HealtyDayS

 Bitton and colleagues publish in the current issue of Lancet further revelations about Tobacco Industry subterfuge employed to discredit scientific research, including work conducted at the International Agency for Research on Cancer (IARC), and to target specific scientists.

“The use of consultants, who fail to declare their associations with the tobacco industry, to publish purchased critiques of scientific research appears to remain one of the key strategic approaches of the Tobacco Industry” said Dr Peter Boyle, Director of the IARC. “Strategically coordinated attacks by hired guns, hiding behind undisclosed paid associations with industry, on the personal research of independent scientists by such means is at best unethical and at worst cowardly.”

Mutations in p53 tumour suppressor gene have been reported in 60% of lung tumours. Work published from 1996 onwards, based to a large extent on IARC’s p53 Database  demonstrated patterned mutagenic effect of benzo[a]pyrene, a carcinogen present in tobacco smoke. “The tobacco industry tried to tamper with this evidence because of the implications in the recognition of tobacco smoke as the cause of individual cases of lung cancer. Their strategy of infiltrating the scientific community to undermine the normal process of peer review and publication is distressing for the scientists whose work is targeted. It is also damaging for outstanding journals and academic institutions whose record with respect to tobacco research might appear to be blurred by the actions of a few individuals who maintained undisclosed tobacco industry ties.”

“Such activity was supposed to be a thing of the past following the U.S. Master Settlement in the late 1990s, but obviously this is not the case” noted Dr Boyle. “The Tobacco companies claim that they are now working with the public health community to support a single, consistent public health message on the role played by cigarette smoking in the development of disease in smokers.”

“If the Tobacco Industry is genuine in their recently proclaimed desire to work with the Public Health community then they cannot expect any cooperation if they continue to be involved in this and other similar activities. This Industry needs to demonstrate true corporate social responsibility. Until then, the public health community can have no confidence in the actions of the Tobacco Industry, and academic institutions should refuse any involvement with them, no matter how loudly the industry claims that they will not interfere in the research.”

 Cigarette use among high school students is on a decline, according to a new report by the Centers for Disease Control and Prevention (CDC). The report, “Trends in Cigarette Use Among High School Students—United States, 1991-2003,” is featured in the June 18 issue of the CDC’s Morbidity and Mortality Weekly Report.

The study found that although the prevalence of lifetime cigarette use was stable among high school students during the 1990s and the prevalence of both current and current frequent cigarette use increased into the late 1990s, all three behaviors declined significantly by 2003. Prevention efforts must be maintained to continue the decline of smoking and to achieve the 2010 national health objective of reducing current smoking rates among high school students to 16 percent or less.

Some of the reports highlights include:

• During 2003, 21.9 percent of high school students currently smoke cigarettes, down from 36.4 percent in 1997. Current smoking is defined as having smoked on one or more days of the 30 days preceding the survey.

• Lifetime cigarette use among high school students is 58.4 percent, down from 70.4 percent in 1999.

• Current frequent smoking, defined as smoking on at least 20 of the 30 days preceding the survey, increased from 12.7 percent in 1991 to 16.7 percent in 1997 and 16.8 percent in 1999, then declined significantly to 9.7 percent in 2003.

• Current, frequent, and lifetime smoking rates in 2003 are at the lowest level since the national Youth Risk Behavior Survey (YRBS) was initiated in 1991.

• During 2003, white students were significantly more likely than black and Hispanic students to report current smoking.

• During 2003, more white female students than black and Hispanic female students and more Hispanic female than black female students reported current smoking.

• The prevalence of smoking was not significantly different among white, black, and Hispanic male students.

Smoking causes nearly a half a million premature deaths in the United States each year. Smoking also leads to a potential of 13.2 years of lost life for men and 14.5 years of lost life for women.

 It is well known that smoking cigarettes can directly and often fatally damage the lungs. But new research, with support from the National Institute for Biomedical Imaging and Bioengineering and the National Institute on Drug Abuse, National Institutes of Health, and the Department of Energy, shows that cigarette smoke also decreases levels of a critical enzyme called monoamine oxidase B (MAO B) in the kidneys, heart, lungs, and spleen. Too much or too little of this crucial enzyme can have an effect on a person’s mental or physical health.

MAO B is important because it breaks down the chemicals that allow nerve cells to communicate and regulate blood pressure.

PET, or positron emission tomography, employs computer technology and radioactive compounds to produce images of biochemical processes within living systems.

“Smoking is a major public health problem that results in approximately 440,000 deaths per year in the United States alone,” says NIH Director Dr. Elias Zerhouni. “This new finding highlights the fact that the act of smoking cigarettes can affect biochemical systems within multiple organs other than the lungs and upper airways.”

“When we think about smoking and the harmful effects of smoke, we usually think of the lungs and of nicotine,” says NIDA Director Dr. Nora D. Volkow, one of the authors of the study. “But here we see a marked effect on a major body enzyme in sites far removed from the lungs that we know is due to a substance other than nicotine. This alerts us to the fact that smoking, which is highly addictive, exposes the whole body to the thousands of compounds in tobacco smoke.”

Dr. Joanna Fowler, together with Dr. Volkow and others at Brookhaven National Laboratory and the State University of New York at Stony Brook, conducted the study, which will be published online during the week of September 8 on the Proceedings of the National Academy of Sciences Web site.

Dr. Fowler and the research team compared PET scans showing MAO B activity in 12 smokers with scans from 8 nonsmokers. The researchers observed that MAO B activity in the peripheral organs was reduced by one-third to almost one-half in smokers compared with nonsmokers.

The scientists caution that the effects of this finding remain unknown at present. “The consequences of reduced levels of this important enzyme need to be examined in greater detail,” explains Dr. Fowler. “Though we do not know the physiological effects of such a reduction in MAO B in peripheral organs, we do know we need the enzyme to break down blood pressure-elevating chemical compounds in certain foods, as well as those that are released by nicotine. Thus, it is possible that lower levels of this enzyme in peripheral organs could have medical consequences.”

 (NC) - Most smokers will admit they’d like to quit. The problem is, smoking is an addiction, and quitting smoking is hard. But it can be done. Aside from the money you’ll save, the health benefits alone are worth it.

The fact is that after 12 hours without a cigarette, carbon monoxide leaves your body and your lungs begin to clear. After two days, your sense of taste and smell starts to come back, and you stop smelling like an ashtray. After about three months, the cilia - your lungs’ cleaning system - recover and begin ridding the lungs of mucus. And after one year, your lung cancer and heart disease risk is reduced.

Here are some tips to help you quit smoking.

• Make a list of why you want to quit smoking. Carry the list with you. This way you will always have a reminder of why you’re quitting.

• Don’t worry about weight gain. It doesn’t happen to everyone and it’s often insignificant if it does. Stick to the same diet you usually eat, and remember to choose low-calorie snacks.

• Try to beat the cravings. Try the four Ds: Delay, Distract, Deep Breathing and Drink Water.

Five Keys for Quitting Smoking

Studies have shown that these five steps will help you quit smoking and quit for good. You have the best chances of quitting if you use them together.

• Get ready.
• Get support.
• Learn new skills and behaviors.
• Get medication and use it correctly.
• Be prepared for relapse or difficult situations.

1. Get Ready

• Set a quit date.
• Change your environment.

1. Get rid of ALL cigarettes and ashtrays in your home, car, and place of work.
2. Don’t let people smoke in your home.

• Review your past attempts to quit. Think about what worked and what did not.
• Once you quit, don’t smoke-NOT EVEN A PUFF!

2. Get Support and Encouragement

Studies have shown that you have a better chance of being successful if you have help. You can get support in many ways:

• Tell your family, friends, and co-workers that you are going to quit and want their support. Ask them not to smoke around you or leave cigarettes out.
• Talk to your health care provider (for example, doctor, dentist, nurse, pharmacist, psychologist, or smoking counselor).
• Get individual, group, or telephone counseling. The more counseling you have, the better your chances are of quitting. Programs are given at local hospitals and health centers. Call your local health department for information about programs in your area.

3. Learn New Skills and Behaviors

• Try to distract yourself from urges to smoke. Talk to someone, go for a walk, or get busy with a task.
• When you first try to quit, change your routine. Use a different route to work. Drink tea instead of coffee. Eat breakfast in a different place.
• Do something to reduce your stress. Take a hot bath, exercise, or read a book.
• Plan something enjoyable to do every day.
• Drink a lot of water and other fluids.

4. Get Medication and Use It Correctly

Medications can help you stop smoking and lessen the urge to smoke.

• The U.S. Food and Drug Administration (FDA) has approved five medications to help you quit smoking:

1. Bupropion SR-Available by prescription.
2. Nicotine gum-Available over-the-counter.
3. Nicotine inhaler-Available by prescription.
4. Nicotine nasal spray-Available by prescription.
5. Nicotine patch-Available by prescription and over-the-counter.

• Ask your health care provider for advice and carefully read the information on the package.
• All of these medications will more or less double your chances of quitting and quitting for good.
• Everyone who is trying to quit may benefit from using a medication. If you are pregnant or trying to become pregnant, nursing, under age 18, smoking fewer than 10 cigarettes per day, or have a medical condition, talk to your doctor or other health care provider before taking medications.

5. Be Prepared for Relapse or Difficult Situations

Most relapses occur within the first 3 months after quitting. Don’t be discouraged if you start smoking again. Remember, most people try several times before they finally quit. Here are some difficult situations to watch for:

• Alcohol. Avoid drinking alcohol. Drinking lowers your chances of success.
• Other Smokers. Being around smoking can make you want to smoke.
• Weight Gain. Many smokers will gain weight when they quit, usually less than 10 pounds. Eat a healthy diet and stay active. Don’t let weight gain distract you from your main goal-quitting smoking. Some quit-smoking medications may help delay weight gain.
• Bad Mood or Depression. There are a lot of ways to improve your mood other than smoking. If you are having problems with any of these situations, talk to your doctor or other health care provider.

 Within 20 minutes after you smoke that last cigarette, your body begins a series of changes that continue for years.

20 Minutes After Quitting Smoking

• Your heart rate drops.

12 hours After Quitting Smoking

• Carbon monoxide level in your blood drops to normal.

2 Weeks to 3 Months After Quitting

• Your heart attack risk begins to drop.
• Your lung function begins to improve.

1 to 9 Months After Quitting

• Your Coughing and shortness of breath decrease.

1 Year After Quitting

• Your added risk of coronary heart disease is half that of a smoker’s.

5 Years After Quitting Smoking

• Your stroke risk is reduced to that of a nonsmoker’s 5-15 years after quitting.

10 Years After Quitting

• Your lung cancer death rate is about half that of a smoker’s.
• Your risk of cancers of the mouth, throat, esophagus, bladder, kidney, and pancreas decreases.

15 Years After Quitting

• Your risk of coronary heart disease is back to that of a nonsmoker’s.

 It’s well known that smoking decreases appetite in adults, that smokers typically weigh less than non-smokers and that they tend to gain weight after kicking the habit. But some recent research suggests that there is another, quite different side to the link between smoking and weight gain.

“The epidemiological finding here is that, although offspring of smokers may have lower birth weight, these offspring grow at a more rapid rate, so they have a greater tendency to childhood obesity,” says Ed Levin, Ph.D., a professor in the department of psychiatry and behavioral sciences at Duke University Medical Center.

“We had done a series of laboratory studies to look at how to look at how prenatal nicotine exposure impairs cognitive function,” says Levin. “There was a recent European study that looked at children of women who smoke, showing the greater tendency to obesity. So we looked back through our old data sets and found that prenatal nicotine exposure increased the weight gain in laboratory rats as well, so that we were able to show a cause-and-effect relationship.”

Levin says this increase in childhood obesity may be caused by nicotine’s suppression of a neurochemical response that affects metabolism. “Its effects on nervous system development, whenever it’s given prenatally, actually blunt the responses that would cause fat to be mobilized,” he says. “Our hypothesis is that the offspring, their children, would lay down the fat but be unable to mobilize it. So they would just get more and more obese.”

Given America’s growing obesity crisis, Levin expects there will be interest among the public health community in the research.

“Premature deaths linked to obesity now exceed 300,000 a year,” Levin says. “Obesity is approaching smoking as a leading preventable cause of death, so there’s enormous interest in trying to determine the causes.

“Certainly, increased eating and decreased activity play a large role, but there may also be a role played by nicotine and other intoxicants. We’re also looking at the effects of pesticide exposure as possibly having a similar effect.”

So, in light of these early findings, are we likely to see yet another health warning on cigarette packs someday? “Certainly cigarette smoking has a lot of adverse effects,” adds Levin. “This may be one additional one.”

 DURHAM, N.C. - A new analysis of data on smoking and health finds that smokers who quit before the age of 35 have a reasonable chance to regain their health over time and to live as long and as well as people who have never smoked. The Duke University Medical Center researchers who performed the analysis said that smokers who quit can dodge the debilitating effects of smoking-related diseases and maintain a high quality of life into middle-age and beyond.

The Duke researchers suggest that smoking cessation efforts should emphasize the impact of smoking on quality of life, in addition to its relationship to early mortality. They said smokers might be more inclined to quit if they understand that not only might their life be shortened, but that the quality of their final years might be significantly lowered.

“Any time smokers quit, they’re bettering their health; however, for many smokers it takes a negative health event to stop. For these people and for smokers who quit later in life, it is much more difficult to get back on track,” said Donald Taylor Jr., Ph.D., Duke University Medical Center and Center for Health Policy, Law and Management at the Terry Sanford Institute of Public Policy, Duke University. “The message is that it’s better to quit now than later. The result is a longer, healthier life.”

The researchers published their findings in the June 2004 issue of the journal Health Services Research. The study was funded by the National Institute on Aging.

The Duke study focused on the effects of smoking on quality of life or years of healthy life (YHL) in middle-aged and older Americans. For the purposes of the study, quality of life was described as the degree to which people perceive themselves able to function physically, emotionally and socially.

The Duke researchers analyzed data on smoking and health taken as part of the Health and Retirement Study (HRS) and its companion study, The Asset and Health Dynamics Among the Oldest Old (AHEAD). Both of these studies collected data from 1993 to 2000 on how retirement impacts the health and wealth of both men and women. The studies were funded by the National Institute on Aging. In the HRS study, 12,652 men and women aged 50 to 60 were interviewed about their health behaviors, disease and disability, and medical care usage. The AHEAD study, which collected similar data, focused on 8,124 men and women aged 70 years and older.

In both studies, participants were asked every two years to rate their health as excellent, very good, good, fair or poor. The HRS group members also were asked if they were current or former smokers. Current smokers were asked if they would describe themselves as heavy (one pack or more per day) or light (less than one pack per day) smokers. Former smokers were asked if they had quit within three years, between three to 15 years or for 15 years or more. The AHEAD study limited the questioning to whether study participants were current or former smokers.

“Former smokers felt healthier and on average lived longer than smokers,” said Truls Ostbye, M.D., Ph.D., professor in Duke’s department of community and family medicine and lead author of the paper. “Smoking had a clear relationship with both years of life remaining and years of healthy life remaining. It’s not a surprising result, but by examining these large data sets that included long periods of follow up, we can confirm what other smaller studies suggested.”

Importantly, former smokers, both male and female, who reported having quit for 15 years or more had no statistically significant difference in years of remaining life or years of healthy life when compared to those who reported never having smoked at all, the study found.

In contrast, the researchers found that a 50- to 54-year-old male heavy smoker would lose approximately two years of healthy life and also reduce their years of life remaining by two years. A heavy smoking 50- to 54-year-old woman loses approximately 1.66 years of healthy life and 1.44 years of life remaining on average. Smoking takes a heavier toll on men because their estimated life expectancy is shorter than women.

Overall in terms of years of healthy life, an estimated 3.1 million years of healthy life were lost per year among U.S. men aged 50 to 84, while 1.6 million years of healthy life were lost per year to U.S. women in the same age group, the researchers said.

“It’s hard to quantify what makes life worth living, but health has an important role in perceived high quality of life,” said Ostbye. “Heart disease, stroke and cancer, all of which have a relationship with smoking, are debilitating diseases. They can limit mobility and steal independence. The consequences of these diseases are severe and to many people this reduced quality of life is worse than a shortened lifespan.”

 It’s well known that smoking decreases appetite in adults, that smokers typically weigh less than non-smokers and that they tend to gain weight after kicking the habit. But some recent research suggests that there is another, quite different side to the link between smoking and weight gain.

“The epidemiological finding here is that, although offspring of smokers may have lower birth weight, these offspring grow at a more rapid rate, so they have a greater tendency to childhood obesity,” says Ed Levin, Ph.D., a professor in the department of psychiatry and behavioral sciences at Duke University Medical Center.

“We had done a series of laboratory studies to look at how to look at how prenatal nicotine exposure impairs cognitive function,” says Levin. “There was a recent European study that looked at children of women who smoke, showing the greater tendency to obesity. So we looked back through our old data sets and found that prenatal nicotine exposure increased the weight gain in laboratory rats as well, so that we were able to show a cause-and-effect relationship.”

Levin says this increase in childhood obesity may be caused by nicotine’s suppression of a neurochemical response that affects metabolism. “Its effects on nervous system development, whenever it’s given prenatally, actually blunt the responses that would cause fat to be mobilized,” he says. “Our hypothesis is that the offspring, their children, would lay down the fat but be unable to mobilize it. So they would just get more and more obese.”

Given America’s growing obesity crisis, Levin expects there will be interest among the public health community in the research.

“Premature deaths linked to obesity now exceed 300,000 a year,” Levin says. “Obesity is approaching smoking as a leading preventable cause of death, so there’s enormous interest in trying to determine the causes.

“Certainly, increased eating and decreased activity play a large role, but there may also be a role played by nicotine and other intoxicants. We’re also looking at the effects of pesticide exposure as possibly having a similar effect.”

So, in light of these early findings, are we likely to see yet another health warning on cigarette packs someday? “Certainly cigarette smoking has a lot of adverse effects,” adds Levin. “This may be one additional one.”

 DURHAM, N.C. - A new analysis of data on smoking and health finds that smokers who quit before the age of 35 have a reasonable chance to regain their health over time and to live as long and as well as people who have never smoked. The Duke University Medical Center researchers who performed the analysis said that smokers who quit can dodge the debilitating effects of smoking-related diseases and maintain a high quality of life into middle-age and beyond.

The Duke researchers suggest that smoking cessation efforts should emphasize the impact of smoking on quality of life, in addition to its relationship to early mortality. They said smokers might be more inclined to quit if they understand that not only might their life be shortened, but that the quality of their final years might be significantly lowered.

“Any time smokers quit, they’re bettering their health; however, for many smokers it takes a negative health event to stop. For these people and for smokers who quit later in life, it is much more difficult to get back on track,” said Donald Taylor Jr., Ph.D., Duke University Medical Center and Center for Health Policy, Law and Management at the Terry Sanford Institute of Public Policy, Duke University. “The message is that it’s better to quit now than later. The result is a longer, healthier life.”

The researchers published their findings in the June 2004 issue of the journal Health Services Research. The study was funded by the National Institute on Aging.

The Duke study focused on the effects of smoking on quality of life or years of healthy life (YHL) in middle-aged and older Americans. For the purposes of the study, quality of life was described as the degree to which people perceive themselves able to function physically, emotionally and socially.

The Duke researchers analyzed data on smoking and health taken as part of the Health and Retirement Study (HRS) and its companion study, The Asset and Health Dynamics Among the Oldest Old (AHEAD). Both of these studies collected data from 1993 to 2000 on how retirement impacts the health and wealth of both men and women. The studies were funded by the National Institute on Aging. In the HRS study, 12,652 men and women aged 50 to 60 were interviewed about their health behaviors, disease and disability, and medical care usage. The AHEAD study, which collected similar data, focused on 8,124 men and women aged 70 years and older.

In both studies, participants were asked every two years to rate their health as excellent, very good, good, fair or poor. The HRS group members also were asked if they were current or former smokers. Current smokers were asked if they would describe themselves as heavy (one pack or more per day) or light (less than one pack per day) smokers. Former smokers were asked if they had quit within three years, between three to 15 years or for 15 years or more. The AHEAD study limited the questioning to whether study participants were current or former smokers.

“Former smokers felt healthier and on average lived longer than smokers,” said Truls Ostbye, M.D., Ph.D., professor in Duke’s department of community and family medicine and lead author of the paper. “Smoking had a clear relationship with both years of life remaining and years of healthy life remaining. It’s not a surprising result, but by examining these large data sets that included long periods of follow up, we can confirm what other smaller studies suggested.”

Importantly, former smokers, both male and female, who reported having quit for 15 years or more had no statistically significant difference in years of remaining life or years of healthy life when compared to those who reported never having smoked at all, the study found.

In contrast, the researchers found that a 50- to 54-year-old male heavy smoker would lose approximately two years of healthy life and also reduce their years of life remaining by two years. A heavy smoking 50- to 54-year-old woman loses approximately 1.66 years of healthy life and 1.44 years of life remaining on average. Smoking takes a heavier toll on men because their estimated life expectancy is shorter than women.

Overall in terms of years of healthy life, an estimated 3.1 million years of healthy life were lost per year among U.S. men aged 50 to 84, while 1.6 million years of healthy life were lost per year to U.S. women in the same age group, the researchers said.

“It’s hard to quantify what makes life worth living, but health has an important role in perceived high quality of life,” said Ostbye. “Heart disease, stroke and cancer, all of which have a relationship with smoking, are debilitating diseases. They can limit mobility and steal independence. The consequences of these diseases are severe and to many people this reduced quality of life is worse than a shortened lifespan.”