medical Center in Los Angeles.

Heavy smokers, however, had more than double the death risk, largely from heart disease and stroke.

"The key to this study is the breakdown effect of smoking. It really does underline the significant detrimental effects of smoking even in young ages," Agarwal. "This study just highlights very strongly that smoking really does increase the risk of heart attacks and hemorrhagic stroke in women taking birth control pills."

So what does it mean to today's pill users? "This study mainly concerns the pills used in the '70s and '80s, and in Britain those pills were mostly pills containing 50 micrograms of estrogen. They were sort of medium dose," Vessey says. "Nowadays the pills used have lower doses of estrogen and hormones generally."

For middle-age and early elderly women who were on the pill during this time period, the results should be very reassuring -- as long as they're not smokers.

"I think you could definitely regard these findings as also being reassuring in terms of modern pills, although obviously there is a bit of extrapolation there," Vessey says.

"We would assume that lower doses equate with more safety, so I think this is encouraging," Agarwal adds. "I think the main areas where oral contraceptives are likely to be safer are with stroke and heart attacks."

Another study is looking at this very thing. And, meanwhile, the current researchers will continue to collect data from this study.

 

Courtesy of Amanda Gardner

SOURCES:  Martin Vessey, M.D., emeritus professor of public health, University of Oxford, Oxford, U.K.; Sanjay Agarwal, M.D., acting director, division of reproductive endocrinology, and director, Center for Reproductive Medicine, Cedars-Sinai Medical Center, Los Angeles; July 19, 2003, The Lancet.

Smoke Screen

Study: Tobacco use in movies spurs teens to smoke

Smoking on the silver screen strongly encourages adolescents to start puffing themselves, new research says.

The study finds that adolescents exposed to more smoke-filled films are far more likely to take up smoking over the next two years than their peers who don't watch such movies.

"Smoking in the movies is associated with about 125,000 children a year dying prematurely," says Stanton Glantz, director of the Center for Tobacco Control Research and Education at the University of California, San Francisco.

Making smoking on screen a trigger for an "R" rating would cut that 125,000 figure in half, says Glantz, author of an editorial accompanying the journal article. "The question is, does the Motion Picture Association of America [MPAA] want to save 63,000 lives a year with appropriate ratings?" he says.

Many previous studies have suggested that depictions of smoking on screen encourage teens to smoke. Indeed, the World Health Organization declared "tobacco-free films" a theme of this year's World No Tobacco Day.

Harder to prove, however, is a direct connection between a teen seeing smoking in a movie and his or her decision to pick up the habit. The latest study sought to determine how often that happened.

A research team led by Madeline Dalton, a professor of pediatrics at Dartmouth Medical School, followed 2,603 boys and girls, ages 10 to 14, who said at the beginning of the study that they'd never smoked. They were asked if they'd seen any of 50 popular films -- out of a possible 601 -- with varying amounts of smoking. Titles ranged from action blockbusters like Die Hard and True Lies to children's movies, including 101 Dalmatians (the live-action version), Free Willy, and The Little Mermaid.

"We picked them based on box office receipts, not on whether they had smoking," Dalton says.

Over the next 13 to 26 months, 259 (about 10 percent) of the boys and girls reported smoking at least once. But while 17 percent of those in the group that saw the most movies with smoking tried tobacco, only 3 percent in the group that saw the fewest such films did so.

Risk-seeking behavior, rebelliousness, self-esteem, parental history of smoking, and other personality and parenting factors affected the chances that a child would start smoking. After weighing these factors, the researchers determined that seeing smoky movies still nearly tripled the odds a youth would experiment with tobacco -- a greater effect even than cigarette advertising, Glantz says.

"We found that of the children who tried smoking, half of them did so based on what they saw in the movies," Dalton says.

Dalton, like Glantz, believes the film rating system needs to start considering smoking. "The current intent of the ratings system is to notify parents of content that is thought to be inappropriate for children," she says. "Now we have evidence that smoking in movies is inappropriate for children and the message needs to be put out there."

Since smoking is rarely integral to movie plots, Glantz says, people should wonder why characters are often lighting up. "Sex and violence sell tickets. Smoking doesn't. Why are [movie studios] clinging to it?"

The MPAA did not return calls seeking comment.

Tobacco industry documents reveal that cigarette makers in the past have forged deals with Hollywood studios to feature certain brands in films -- despite denials by both sides. And while scripts may not call for a character to smoke, actors and directors often decide a scene calls for cigarettes anyway.

Kimberly Thompson, a Harvard epidemiologist who has studied tobacco use and movies, calls the new study "important" because it's the first thorough attempt to put a time-frame around youth smoking and exposure to the habit on film. However, she says, the researchers fall short of sealing their case.

"A strong correlation still doesn't get you to causation. This is good and strong evidence, but it's still a correlation," Thompson says.

By Adam Marcus
HealthDay Reporter

Studies Rap Philip Morris on Gay Marketing

In two new reports, researchers claim the Philip Morris tobacco company tried to extend its advertising reach into the gay community in the early 1990s while denying it was targeting any specific group.

"They were trying to have it both ways. They want the market, they want the business, but they want to buy our silence and distance themselves when homophobes object to their involvement," says Naphtali Offen, co-author of one of the studies and a research associate at the LGBT (Lesbian, Gay, Bisexual & Transgender) Tobacco Project at the University of California at San Francisco (UCSF).

Philip Morris also turned a boycott led by gays into a public relations opportunity by boosting its funding for AIDS organizations, the researchers say.

But a spokesman for Philip Morris defends the company, saying it markets its product -- which he acknowledges is "addictive" and "causes serious disease" -- to all kinds of groups and has advertised for years in gay-oriented magazines. In regard to the boycott issue, spokesman Brendan McCormick says the company has a history of supporting charitable organizations, including those that fight AIDS.

Today, tobacco companies actively pitch their products to gays through advertising in magazines and newspapers, and the market seems to be receptive. Studies have shown gays and lesbians are more likely to be smokers than heterosexuals.

But tobacco companies weren't always interested in advertising directly to gays. In 1992, Philip Morris became the first tobacco company to buy ads in a gay-oriented magazine.

But the groundbreaking ads in a magazine called Genre, geared toward gay men, created a stir. Philip Morris responded to media requests by saying it didn't target "specific groups in society," researchers report in the June issue of the American Journal of Public Health.

That, the researchers charge, was disingenuous. An examination of internal tobacco company documents found that a marketing consultant in early 1992 urged the company to advertise its Benson & Hedges cigarette brand in gay publications.

The documents were released in 1998 as part of a settlement between the attorneys general of several states and the tobacco industry.

The consultant wrote that the company could target the gay community and that "you can own this market." The company agreed to do so, "but when they got called on it, they said they really didn't even see [Genre] as a gay magazine," says study co-author Elizabeth A. Smith, a research associate at UCSF's LGBT Tobacco Project.

Philip Morris continued to advertise in gay publications throughout the 1990s. "Our marketing efforts are designed to appeal to diverse people of both genders and all ethnic groups and sexual preferences," McCormick says.

In another report, in the June issue of Tobacco Control, researchers at the University of California at San Francisco claim a 1990 gay boycott against Philip Morris backfired.

The boycott was launched by the Washington, D.C., chapter of the ACT-UP organization, which used a blend of public theater and shock tactics to draw attention to the AIDS epidemic. The chapter was angry about the tobacco company's support of then Senator Jesse Helms, R-N.C., an opponent of AIDS funding and gay rights.

The boycott, against Marlboro cigarettes, had no major effect on the earnings of Philip Morris, the researchers say. But the company did respond by boosting its funding of AIDS organizations and the chapter ended its boycott efforts, even though Philip Morris still supported Helms.

"The boycott that was initially against the industry ended up being an opportunity for [Philip Morris] to make friends by settling the boycott," Smith says.

McCormick, however, says Philip Morris has long supported charities, including those involved in health efforts. In fact, he says, the tobacco company even supports efforts to educate people about the risks of smoking.

"We manufacture a product that causes serious disease in smokers and is addictive," he says. "The safest thing for people to do is not for smoke at all."

However, he adds, 45 million Americans haven't made that choice.

Meanwhile, the company went a step further Tuesday toward accepting more government regulation. Mike Szymanczyk, chief executive of Philip Morris, told a Congressional panel that oversight from the U.S. Food and Drug Administration (FDA) would let the company sell two products that are less harmful than cigarettes, according to an Associated Press report.

The company had long opposed any government regulation over tobacco, but changed course in 2000, saying it would be amenable to some oversight. However, the U.S. Supreme Court ruled that year that the FDA had no authority.

SOURCES: Naphtali Offen and Elizabeth A. Smith, Ph.D., research associates, LGBT Tobacco Project, University of California at San Francisco; Brendan McCormick, spokesman, Philip Morris, New York City; June 2003 American Journal of Public Health; June 2003 Tobacco Control

Courtesy:  By Randy Dotinga HealthDayNews Reporter

 

Smoking Increases Panic Attack Risk

Studies in the past suggested an association between smoking and mental disorders. Now, new research finds a unique connection between smoking and the risk of a panic attack.

For the research, authors used data from the Early Developmental Stages of Psychopathology Study. The study included adolescents and young adults in Munich, Germany. Researchers assessed number of cigarettes smoked, nicotine dependence, panic attacks, panic disorder, other anxiety disorders, and other mental disorders. Study participants were followed for four years.

At the start of the study researchers note a clear association between panic attacks and disorders and regular smoking and nicotine dependence. After analyzing the data, researchers say they also found an increased risk for the onset of a panic attack in those who smoked regularly and were nicotine dependent. Prior nicotine dependence also increased a person's risk for the onset of a panic disorder, whereas those who had panic problems did not show a tendency to turn to smoking.

Researchers say this study shows a rather unique and specific relationship between smoking and the increased risk for a panic attack or panic disorder. They say their results suggest smoking and nicotine dependence increase the risk for panic attacks and disorder but not for most other anxiety disorders. Furthermore, prior smoking increases the risk for a panic problem, but there is no higher incidence of smoking among cases with an anxiety disorder.

SOURCE: Archives of General Psychiatry, 2003;60:692-700

Smoking on the Big Screen

Now researchers in New Hampshire say parental guidance can impact what movies kids see, and, in turn, their exposure to harmful habits. It's clear the presence of smoking by celebrities in movies influences adolescent attitudes and behavior.

Movies traditionally glamorize smoking, associating it with character traits such as toughness, rebelliousness, and sexiness, the research explains. Past research has shown adolescents are responsive to actions, including smoking and drinking, portrayed on screen. The influence of the media in this situation, finds research, can be very powerful. James D. Sargent, M.D., and his team of researchers at Dartmouth-Hitchcock Medical Center, sought to determine what factors could modify adolescent exposure to smoking in movies.

Nearly 5,000 junior high school students participated in the study. The students reported which of the 50 randomly chosen movies they had seen. The researchers then analyzed the occurrence of smoking in these films. In general, the students who had the most exposure to smoking in movies had the least amount of parental restriction and the greatest access to movies, including movie channels available at home. Dr. Sargent concludes, "Exposure to movie smoking is reduced when parents limit movie access" and monitor the films they allow their child to view.

Dr. Sargent proposes that a new approach to the exposure of movie smoking "may be to limit access of young adolescents to movies," because adolescents who saw fewer smoking depictions also saw fewer movies in general.

SOURCE: Archives of Pediatric & Adolescent Medicine 2003;157:643-648

Banning Smoking in the Home Helps Infants

Banning smoking in the home limits infants' exposure to tobacco smoke. Infant exposure to environmental tobacco smoke increases the risk of sudden infant death syndrome, asthma, and other respiratory conditions.

A recent study analyzed the urinary cotinine levels, a byproduct of nicotine, of 314 infants living in smoking households. Participating infants were between 4 weeks and 24 weeks old. Researchers from the University of Warwick, United Kingdom, found banning smoking in the home was associated with a small but significant reduction in cotinine levels. Other methods to reduce tobacco smoke in the home, such as no smoking while the infant sleeps or limiting the number of cigarettes, produced no reduction in the cotinine levels and had no effect on exposure of infants.

More than 80 percent of participating parents thought environmental tobacco smoke was harmful and 90 percent believed that their children could be protected from smoke exposure in the home. At least half of the parents reported using more than one measure to reduce infant tobacco smoke exposure in the home. Further research is needed to determine if measures less strict than banning smoking, like opening windows and using fans while smoking will have any effect on infant cotinine levels.

SOURCE: British Medical Journal, 2003;327:257-260

Courtesy of (Ivanhoe Newswire)

Smoking and Oral Contraceptives: A Deadly Combination

A new study shows oral contraceptives are safe for non-smokers but can be deadly for women who smoke. The study began 35 years ago and included 17,000 women.

Oral contraceptives were widely used in the 1970s and 1980s. There has long been a question of whether being on the birth control pill could increase your chance for cancer or other fatal diseases. As part of the Oxford Family Planning Association study, researchers from the Institute of Health Sciences in England looked at the deaths associated with oral contraceptives use and cigarette smoking.

The women in the study were between 25 and 39 years old. They either used oral contraceptives, a contraceptive diaphragm or an intrauterine device. Follow-up information was available on the women up until 2000. By that time, researchers report 889 of the 17,000 women had died. Researchers looked at the cause of death and which contraceptive they used.

The study reports there was no increased risk of death among the women who used the birth control pill compared to the women who never used oral contraceptives. In fact, the numbers suggest the death rate was lower among those who were on birth control pills. However, there was an increased risk of death from heart disease in women who used the oral contraceptive and smoked. Specifically, there was a 25-percent increased risk of death for light smokers. The study also found women who smoked more than 15 cigarettes a day and were taking oral contraceptives were twice as likely to die than non-smokers.

Researchers say this study confirms what three other studies have found in that there is no adverse effect from oral contraceptive use in non-smokers. Study authors say this should be a reassuring finding for many older women today. However, the study also confirms that smoking and oral contraceptive use can be a deadly combination.

This article was reported by Ivanhoe.com, who offers Medical Alerts by e-mail every day of the week. To subscribe, go to: http://www.ivanhoe.com/newsalert/.

Teaching Blue-Collar Workers to Kick Butts

Blue-collar workers have traditionally had the hardest time trying to kick the smoking habit. But researchers have found a new method that doubles the success rate for those who want to quit.

The study, published in the August issue of the journal Cancer Causes and Control, found that blue-collar workers are more willing to quit when they're taught about the risks of combining smoking with other common workplace hazards.

"We're trying to catch their attention," says the study's lead author, Glorian Sorensen, a Harvard University professor and director of the Dana-Farber Cancer Institute's Center for Community-Based Research.

"Blue-collar workers have a harder time quitting. And more traditional workplace programs haven't been as successful with blue-collar workers," she says.

There's a pressing need for a successful cessation program because blue-collar workers smoke far more than other workers. A 1997 study found that 37 percent of male blue-collar workers and 33 percent of female workers smoked. For white-collar workers, just 21 percent of men and 20 percent of women smoked, Sorensen says. Moreover, white-collar workers are quitting at a faster rate, she says.

But the risks of smoking on the job aren't just limited to cigarettes for blue-collar workers. Those workers are often exposed to chemicals that can become deadlier when combined with smoking. For example, asbestos workers who smoke dramatically increase their chances of dying of lung cancer, the American Lung Association says.

Even without smoking, American workplaces can be dangerous. An estimated 60,000 people die of occupational diseases every year; of those, more than 17,000 die of lung cancer because of inhaling cancer-causing agents, the American Lung Association says.

Those factors increase the urgency of persuading blue-collar workers to quit, Sorensen says.

In prior studies, she found that blue-collar workers get less support in their efforts to quit than white-collar workers, even though they're often very willing to try.

"Blue-collar workers attempt to quit at the same rate as white-collar workers, but they're much less successful. Maybe there is more peer pressure in these workplaces," adds Greg DeLaurier, a consultant with the University of Massachusetts in Lowell, who works with labor unions around the country to establish smoking-cessation programs.

For the Dana-Farber study, researchers randomly selected 15 large manufacturing companies around the Boston area. Then they divided the workers into two groups. One group went through a general health program, which included information about the risks of smoking. The other group focused on specific occupational hazards within the workplace, and how smoking makes them worse.

Twice as many workers in the latter group quit smoking over the 16-month study, Sorensen found. And because they were already careful about workplace hazards, they were much more willing to support their co-workers' efforts to quit smoking.

DeLaurier has had the same experience in working with blue-collar smokers.

"What doesn't work very well is if you just offer a generic smoking program," he says. "But if you tie it into the specifics of the workplace, smoking is no longer just an abstraction. It puts it in a context the worker will listen to."

The study also supports the idea that the work environment is an ideal place to tackle health issues, Sorensen says.

"The large majority of adults spend their time in a work setting. It's a place that shapes our behavior through social norms and the support you get from your co-workers," she says. "As we think about health, whether smoking or anything else, we need to think about how those individual factors are situated in the broad fabric of a person's life."

What To Do

To learn more about occupational hazards and their long-term effects, visit the American Lung Association. For information about smoking on the job, visit this site. To read one of the first federal reports about the risks of smoking in blue-collar work sites, try the Centers for Disease Control and Prevention.

SOURCES: Glorian Sorensen, Ph.D., professor of health and social behavior, department of health and social behavior, Harvard School of Public Health, and director, Dana-Farber Institute's Center for Community-Based Research, Boston; Greg DeLaurier, labor consultant with the University of Massachusetts, Lowell; August 2002 Cancer Causes and Control.  By Ross Grant HealthScoutNews Reporter

Smoking Cessation and Its Benefits

Description
Quitting smoking can have a profound, positive impact on a person's quality of life.

Data from large prospective studies have shown that cigarette-smoking men have a 70 percent higher overall death rate than nonsmokers. The excess mortality of female smokers has been somewhat less than that of male smokers, but is increasing.

A strong dose-response relationship exists between cigarette smoking and excess mortality, as measured by the age at onset of smoking, the number of cigarettes smoked, the number of years smoking, and the depth of inhalation. Cessation of smoking is associated with a decrease in excess mortality.

Treatment
Speak with your physician about quitting smoking. He or she will help you through the process, answer your questions, and give you support.

Nicotine replacement therapy is available (nicotine patch, nicotine gun, and nicotine nasal spray) after you have quit.

Other medications may be helpful as well.

Questions To Ask Your Doctor
Are there tests that will show the status of my lungs?

Will there be weight gain if smoking is stopped?

Are there any medications to help a person stop smoking?

What are their side effects?

Is nicotine addicting?

Will there be increased nervousness when a person stops smoking?

Does genetics have anything to do with smoking?

Does smoking cause permanent staining of the teeth?

What are the pros and cons of the nicotine patch, nicotine gum, and nicotine nasal spray?

Passive Smoke Tied to Dental Woes in Kids

Study finds link, but expert sees no association

Parents have yet another reason to quit smoking: Passive smoke from their puffing could be ruining their children's baby teeth.

That's what researchers from the University of Rochester Medical Center in New York conclude in a new study, although at least one dental expert isn't convinced this study proves such a link.

In the March 12 issue of the Journal of the American Medical Association, the Rochester researchers report that children who are exposed to environmental tobacco smoke have almost twice the risk of cavities that youngsters in smoke-free homes do.

"This is just one more piece of evidence that passive smoke harms children," says study author Dr. C. Andrew Aligne, who was with the University of Rochester Medical Center at the start of the study but finished it after founding a company called Pediathink.

Aligne says further research needs to be done to corroborate their findings, but adds, "if this relationship is causal, one quarter of children with cavities in their baby teeth would be cavity-free if tobacco smoke exposure could be eliminated."

However, Dr. Manuel Cordero, a New Jersey dentist and a spokesman for the Academy of General Dentistry, isn't convinced. "There may be a connection [between passive smoking and children's cavities], but it has not been proven by this study," he says.

Despite advances in dental care, tooth decay remains a common childhood disease, costing the U.S. more than $4 billion a year, according to the study. Tooth decay causes pain, poor appearance and possible problems with speech development.

The researchers gathered data on 3,531 children between the ages of 4 and 11 for this study from the Third National Health and Nutrition Examination Survey. All of the children had a complete dental examination and blood tests that measured their cotinine levels. Cotinine is a byproduct of nicotine that is present in the blood of people who are exposed to smoke, either directly or indirectly.

Fifty-three percent of the children had cotinine levels high enough to indicate passive smoke exposure, according to the study. Nearly half of all the children had at least one decayed or already filled baby tooth, while 26 percent already had a cavity in one of their permanent teeth.

Children exposed to passive smoke had almost twice the risk of having a cavity in their baby teeth, according to Aligne. However, there was no statistically significant relationship between cavities in permanent teeth and passive smoke. While the researchers weren't able to address the reason why with the data available, Aligne believes that as with other health risks, younger children and their developing bodies are simply more susceptible.

Cordero points out the researchers found that cavities in baby teeth were nearly three times as common in kids whose parents had less than a high school education compared to those with more than a high school education. This factor, he says, is probably more of an influence on cavity development than passive smoking.

Aligne, however, says he and his colleagues tried to control the data for other potential risk factors -- such as poverty, race, sugar intake and family income -- and that they still found an association between passive smoke and cavities in baby teeth after doing so.

In the study, the researchers explain it may not necessarily be the smoke exposure, but that parents who smoke may also have other unhealthy behaviors, such as not brushing teeth regularly or eating too much candy, which could be causing the cavities.

Cordero believes these explanations are much more likely. "Parents who smoke are teaching poor overall health habits," he says.

Whether the connection between passive smoke and cavities holds up in future studies or not, Aligne says, "Dental cavities and passive smoking are still very big public health problems and we need to do more to prevent them."

Source:  By Serena Gordon, HealthScoutNews Reporter

 

Temporary Symptoms May Cause Some to Relapse

Smokers are likely to develop mouth ulcers and cold symptoms for up to two weeks after quitting. This problem, which researchers say is temporary, may be one reason so many succumb to nicotine's urges.

But if smokers trying to quit can hang on, all symptoms seem to be gone after six weeks, according to new research. The study is published in the February issue of Tobacco Control.

Researchers followed the progress of 174 smokers wanting to quit. The smokers went through a seven-week smoking cessation program combining behavior support with nicotine patches.

After weeks one and two, there were significant increases in mouth ulcers and cold symptoms, such as coughing, sneezing, and sore throats. It was during this time, according to researchers, that people were more likely to have setbacks. Slightly less than half the participants managed to resist temptation for the entire six weeks of the study.

The researchers say that mouth ulcers may be caused by the loss of antibacterial properties of smoking while an increase in cold symptoms may be due to a loss of natural antibodies in the saliva.

Michael Ussher, MD, and colleagues, conclude that more research is needed to determine if cold symptoms and mouth ulcers persist beyond two weeks after quitting.

Being psychologically prepared for these effects may improve smokers' odds of quitting, they say.

SOURCE: Fern Garber - WebMD News Tobacco Control, February 2003

Can Lung Cancer Be Prevented?

Retinoid May Help Prevent Lung Cancer - Vitamin A Derivative May Lower Risk Among Former Smokers

by Jennifer Warner (WebMD Medical News   )

Quitting smoking is the single biggest thing a person can do to reduce their risk of lung cancer, but now researchers may have finally found a way to lower the risk for people who have already quit their cigarette habit. A new study shows that daily treatment with a retinoid drug may prevent lung cancer in former smokers.

Retinoids are natural and synthetic compounds related to vitamin A (retinol) and retinoic acid (RA). Although they have been found to help prevent head and neck cancers, until now retinoids have not been shown to be effective in preventing lung cancer.

In fact, researchers say some studies have shown that retinoids are of no benefit in reducing the risk of lung cancer in current smokers. But this may be the first study that has shown a benefit in targeting former smokers and reversing signs of precancerous lesions in lung tissue.

Lung cancer is the leading cause of cancer death in the U.S., and researchers say about 90% of all lung cancers occur in people who smoke, which has made smoking cessation efforts a major focus of lung cancer prevention efforts.

Although the risk of lung cancer decreases in people who quit smoking, the risk still remains about twice as high as those who have never smoked, for about 20 years after they quit. The risk after 20 years lowers some but continues to remain high.

In the study, published in the Feb. 5 issue of the Journal of the National Cancer Institute, researchers looked at the effects of two different types of retinoids on restoring the presence of a substance called retinoic acid receptor beta (RAR-beta) in lung tissue from a group of 226 former smokers. Loss of RAR-beta is considered a sign of pre-cancerous tumors.

Researcher Jonathan M. Kurie, MD, of the University of Texas M.D. Anderson Cancer Center in Houston, and colleagues found a loss of RAR-beta in nearly 60% of the participants at the start of the study.

But after three months of twice-daily treatment with the retinoid known as 9-cisRA, there was a significant increase in the presence of RAR-beta among those who received the retinoid compared with the placebo. No benefit was found for the second type of retinoid tested.

Researchers say the study shows that the benefits of retinoid treatment may differ among current vs. former smokers.

In an editorial that accompanies the study, Jason S. Vourlekis, MD, and Eva Szabo, MD, of the National Cancer Institute, say it remains to be seen how restoration of RAR-beta might correlate to a reduction in risk of lung cancer, and more studies will be needed to examine that issue.

SOURCE: Journal of the National Cancer Institute, Feb. 5, 2003.

Smokers have more aches and pains!

As if lung cancer, heart disease, and emphysema weren't enough, researchers now say smoking may be to blame for some common aches and pains, too. A new study shows smokers are more likely to complain about pain in their back, neck, arms, and legs than non-smokers.

The report, published in the January issue of the Annals of Rheumatic Diseases, shows smokers as well as ex-smokers are at higher risk for aches and pains -- especially those that lead to chronic disabilities and interfere with daily activities.

Researchers surveyed nearly 13,000 adults across Great Britain and asked them about whether they suffered pain in the low back, neck, upper and lower limbs in the last 12 months. They also asked questions about their smoking habits, physical activities at work, headaches, tiredness, and stress.

They found the percentage of people who reported pain in the past year was consistently higher among smokers and ex-smokers for all the parts of the body examined by the study.

Smokers and ex-smokers were at especially high risk for pain that prevented them from performing daily tasks.

Researcher K. T. Palmer, MD, of the Southampton General Hospital, and colleagues say some of their findings may be muddled by the fact that current and ex-smokers were more likely to have a physically demanding job. This group also reported feelings of frequent tiredness, stress, and headaches, which could indicate a lower overall threshold for pain.

But researchers say the pattern persisted even when they adjusted for these factors and when they looked at pain reported among only white-collar workers.

Even so, they say it's unclear whether tobacco affects the body's pain sensors, or whether people with a low tolerance for reporting pain and disability are more likely to take up and keep smoking.

"If taking up smoking increases pain susceptibility, then this provides another reason to avoid the habit," according to the researchers, "but if the type of people who smoke report pain more readily, a search should next be made for the underlying mechanisms...."

~Jennifer Warner

 

Nicotine Replacement Backed Despite Cancer Study

Researchers, maker say they're still much safer than smoking

By Randy Dotinga

Nicotine replacement products are much safer than smoking despite a new study suggesting that nicotine could play a role in lung cancer.

That assurance comes from a leading maker of these products as well as researchers who reported last week that nicotine appears to give a helping hand to cancer cells in the lungs.

"Our study is probably the first to show that nicotine can act similarly to a carcinogen," says Kip A. West, a researcher with the National Cancer Institute.

However, the study is based on findings in the laboratory, and researchers haven't tested their theories on animals or humans. And the scientists aren't suggesting that smokers give up trying to quit with the aid of nicotine replacement products, which now include lozenges in addition to the ubiquitous patches and gum.

To make the point even clearer, GlaxoSmithKline issued a statement saying the risks of using nicotine-based smoking cessation products "are extremely small compared to the known deadly risks of smoking." The pharmaceutical company makes NicoDerm CQ nicotine patches, Nicorette gum and Commit lozenges, which let smokers slowly wean themselves off their addiction by getting doses of nicotine without having to light up.

According to the American Cancer Society, the nicotine replacement products deliver lower doses of the chemical than tobacco. They also let smokers focus more on the psychological difficulties of quitting than the physical addiction.

While nicotine is considered to be largely responsible for turning smokers into addicts, scientists have not considered it to be a cause of cancer. Instead, researchers blame hundreds of other poisonous chemicals in cigarettes, pipes and cigars.

Federal researchers, however, wondered whether nicotine could play a role in the development of cancer. They set up experiments involving lung cells in a laboratory and report their findings in a recent issue of the Journal of Clinical Investigation.

In a healthy body, cancer-infected cells will automatically activate a kind of suicide program: The cells will kill themselves before they can wreak havoc on the body. However, when researchers hit human lung cells with cancer-causing chemicals, the levels of nicotine normally experienced by smokers appeared to prevent the cells from switching on the suicide protocol.

"It has a protective effect," West says. The survival of the cells, in turn, "allows them to accumulate mutations that would enable them to become tumor cells."

The researchers found that nicotine and a related chemical in tobacco known as NNK appear to affect the cells by influencing pathways where command signals travel.

What does this mean for nicotine products that are geared to help people stop smoking? West says the research does raise concerns if people use the products for a long time. "Prolonged use could be a bad thing," he says.

GlaxoSmithKline says its products are designed to be used over 10 to 12 weeks as a "step-down therapy" that more than doubles the chances of successfully quitting over the "cold turkey" approach.

However, the company suggested that long-term use might not be a problem. It cited a 1997 federally funded study that found people could safely take nicotine gum for five years.

What To Do

For a fact sheet on nicotine replacement products, go to the American Lung Association or the American Cancer Society.

SOURCES: Kip A. West, Ph.D., postdoctoral fellow and researcher, Cancer Therapeutics Branch, National Cancer Institute, Bethesda, Md.; statement from GlaxoSmithKline; Jan. 1, 2003, Journal of Clinical Investigation

Copyright © 2003 ScoutNews, LLC. All rights reserved.

Study: 'Safer' Cigarettes May Be All Smoke

Two studies find targeted brands may lead to increased addiction

By Jennifer Thomas
HealthScoutNews Reporter

They're sold by big tobacco companies and go by names like Advance, Eclipse and Accord.

They're marketed as safer cigarettes that can lessen the risks of smoking by releasing fewer cancer-causing substances.

But two new studies show these so-called safer cigarettes may not be safer at all -- and may even lead to increased addiction.

In the first study, researchers invited 20 smokers in the lab and, over three days, had them puff on their own brand of cigarettes, then an Advance cigarette, now sold by Brown & Williamson Tobacco Corp., and also an unlit cigarette for comparison.

Advance cigarettes are marketed as a safer cigarette because they supposedly contain less of a type of cancer-causing substance called nitrosamines, said Thomas Eissenberg, an associate professor of psychology at Virginia Commonwealth University and lead author of both studies.

The Advance study, which did not look at nitrosamine levels, found the cigarette produced 11 percent less carbon monoxide. Carbon monoxide has been linked to cardiovascular disease in smokers, Eissenberg said.

But Advance also delivered 25 percent more nicotine into the blood than the smokers' own brands. Nicotine is the addictive substance in cigarettes.

"We don't know for sure if it causes increased dependence, but certainly many smokers would like to know if they're being exposed to more nicotine," Eissenberg said.

A spokesman for Brown & Williamson responded that the researchers had looked at an early version of Advance cigarette made by a different company.

"The nicotine levels they are reporting are not correct," spokesman Marc Smith said. "They are looking at a product that is not on the market today. The product being sold today has much lower nicotine levels ..." He did not say what the nicotine levels were.

The study appears in the December issue of the journal Tobacco Control.

In a second study, published in the December issue of Harm Reduction, Eissenberg and his colleagues conducted a similar experiment with Accord cigarettes, made by Philip Morris Co. Inc., and Eclipse, made by R.J. Reynolds Tobacco Co..

Both cigarettes heat rather than burn tobacco, presumably reducing carcinogen levels.

Researchers didn't look at carcinogen levels, but they did look at nicotine, carbon monoxide and the effects on smokers' heart rate.

On the plus side, they found Accord delivered significantly less nicotine and boosted smokers' heart rate and carbon monoxide levels less than traditional cigarettes.

But Accord didn't do as well as traditional cigarettes in suppressing cravings or reducing such withdrawal symptoms as anxiety, restlessness and irritability, they found.

If Accord fails to give smokers the same satisfaction they get from smoking their regular brand, they may simply smoke more, which would defeat the purpose of safer cigarettes, Eissenberg said.

Eclipse, on the other hand, increased heart rate and suppressed withdrawal symptoms about as well as conventional cigarettes. However, Eclipse delivered about 30 percent more carbon monoxide than regular cigarettes, Eissenberg said.

"Based on our evaluation, all three alternative cigarettes appear to reduce some toxins that are associated with smoking-related diseases," Eissenberg said. "But our testing also revealed that Eclipse and Advance may increase levels of dangerous substances produced by these cigarettes that smokers should be aware of."

A spokeswoman for R.J. Reynolds said the 30 percent increase in carbon monoxide (CO) cited in the study is not correct.

"The CO claim mentioned in the study is contrary to what we have found during our extensive investigations. Under FTC machine-smoking puffing conditions, the 'tar' and nicotine yields for Eclipse are in the range of ultra-low-'tar' cigarettes, while the CO yield is in the low-'tar' range," said Carole Crosslin.

The company's extensive studies, she added, "have found that, on average, there is about a 10 percent increase in COhB in smokers switching to Eclipse from their usual brand."

However, Patrick Reynolds, founder of the Foundation for a Smokefree America, called the research an important step in debunking claims of safe cigarettes.

"There is an array of tobacco products on the market all claiming to varying degrees to be safer," said Reynolds, the grandson of R.J. Reynolds and the son of a man who died of smoking-related disease. "It will be decades before we have the medical data and studies in about whether these products are substantially safer."

Even if a product delivers less carbon monoxide or carcinogens, he added, it is still unknown what amount causes an individual smoker to get cancer or heart disease.

"Whether the products are one percent safer or 15 percent safer, we really don't have any clue," Reynolds said. "The big danger is that many smokers may believes these products are far safer than they really are and will justify their continued smoking based on that."

Hiking Cigarette Tax Could Save Millions Of Lives

Raising price seen as most effective way to cut smoking-related deaths

By Jennifer Thomas
HealthScoutNews Reporter

What's the single most effective way of preventing deaths from smoking?

Hike the price of cigarettes, new research says.

Raising the tax on cigarettes could avert between 5 million and 16 million tobacco-related deaths worldwide in the coming years, according to a study in the September issue of Nicotine & Tobacco Research.

Researchers evaluated the effectiveness of several types of tobacco control: tax increases; nicotine replacement; and a package of interventions, including bans on advertising and promotion of tobacco products, anti-smoking education and smoking restrictions in public places or work places.

They then used economic models and the results of previous smoking cessation studies to estimate the number of deaths that could be avoided by using the three methods around the world. These results were applied to a global model of smokers in 1995.

Raising the price of cigarettes by 10 percent worldwide would prevent between 5 million and 16 million deaths, they found. People in low- to mid-income countries and people between the ages of 15 and 29 would be the most impacted by the price increases, according to the study.

"In general, price increases are the most cost-effective, anti-smoking intervention," writes lead author Dr. M. Kent Ranson, of the London School of Hygiene and Tropical Medicine in England.

John Banzhaf, executive director Action on Smoking and Health, says the study is consistent with previous research.

"There are many studies which show that increasing taxes on cigarettes is a very effective way to decrease consumption," Banzhaf says. "And it's no surprise that they are most effective with kids and with people who are in the lower socioeconomic classes."

Nicotine replacement includes products such as chewing gum, skin patches, nasal sprays, inhalers and lozenges. Liberalizing access to nicotine replacement could avoid 1 million to 5 million smoking-related deaths, the study found. It would have the greatest impact on people between 30 to 59 years old.

Bans on advertising, prohibition of smoking in public places and anti-smoking educational programs would probaably reduce smoking worldwide by about 2 percent, meaning another 5 million lives would be saved.

In the United States, about 23.3 percent of adults smoke, according to the Centers for Disease Control and Prevention (CDC). And 70 percent of them want to quit, reports the 2000 National Health Interview Survey.

Peter Jacobson, an associate professor of health law at the University of Michigan in Ann Arbor, says the new study is logical based on previous research findings.

However, Jacobson adds, the study underestimates the power and importance of education programs that "de-normalize" smoking, making it a habit that is socially unacceptable.

This change in attitude toward smoking is largely a result of ceaseless efforts by educators and public health experts to spread the message about the dangers of tobacco, says Jacobson, lead author of Combating Teen Smoking: Research and Policy Strategies.

"One might get the false impression from this study that the only thing that's needed is to raise taxes," Jacobson says. "What's missing, and what many tobacco control researchers are starting to look at, are more comprehensive programs."

Raising taxes is but one, albeit important, weapon in the arsenal against tobacco.

He points out that smoking rates are higher in European countries than in the United States, even though Europe has higher taxes on cigarettes. In countries such as Denmark and Portugal, taxes account for more than 70 percent of the price of a pack of cigarettes. In the United States, Massachusetts has the highest tax rate at 38 percent, he notes.

What about smokers' rights?

Banzhaf puts little stock in their arguments that they're being overtaxed. He cites a CDC study that found each pack of cigarettes will mean subsequent health-care costs of about $12.85. Much of that cost is paid for by non-smokers in the form of taxes and higher health-care costs, Banzhaf says.

In the state of New York, for example, smokers pay $1.50 tax on each pack of cigarettes -- far less than the $12.85 it will eventually cost in health-care expenses, he adds.

"It's a small step in the right direction to make them pay their fair share of these huge costs," he says.

What To Do

For more information on the legal battle against tobacco, upcoming anti-smoking legislation and the latest tobacco research, visit Action on Smoking and Health.

The Centers for Disease Control and Prevention has tips on quitting smoking.

SOURCES: John Banzhaf, executive director, Action on Smoking and Health, Washington, D.C.; Peter Jacobson, J.D., M.P.H., associate professor, health law, University of Michigan, Ann Arbor; September 2002 Nicotine & Tobacco Research

Copyright © 2002 ScoutNews, LLC. All rights reserved.

 

All it takes is one cigarette!

Up to now, it was thought it took a few years for smokers to become addicted, but the latest research shows addiction takes place in days

LONDON -- Scientists have confirmed a suspicion held by some smokers but never proven: it could take just one cigarette to become addicted.

Experts have tried for years to determine how long people have to smoke before becoming addicted, said Dr Richard Hurt, director of the Nicotine Dependency Unit at the Mayo Clinic in the United States.

"The best answer to date has been one to two years," said Dr Hurt, who was not involved with the latest research. "There's been a suspicion that many people become addicted very quickly, but this is really the first hard evidence that we've had that this occurs."

Research reported in the British Medical Association journal, Tobacco Control, found that several 12- and 13-year-olds showed evidence of addiction within a few days of their first cigarette.

Dr Hurt said the findings would help scientists better understand the biology of nicotine addiction and lend more plausibility to the idea that some people may be more susceptible genetically to it than others.

The study was conducted by scientists at the University of Massachusetts in 1998. The experts followed 681 teenagers aged 12 and 13 from seven schools in central Massachusetts for a year and tracked their smoking habits.

The researchers did not label any of them as addicted because the standard definition of nicotine dependence assumes that addiction cannot happen without prolonged heavy smoking.

The scientists simply recorded symptoms that indicate addiction. Symptoms include cravings, needing to smoke more to get the same buzz, withdrawal symptoms when not smoking, feeling addicted to tobacco and loss of control over the number of cigarettes smoked or the duration of smoking.

A total of 95 teens said they had started smoking occasionally - at least one cigarette a month - during the study.

The scientists found that 63 per cent of them had one or more symptoms of addiction.

A quarter of those with symptoms got them within two weeks of starting to smoke and several said their symptoms began within a few days.

Sixty-two per cent said they had their first symptom before they began smoking every day, or that the symptoms had made them start smoking daily.

"The really important implication of this study is that we have to warn kids that you can't just fool around with cigarettes or experiment with them for a few weeks and then give them up," said Dr Joseph DiFranza, who led the research team.

"If you fool around with cigarettes for a few weeks, you may be addicted for life." - AP.

*courtesy of  QuitSmoking.Com

 

 

Turns Out Secondhand Smoke, Not Curiosity, Can Kill a Cat
Study underscores the threat to humans, especially children

WEDNESDAY, July 31 (HealthScoutNews) -- Even having nine lives is no protection against secondhand smoke.

Cats who live with people who smoke are more than twice as likely as other cats to develop a deadly form of cancer called feline lymphoma, says a study by scientists at Tufts University School of Veterinary Medicine and the University of Massachusetts.

The study appears in tomorrow's issue of the American Journal of Epidemiology.

The finding provides compelling evidence of the need for further study of the link between secondhand smoke and non-Hodgkin's lymphoma in humans, which is similar to lymphoma in cats, the study authors say.

"We believe the feline exposure patterns to environmental tobacco smoke may mimic those of young children living in households where adults smoke and where the children inhale tobacco smoke or ingest particulate matter by mouthing contaminated objects," says lead author Elizabeth R. Bertone, an epidemiologist at the University of Massachusetts at Amherst.

The study looked at 180 cats treated at Tufts Veterinary School's Foster Hospital for Small Animals between 1993 and 2000. Eighty of the cats were treated for lymphoma; the rest were treated for renal failure.

The authors adjusted for age and other factors and concluded that cats exposed to any household environmental tobacco smoke had 2.4 times greater risk of lymphoma than cats who lived with non-smokers.

The risk increased with longer exposure. Cats subjected to at least five years of secondhand smoke were 3.2 times more at risk for lymphoma than other cats.

The number of smokers in a house also made a difference. One smoker in a home increased a cat's risk by 1.9 times, while two or more smokers made a cat 4.1 times more likely to develop lymphoma.

Cats living in homes where people smoked a pack or more of cigarettes a day were 3.3 times more at risk than cats in smoke-free homes.

 

For more research on smoking click here