Category Archives: Tobacco
White House Announces Significant Increase in U.S. Ebola Response
Yesterday, NewPublicHealth reported President Obama’s initial planned response to the ongoing Ebola outbreak in West Africa. The White House has since expanded on the plans. They will include:
- A military command center in Liberia.
- A staging area in Senegal to help dispatch personnel and aid to affected communities more quickly
- Personnel from the U.S. Public Health Service will deploy to a new field hospitals the U.S. is setting up in Liberia.
- US AID will help distribute home kits with items such as gloves and masks to help reduce the number of Ebola cases.
Read more about Ebola.
Survey Finds Doctors are Overextended or At Capacity for Patients
A new survey of 20,000 doctors by the Physicians Foundation, a non-profit group that works with practicing physicians, finds that 81 percent of doctors say they are over-extended or at full capacity and only 19 percent indicate they have time to see more patients. Forty-four percent of doctors responding say they plan to take steps that would reduce patient access to their practices , including cutting back on patients seen, retiring, working part-time, closing their practice to new patients or seeking non-clinical jobs, leading to the potential loss of tens of thousands of physicians in the United States. The timing of the survey is significant because signup for health insurance coverage under the Affordable Care Act begins in just a few weeks. Read more about access to care.
Number of Smokers Increases in New York City
Earlier this week the New York City Health Department released new 2013 data showing that 16.1 percent of adult New Yorkers are smokers, a significant increase from the city’s lowest recorded adult smoking rate of 14 percent in 2010. For the first time since 2007, there are more than one million smokers in New York City who are at risk of developing a smoking-related illness, including heart disease, stroke, diabetes, emphysema, lung and other cancers, according to the health department. So far, the city does not have strong data to explain the uptick in smoking. Nationally, the U.S. Centers for Disease Control and Prevention estimates that 18 percent of U.S. adults are smokers, down from 20 percent several years ago. However, New York City is often a bellwether for public health issues, and the health experts across the country will be looking to see whether the city’s tobacco control efforts—including a new ad campaign that focuses on both daily and occasional smokers—have an impact on smoking rates. Read more on tobacco.
With Classes Well Underway, It’s a Good Time for Colleges and Universities to Think about their Campus Tobacco Policies
Just a few weeks ago the Bloomberg School of Public Health at Johns Hopkins University announced that it had launched the Tobacco-Free Campus Initiative, which prohibits the use of any tobacco product—not just cigarettes—in all buildings, facilities and vehicles. The initiative also forbids e-cigarettes and discourages the use of tobacco products on all outdoor campus grounds. Organizers of the initiative say that deterring the use of tobacco in all forms is crucial to protect the health of the students and workforce of the campus community.
“By keeping out all tobacco products, the initiative ensures that the School doesn’t unintentionally encourage or reinforce tobacco addiction among students, faculty and staff,” according to a statement released by the school.
However, the rest of the university won’t be taking the same steps, at least for now. In 1991, all Johns Hopkins campuses followed the example first set by the School of Public Health in becoming smoke-free, said Dennis O’Shea, a spokesman for the university, adding that the “school could follow the new initiative, but no decision has been made.”
Hopkins is not the only college deliberating. While there are a few states that require state campuses to adopt smoke-free policies most campuses voluntarily adopt them, according to Cynthia Hallett, the executive director of Americans for Non-Smokers Rights (ANR). According to ANR, there are a little more than 4,000 colleges and universities in the United States, and as of July 2014 there were 1,372 smoke-free campuses in the United States, of which 938 are 100 percent tobacco-free and 176 prohibit the use of e-cigarettes anywhere on campus. That’s up from 446 smoke-free campuses in 2010; reporting on tobacco-free campuses began in 2012, when there were 608.
Credit some of that change to the Tobacco-Free College Campus Initiative (TFCCI) of the U.S. Department of Health and Human Services (HHS), launched two years ago to promote and support the adoption and implementation of tobacco-free policies at colleges and universities. TFCCI is a partnership of HHS, the American College Health Association and the University of Michigan, with sponsorship from the American Legacy Foundation.
While support for making campuses smoke- and even tobacco-free is growing, it’s hardly a slam dunk, especially when the move requires students to vote. Universities say opposition can come from foreign students who are sometimes more likely to smoke than their U.S. counterparts or contract employees who don’t want to be barred from smoking on campus. It can even come from the media. Two years ago, when UCLA announced its campus-wide tobacco free policy, the Los Angeles Times published an editorial titled “A Smoke Free UC Goes too Far” which said that “[s]moking is a detestable, dangerous habit—but it's also a legal one, and there is plenty to say in defense of allowing adults to make bad decisions if they're not breaking the law or harming others.”
Hoping to get the initiatives to pick up steam, TFCCI has launched challenges aimed at getting more campuses—and their students, faculty and employees—to give up their smokes.
- Read a NewPublicHealth interview with former HHS Assistant Secretary Howard Koh on the goals for Tobacco-Free College Campus Initiative.
- Download TFCCI resource toolkits on how to make campuses tobacco-free.
EBOLA UPDATE: HHS Partners with Mapp Biopharmaceutical on Development of Ebola Treatments
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The U.S. Department of Health and Human Services has contracted with Mapp Biopharmaceutical Inc. for the development of an Ebola treatment. The funding will come through the Assistant Secretary for Preparedness and Response’s Biomedical Advanced Research and Development Authority. Under the 18-month, $24.9 million contract, Mapp will also continue the development and manufacture of its existing Ebola drug, ZMapp, which was used to successfully treat two Americans who were infected in the outbreak in West Africa. “While ZMapp has received a lot of attention, it is one of several treatments under development for Ebola, and we still have very limited data on its safety and efficacy,” said Nicole Lurie, MD, assistant secretary for preparedness and response, in a release. “Developing drugs and vaccines to protect against Ebola as a biological threat has been a long-term goal of the U.S. government, and today’s agreement represents an important step forward.” Read more on Ebola.
CVS Announces All Stores are Now Tobacco Free
Tobacco products are no longer sold at any of the approximately 7,700 CVS/pharmacy locations, the company announced today, almost a month ahead of its planned tobacco-free schedule. The company also announced that is has changed its corporate name to CVS Health. "Every day, all across the country, customers and patients place their trust in our 26,000 pharmacists and nurse practitioners to serve their health care needs," said Helena B. Foulkes, President of CVS/pharmacy, in a release. "The removal of cigarette and other tobacco products from our stores is an important step in helping Americans to quit smoking and get healthy." Read more on tobacco.
Study: Double Mastectomies and Lumpectomies Carry Similar Survival Rates
Double mastectomies for early stage breast cancer are no more effective than lumpectomies at improving survival rates, according to a new study in the Journal of the American Medical Association. Analyzing data on more than 189,000 patients in California, researchers found that while the percentage of women who opted for double mastectomies climbed from 2 percent in 1998 to 12.3 percent in 2011—and that in 2011 approximately one-third of patients younger than 40 chose to have a double mastectomy rather than the potentially breast-conserving lumpectomy—the death rates for the two treatments were similar. The researchers said their findings are especially significant for women at average risk. Read more on cancer.
EBOLA UPDATE: Roundup of the Latest News Out of West Africa
(NewPublicHealth is monitoring the public health crisis in West Africa.)
As the death toll continues to rise, here’s a look at some of the latest news on the ongoing Ebola outbreak in West Africa.
- “WHO Moves Team in Sierra Leone After a Medical Worker Contracts Ebola”: The global health organization has removed its response teams from a region of Sierra Leone that has been hardest hit by the outbreak due to a Senegalese epidemiologist contracting Ebola.
- “3rd Doctor Dies from Ebola in Sierra Leone”: A third top doctor has died in Sierra Leone, and health workers in the country are attempting to determine how a fourth scientist contracted Ebola before being evacuated to Europe.
- “Ebola Outbreak: Nigeria Closes All Schools Until October”: Although the academic year was supposed to start this week, Nigeria has ordered the close of all schools until October 13 in order to give staff more training on how to identify potential Ebola cases.
Read more on Ebola.
Study: Significant Time Spent Playing Violent Video Games Increases the Risk for Depression in Kids
Significant time spent playing violent video games is linked to a greater risk for depression in preadolescent youth, according to a new study in the journal Cyberpsychology, Behavior and Social Networking. Researchers from The University of Texas Health Science Center at Houston (UTHealth) examined 5,147 fifth grade students in three major cities and found that kids who play such games for more than two hours per day showed significantly more depression symptoms, including lack of pleasure, lack of interest in activities, concentration difficulties, low energy, low self-worth and suicidal ideation over the past year. “Previous studies have observed how aggression relates to video games, but this is the first to examine the relationship between daily violent video game exposure and depression,” said Susan Tortolero, PhD, principal investigator and director of the Prevention Research Center at the UTHealth School of Public Health, in a release. Read more on mental health.
WHO Calls for Stronger Regulation of E-Cigarettes
The World Health Organization (WHO) has joined the American Heart Association and other organizations in calling for stronger regulation of e-cigarettes, which are a $3 billion worldwide industry. WHO is now recommending that their indoor use be banned until they are proven harmless to bystanders; the international health organization is also calling for its 194 member states to ban the sale of e-cigarettes to minors, as well as to ban or minimize their advertising. According to the agency, regulation "is a necessary precondition for establishing a scientific basis on which to judge the effects of their use, and for ensuring that adequate research is conducted and the public health is protected and people made aware of the potential risks and benefits." Read more on tobacco.
EBOLA Update: RWJF Gives $1M to the CDC Foundation’s Global Disaster Response Fund
(NewPublicHealth is monitoring the public health crisis in West Africa.)
In order to assist the U.S. Centers for Disease Control and Prevention’s (CDC) ongoing efforts to combat the Ebola outbreak in West Africa, the Robert Wood Johnson Foundation (RWJF) has given a $1 million grant to the CDC Foundation’s Global Disaster Response Fund. The CDC has activated its Emergency Operations Center and deployed more than 70 public health experts in response to the outbreak, which so far has killed more than 1,400 people. “The spread of the Ebola virus in West Africa represents a global public health crisis,” said Risa Lavizzo-Mourey, MD, MBA, president and CEO of the Robert Wood Johnson Foundation, in a release. “We are privileged to assist CDC in its heroic efforts to contain this outbreak, and we are confident of their ability to control this scourge—provided they have the support required to do the job. Additional resources are urgently needed, and we encourage other funders to respond as well.” Read more on Ebola.
CDC: More than a Quarter-Million Youth Who Never Smoked Used E-Cigarettes in 2013
More than a quarter-million middle school and high school students who had never smoked regular cigarettes used electronic cigarettes—or e-cigarettes—in 2013, according to a new U.S. Centers for Disease Control and Prevention (CDC) study appearing in the journal Nicotine and Tobacco Research. The study found that youth who had never smoked traditional cigarettes, but had tried e-cigarettes, were twice as likely to intend to smoke traditional cigarettes than were youth who had never used e-cigarettes. “We are very concerned about nicotine use among our youth, regardless of whether it comes from conventional cigarettes, e-cigarettes or other tobacco products. Not only is nicotine highly addictive, it can harm adolescent brain development.” said Tim McAfee, MD, MPH, Director of CDC’s Office on Smoking and Health, in a release. Read more on tobacco.
U.S. Veteran Homelessness Down 33 Percent Since 2010
There has been a 33 percent decline in U.S. veteran homelessness and a 40 percent decline in the number of veterans who sleep on the street since 2010, according to new national estimates from the U.S. Department of Housing and Urban Development (HUD); the U.S. Department of Veterans Affairs (VA); and the U.S. Interagency Council on Homelessness (USICH). The agencies credited evidenced-based practices such as Housing First and other federal programs for the declines. There were an estimated 49,933 homeless veterans in American in January 2014. “We have an obligation to ensure that every veteran has a place to call home,” said HUD Secretary Julián Castro, in a release. “In just a few years, we have made incredible progress reducing homelessness among veterans, but we have more work to do. HUD will continue collaborating with our federal and local partners to ensure that all of the men and women who have served our country have a stable home and an opportunity to succeed.” Read more on the military.
EBOLA UPDATE: Japan Willing to Provide Experimental Treatment Without WHO Approval
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Japan would be open to providing access to an experimental Ebola treatment before the World Health Organization (WHO) rules on whether to approve the drug, known as T-705 or favipiravir. "I am informed that medical professionals could make a request for T-705 in an emergency even before a decision (on approval) by the WHO. In that case, we would like to respond under certain criteria," said Chief Cabinet Secretary Yoshihide Suga at a news conference. The death toll for the West African outbreak climbed to more than 1,400 over the weekend. Read more on Ebola.
AAP Calls on Later School Opening Times for Students Ages 10 and Older
The American Academy of Pediatrics (AAP) is calling for all U.S. schools with students aged 10 to 18 to open no earlier than 8:30 a.m. in order to help kids better manage changes to their body clocks during puberty. Currently only 15 percent of such schools start after that time. “Chronic sleep loss in children and adolescents is one of the most common—and easily fixable—public health issues in the U.S. today,” said pediatrician Judith Owens, MD, FAAP, lead author of the policy statement, “School Start Times for Adolescents,” in a release. “The research is clear that adolescents who get enough sleep have a reduced risk of being overweight or suffering depression, are less likely to be involved in automobile accidents, and have better grades, higher standardized test scores and an overall better quality of life.” Read more on pediatrics.
AHA: E-Cigarettes Should Be Regulated Like Tobacco Products
E-cigarettes should be regulated the same as any tobacco product, according to the American Heart Association’s first policy statement on the products. The statement said that e-cigarettes target young people, can keep people hooked on nicotine and threaten to “re-normalize” tobacco use. “Over the last 50 years, 20 million Americans died because of tobacco. We are fiercely committed to preventing the tobacco industry from addicting another generation of smokers,” said Nancy Brown, CEO of the American Heart Association, in a release. “Recent studies raise concerns that e-cigarettes may be a gateway to traditional tobacco products for the nation’s youth, and could renormalize smoking in our society.” Read more on tobacco.
Helping the Homeless Quit Smoking: Q&A with Michael Businelle and Darla Kendzor, The University of Texas School of Public Health
Not surprisingly, a recent study in the American Journal of Public Health found that homeless smokers struggle with quitting more than economically disadvantaged smokers who have their own housing. The study compared homeless smokers receiving treatment at a shelter-based smoking cessation clinic to people enrolled in a smoking cessation program at a Dallas, Texas, safety-net hospital.
“On average, homeless people reported that they found themselves around about 40 smokers every day, while the group getting cessation care at the hospital reported that they were more likely to be around three to four smokers every day,” said Michael S. Businelle, PhD, assistant professor of health promotion and behavioral sciences at The University of Texas School of Public Health Dallas Regional Campus, and the lead author of the study. “Imagine if you had an alcohol problem and were trying to quit drinking—it would be almost impossible to quit if you were surrounded by 40 people drinking every day. That is the situation homeless folks have to overcome when they try to quit smoking.”
Businelle said research shows that about 75 percent of homeless people smoke and that smoking is a leading cause of death in this population. And although homeless smokers are just as likely to try to quit smoking as are other smokers, they are far less successful at quitting, according to Businelle’s work. He said tailored smoking cessation programs are needed for homeless people, including smoke-free zones in shelters.
NewPublicHealth recently spoke with Businelle and his wife, Darla Kendzor, PhD, who is a co-author of the recent study on smoking and the homeless, as well as an assistant professor at The University of Texas.
NPH: Why did you embark on the study?
Michael Businelle: The smoking prevalence in this population is so high and homeless people are not enrolled in clinical trials so we don’t know what will work best for them. We’ve developed, over the last 50 years, really good treatments for the general population of smokers, but there are very few treatments that have been tested in homeless populations.
Darla Kendzor: And cancer and cardiovascular disease, which are in large part due to tobacco smoking, are the leading causes of death among homeless adults. So quitting smoking would make a big difference for them.
Proposed Tobacco Merger Could Boost Smoking Rates
The proposed merger of the Reynolds American and Lorillard tobacco companies announced earlier this week could result in increased smoking rates, according to the Campaign for Tobacco-Free Kids. “This proposed merger is clearly driven by steep smoking declines in the U.S.,” said Matthew L. Myers, president of Tobacco-Free Kids. Myers said cigarette sales fell by 37.1 percent from 2000 to 2013, with the largest decline in 2009, when a 62 cent per-pack increase in the federal cigarette tax was implemented. “Reynolds and Lorillard no doubt hope the economic and political power of a merged company will help them slow or reverse these trends. Elected officials and regulators must be equally aggressive in working to accelerate progress in reducing smoking and other tobacco use.” Read more on tobacco.
Health Education Program Also Reduces Youth Dating Violence
A health education program designed to delay sexual behavior and promote healthy data relationships also significantly reduces dating violence behaviors among minority youth, according to a new study in the American Journal of Public Health. Researchers at the University of Texas Health Science Center at Houston (UTHealth) analyzed 766 students in 10 middle schools in a large, urban school district in southeast Texas, where 44 percent were African American and 42 percent were Hispanic. They looked at four areas—physical victimization, emotional victimization, physical perpetration and emotional perpetration—finding that the It’s Your Game...Keep it Real program reduced all but physical dating violence, which comprised the smallest portion of the program; a revised program with a heavier emphasis on this area is currently being tested in schools. The U.S. Centers for Disease Control and Prevention estimates that 10 percent of high school youth are victims of physical dating violence (with ethnic-minority students at increased risk), with other studies indicating that as many as 20 percent are victims of emotional dating violence. Read more on violence.
CDC Report Finds High Rates of Youth Fruit, Vegetable Consumption
Approximately 77.1 percent of U.S. youth ages 2-19 years consume fruit on any given day and 92 percent consume vegetables, according to a recent NCHS Data Brief from the U.S. Centers for Disease Control and Prevention. However, the rate drops as youth age, while at the same time the amount of fruits and vegetables they eat should be increasing. The report used data from the National Health and Nutrition Examination Survey, 2009–2010. The focused report looked only at whether the foods were consumed, and now how much was consumed. Read more on nutrition.
The public comment period for rules regulating the sale and use of e-cigarettes proposed in April by the U.S. Food and Drug Administration (FDA) ends on August 8, after which the agency is expected to release final rules governing the products. Experts say the timing is critical because sales of the products—which weren’t even on the market a decade ago—are heating up, with revenues approaching $1 billion a year, according to Forbes Magazine.
Last week, Health Affairs and the Robert Wood Johnson Foundation (RWJF) released a health policy brief about e-cigarettes that sets out key issues concerning the products and provides important background, particularly for people poised to comment on the FDA’s proposed rules.
Among the issues the policy brief addresses are e-cigarette safety; whether the devices ought to be regulated as a medical (smoking cessation) device or as a cigarette; and whether e-cigarettes pose a risk as a “gateway” drug to tobacco products. It notes that the FDA is currently funding close to 40 studies on e-cigarettes.
The issue is especially critical because sales to kids and teens are increasing, and there is still insufficient information on whether the vapor emitted by the devices pose a cancer risk. A 2013 study of 40,000 middle and high school students around the country by researchers at UC San Francisco found that e-cigarette use in that group doubled between 2011 and 2012, from 3.1 percent to 6.5 percent.
Read the policy brief from Health Affairs and RWJF.
>>Bonus Link: Read a NewPublicHealth post on initiatives by major cities to regulate the sale and use of e-cigarettes.
“Getting cigarettes out of our stores is a first step to making pharmacies a place where health happens,” said Troy Brennan, Executive Vice President and Chief Medical Officer of CVS Caremark Corporation, of the company’s decision earlier this year to stop selling tobacco products in its stores. In a Spotlight: Health session at the Aspen Ideas Festival last week, Brennan and other business CEOs discussed how making health a priority can lead to better business outcomes.
By decreasing the number of places that consumers are exposed to cigarettes and eliminating the convenience of tobacco, he said that CVS is actively trying to reduce smoking rates in the areas it serves. However, the healthy decision is also good for the company’s bottom line—already the decision has had positive business results that it didn’t anticipate, including an increase in the company’s stock price following the announcement.
“Companies that make health a priority—consumers gravitate toward that,” he said. “That’s the business incentive.”
Joining Brennan in the conversation, Vitality Institute Executive Director Derek Yach added that the private sector needs to complement public efforts when it comes to health and prevention. For example, taxes and increased prices must work in concert to discourage consumers from unhealthy products or behaviors.
“There may be an economic hit in the short term,” said Yach of companies that make healthy choices easier. “But in the long term, businesses are going to get an inflow of customers who know that their values are aligned.”
Yach also encouraged using County Health Rankings data to understand the underlying risks in each local area, as businesses are uniquely positioned to tailor their interventions to what the surrounding community needs.