Category Archives: Tobacco
CDC Study Finds No Significant Change in Use of Smokeless Tobacco
From 2005 to 2010 there was no significant change in the percentage of U.S. working adults who used smokeless tobacco, according to the new National Health Interview Survey from the U.S. Centers for Disease Control and Prevention (CDC). In 2005, approximately 2.7 percent of workers reported using smokeless tobacco, with the percentage climbing slightly to 3.0 percent in 2010; males (5.6 percent) and non-Hispanic whites (4.0 percent) reported the highest usage, followed by adults ages 25-44 years, people with no more than a high school education and people living in the South (all 3.9 percent). By industry, smokeless tobacco use was most common in mining (18.8 percent), and by occupation it was most common in construction and extraction (10.8 percent). According to the CDC, these findings indicate opportunities to engage workers with tobacco cessation efforts, such as providing employee health insurance coverage for proven cessation treatments; offering help for those who want to quit; and establishing and enforcing tobacco-free workplace policies. Read more on tobacco.
6,000 Steps Per Day May Improve Knee Arthritis, Reduce Future Disability Risk
Walking 6,000 steps a day—or about one hour at the average person’s pace—may both help improve knee arthritis and prevent further disability, according to a new study in the journal Arthritis Care & Research. In a study of approximately 1,800 adults who either had knee arthritis or were at risk, researchers found that for every 1,000 steps a person took a day, their functional limitations were reduced by 16-18 percent. The study also pegged 6,000 steps as the target to reach to ensure the healthiest results. Approximately 27 million Americans age 25 and older live with osteoarthritis, which is the most common type of arthritis and often referred to as “wear-and-tear arthritis,” according to the Mayo Clinic. Read more on physical activity.
Study: Great Recession Contributed to Additional 10,000 Suicides in North America, Europe
Stress and other health issues resulting from the Great Recession were associated with more than 10,000 additional economic suicides—suicides in response to financial hardship—between 2008 and 2010 in North America and Europe, according to a new study in The British Journal of Psychiatry. While job loss, debt and foreclosure can increase the risk of suicidal thinking, researchers determined that many such suicides could have been avoided. They recommend upstream return-to-work programs, antidepressant prescriptions and other interventions as ways to mitigate the risk of economic suicides if and when another economic downturn strikes. Read more on the prevention.
FDA Initiative Gives Developers Easy Access to Public Health Data
A new online initiative from the U.S. Food and Drug Administration (FDA), openFDA, will give mobile application creators, web developers, data visualization artists and researchers access to the agency’s vast public health datasets in order to streamline the creation of their own applications. The structured, computer-readable format allows researchers to determine what types of data they want to search and how they want to present that data to end-users. “The openFDA initiative leverages new technologies and methods to unlock the tremendous public data and resources available from the FDA in a user-friendly way,” said Walter S. Harris, the FDA’s chief operating officer and acting chief information officer. “OpenFDA is a valuable resource that will help those in the private and public sectors use FDA public data to spur innovation, advance academic research, educate the public, and protect public health.” Read more on technology.
Study: 24 Million U.S. Youth Exposed to E-cigarette Advertisements
Unlike with traditional cigarettes, the U.S. Food and Drug Administration (FDA) does not regulate the marketing of e-cigarettes unless they are advertised as a smoking cessation aid. As a result, e-cigarette companies currently market their products to an audience that includes 24 million youth, according to a new study in the journal Pediatrics. Researchers determined that, from 2011 to 2013, youth exposure to e-cigarette advertisements climbed 256 percent and young adult exposure climbed 321 percent. They also determined that approximately 76 percent of the youth exposure came from advertisements on cable networks. Read more on tobacco.
Study: Global Investment in Midwives Needed to Save the Lives of Mothers, Newborns
Investments in midwifery could save the lives of millions of mothers and newborns, according to a new report from the United Nations Population Fund (UNFPA), the International Confederation of Midwives (ICM) and the World Health Organization (WHO). The report determined that 73 African, Asian and Latin American countries experienced 96 percent of the world’s maternal deaths, 91 percent of stillbirths and 93 percent of newborn deaths, with lack of access to midwives a significant contributing factor. Those countries have only 42 percent of the world’s midwives, nurses and doctors.
- Among the report’s recommendations:
- Increased access to preventive and supportive care from a collaborative midwifery team
- Immediate access to emergency services when needed
- Completing post-secondary education
- And, from a broader perspective, women should delay marriage, have access to healthy nutrition and receive four pre-birth care visits
"Midwives make enormous contributions to the health of mothers and newborns and the well-being of entire communities. Access to quality health care is a basic human right. Greater investment in midwifery is key to making this right a reality for women everywhere," said Babatunde Osotimehin, UNFPA Executive Director, in a release. Read more on maternal and infant health.
Citylab—formerly Atlantic Cities—reported recently on an architectural award bestowed by Residential Architect on the Corinthian Gardens Smokers Shelter, a 275-square-foot structure in Des Moines, Iowa. It was created by local architectural firm ASK Studio for smokers who live in a nearby apartment building. “This project serves as a reminder that smokers aren’t extinct by quietly celebrating an activity that has gone from banal to banned,” reads the description on the publication’s online portal.
“It’s the sort of structure that has the feel of a private clubhouse for the tobacco-initiated,” according to award juror Cary Bernstein, whose comments were published by Residential Architect. “It makes you want to smoke so you can be in it.”
Wisely, the materials used to construct the shelter are nonflammable. Smokers get benches to sit on while they smoke and lighting for security after dark.
Corinthian Gardens is hardly the only such smoking shelter in the United States. An online search finds several companies that make the shelters, although none seem as glitzy as the one in Des Moines. And late last year a judge in Great Falls, Montana, ruled that smoking shelters that also house gambling machines don’t violate the city’s Clean Indoor Air Act.
So far, it seems, the shelters are legal so long as they adhere to rules governing smoking in the state or city they’re in, such as being built the requisite distance away from a building to avoid blowing second hand smoke at non-smokers. But tobacco- control advocates worry that the shelters, especially the recent award winner, can hurt the goals of completely eradicating smoking as a social norm—especially when 19 percent of U.S. adults still smoke.
“The fact that people are being protected from the elements is fine, we support the design perspective, but we worry about anything that normalizes or glamorizes smoking,” said Robin Koval, president and CEO of tobacco control advocacy group Legacy.
“We don’t’ hate smokers, we love smokers, what we hate is tobacco,” said Koval, “and so you have to call the structure what it is: a waiting room for the cancer ward because one out of two people who use it will die of tobacco-related diseases. To us that’s really the issue.”
CDC: Man Previously Reported Having MERS Does Not Harbor the Virus
After completing additional and more definitive laboratory tests, the U.S. Centers for Disease Control and Prevention (CDC) has retracted a report made last week that an Illinois man contracted the potentially deadly MERS virus from a patient who was diagnosed with MERS in the United States after spending time as a health care worker in Saudi Arabia. The confusion over the diagnosis came from earlier tests that indicated antibodies to a coronavirus, the class of virus MERS belongs to. However, more definitive tests found that he did not harbor the MERS virus. There are six known versions of the coronavirus; four cause mild illness and two cause the much more serious MERS and SARS viruses. Read more on infectious disease.
Study: 30 Percent of the World’s Population is Obese
A new analysis of global obesity trends finds that approximately 2.1 billion people—or nearly 30 percent of the world population—are obese, according to a new study in The Lancet. Researchers found that rates of being obese or overweight climbed 20 percent in adults and 47 percent in children during the 33 years analyzed. The study, which was funded by the Bill & Melinda Gates Foundation, determined that while obesity was once more common in wealthier nations, approximately two-thirds of the world’s obese population lives in developing countries. In addition, the statistics for the United States were especially troubling; while only 5 percent of the world’s population lives in the United States, the country is home to approximately 13 percent of the world’s obese population. Read more on obesity.
Study: Lung Cancer Screening Can Scare People into Quitting Smoking
In addition to early detection and treatment of lung cancer, early screening can also scare people into quitting smoking before they even develop the disease, according to a new study in the JNCI: Journal of the National Cancer Institute. Researchers based their findings on an analysis of 14,621 current smokers, 55-70 years old, with a 30 or more pack-year smoking history and who had smoked during the last 15 years. The data was taken from the Lung Screening Study component of the U.S. National Lung Screening Trial. The study found that "...abnormal screening results may present a 'teachable moment'" and that "[f]uture lung cancer screening programs should take advantage of this opportunity to apply effective smoking cessation programs." Read more on tobacco.
Study: Family Stress Can Impact Mortality Risk
Stressful family situations can significantly increase the risk of death, according to a new study in the Journal of Epidemiology and Community Health. Using health data on 9,875 men and women aged 36-52 years from The Danish Longitudinal Study on Work, Unemployment and Health, researchers determined that frequent worries and/or demands from a partner or children were linked to a 50-100 percent increase in mortality risk, and that frequent conflicts with any type of social relation were linked to a 2-3 times increase in mortality risk. Researchers also concluded that people outside the labor force were at higher risk of exposure to stress family situations. Read more on mortality.
National Task Force Recommends Regular Hep B Screening for People at Highest Risk
The U.S. Preventive Services Task Force is recommending regular screening for all people at high risk for contracting hepatitis B virus. If left untreated, the chronic illness can lead to liver cancer. Among the groups that the national panel says should be screened are:
- People born in countries with a high rate of infection, mainly in Asia, sub-Saharan Africa, the Pacific Islands, the Middle East and Eastern Europe.
- Those who share risk factors similar to those for HIV, including injection drug users, men who have sex with men, and people living with or having sex with someone with a hepatitis B infection.
- Patients with a weakened immune system or who are undergoing treatment for kidney failure.
"We have treatments that are effective at suppressing the virus and at improving abnormalities in the liver, so we can prevent some of the damage that occurs due to chronic hepatitis B," said Roger Chou, MD, an assistant professor at Oregon Health & Science University in Portland and director of the Pacific Northwest Evidence-based Practice Center, as well as lead author for the evidence review that formed the basis of the task force's recommendation. Read more on infectious disease.
Fewer Smokers See E-cigarettes as a Safer Smoking Alternative
While the national profile of e-cigarettes continues to increase, smokers are also increasingly less likely to view them as safer than traditional cigarettes, according to a new study in the American Journal of Preventive Medicine. Using data collected from the Health Information National Trends Survey (HINTS), researchers determined that awareness of e-cigarettes rose to 77.1 percent in 2013 from 16.4 percent in 2009. However, while 84.7 percent of smokers in 2010 viewed e-cigarettes as less harmful than traditional cigarettes, that number was down to 65 percent in 2013. Current estimates are that c-cigarette sales will soon reach $1.7 billion annually, or approximately 1 percent of all U.S. cigarette sales. Read more on tobacco.
Data on thirdhand smoke—tobacco smoke left on surfaces, walls and floors—was first published in 2009. The data has raised significant concerns that the smoke can linger for months or longer, as well as combine with indoor air compounds to possibly form new carcinogens. In the last few months researchers from the California Thirdhand Smoke Consortium, funded by the University of California’s Tobacco-Related Disease Research Program (TDRP), have been presenting and publishing data that indicates that thirdhand smoke is linked to serious health risks in animals and humans—though more research is needed to better measure thirdhand smoke constituents and their health impact.
Consortium researchers published the first animal study on thirdhand smoke in January in the journal PLOS One, finding that mice exposed to thirdhand smoke developed a range of medical conditions, including liver damage and hyperactivity. Research published last year, as well as presented at the annual meeting of the American Chemical Society a few weeks ago, finds that thirdhand smoke likely causes damage to human DNA.
And last month several of the Consortium scholars presented their findings at a tobacco conference n California.
“The potential health risks of what we call thirdhand smoke are only now being studied. This is a new frontier,” said Georg Matt, a Consortium member and psychology professor of at San Diego State University who focuses on policies to protect nonsmokers. “We don’t yet know the degree of risk, but we are already finding that indoor smoking leaves a nearly indelible imprint. We need to find out what risk this pollution poses.”
Census: Bicycle Commuting Up 60 Percent in Past Decade
U.S. cities across the country are seeing increases in bicycle commuters, according to a recent report from the U.S. Census Bureau. The report found that the total number of people who use a bike to get to work jumped by approximately 60 percent in the past decade, to about 786,000 during the 2008-2012 period, making the largest percentage increase of all commuting modes tracked by the 2000 Census and the 2008-2012 American Community Survey. Portland, Ore. had the highest bicycle-commuting rate at 6.1 percent; the overall national rate was 0.6 percent. "In recent years, many communities have taken steps to support more transportation options, such as bicycling and walking," said Brian McKenzie, a Census Bureau sociologist and the report's author, in a release. "For example, many cities have invested in bike share programs, bike lanes and more pedestrian-friendly streets." Read more on physical activity.
May 19 is ‘Hepatitis Testing Day’
Approximately 5.3 million Americans live with chronic viral hepatitis, although many don’t even realize they’re infected, according to the U.S. Department of Health and Human Services. Today, May 19, marks the third national Hepatitis Testing Day, founded to work to increase the number of people who know their hepatitis B and hepatitis C status; what severe—or even fatal—complications they may face if they’re infected; and their risk of spreading it to others. The U.S. Centers for Disease Control and Prevention (CDC) offers an online Hepatitis Risk Assessment, which utilizes brief questions to determine risk, and then prints out recommendations based on CDC’s testing and vaccination guidelines to discuss with their health care provider. Read more on prevention.
Current, Former Smokers May Have Harder Time Becoming Pregnant
Current and former smokers may face more difficulty when trying to become pregnant, according to a new study in the journal Fertility and Sterility. Researchers at the Boston University School of Public Health (BUSPH) analyzed the chances of getting pregnant among 686 current smokers, 741 former smokers and 2,346 women who never smoked, finding that among the former smokers with the highest level of exposure, the chance of getting pregnant was reduced on average by 26 percent per menstrual cycle. “Pregnant women are already encouraged to quit smoking because of the risks to the mother and baby. Some women might not be aware that current regular smoking also harms female fertility, as concluded by the U.S. Surgeon General based on observational studies and animal studies,” said Rose Radin, a doctoral student in the BUSPH Department of Epidemiology and the lead author of the study, in a release. “Our study also found that current regular smokers take longer to get pregnant than never smokers.” Read more on tobacco.
FDA Requires Lunesta Manufacturer to Lower Recommended Dosage
The U.S. Food and Drug Administration (FDA) is requiring the manufacturer of Lunesta to lower the current recommended starting dose. The current recommended dose of the sleep drug, also known as eszopiclone, may be high enough to impair activities that require alertness the following morning, even if the user feels fully awake, according to the agency. Any patient currently taking the 2 mg or 3 mg doses should contact their physician for instructions. “To help ensure patient safety, health care professionals should prescribe, and patients should take, the lowest dose of a sleep medicine that effectively treats their insomnia,” said Ellis Unger, MD, director, Office of Drug Evaluation I in the FDA's Center for Drug Evaluation and Research. Read more on prescription drugs.
CDC: Nearly 5,000 Preventable Injuries Related to Pool Chemicals in 2012
There were nearly 5,000 emergency department visits related to preventable injuries from pool chemicals in 2012, according to the U.S. Centers for Disease Control and Prevention (CDC). Almost half of the injuries were to children and teenagers; the injuries were most common during the summer swim season, from Memorial Day to Labor Day. The CDC provided these tips to help pool owners and operators prevent pool chemical injuries:
- Read and follow directions on product labels.
- Wear appropriate safety equipment, such as goggles and masks, as directed, when handling pool chemicals.
- Secure pool chemicals to protect people and animals.
- Keep young children away when handling chemicals.
- NEVER mix different pool chemicals with each other, especially chlorine products with acid.
- Pre-dissolve pool chemicals ONLY when directed by product label.
- Add pool chemical to water, NEVER water to pool chemicals.
“Chemicals are added to the water in pools to stop germs from spreading. But they need to be handled and stored safely to avoid serious injuries,” said Michele Hlavsa, chief of CDC’s Healthy Swimming Program. Read more on injury prevention.
Study: Hookahs Not a Safe Alternative to Smoking
Hookahs produce significant amounts of nicotine and compounds that can cause cancer, heart disease and other health problems, according to a new study in the journal Cancer Epidemiology, Biomarkers & Prevention. "Water pipe smoking is generally perceived to be a safe alternative to cigarette smoking, even for children and youths. Our study shows that water pipe use, particularly chronic use, is not risk-free," said study author Gideon St. Helen, a postdoctoral fellow in the division of clinical pharmacology and the Center for Tobacco Control Research and Education at the University of California, San Francisco, according to HealthDay. In the study, researchers examined the urine of 55 men and women, who were regular hookah smokers, once after they avoided all smoking for a week and then again after an evening of smoking hookahs. After that single evening the found that the urine samples had: 73 times higher nicotine levels; four times higher levels of cotinine; two times higher levels of NNAL, a breakdown product of a tobacco-specific chemical called NNK; and 14 percent to 91 percent higher levels of breakdown products of volatile organic compounds such as benzene and acrolein. Read more on tobacco.
U.S. Cervical Cancer Rates Higher than Previously Reported
Cervical cancer rates in the United States are higher than previously reported, especially among women ages 65-69 and African-American women, according to a study published in the journal Cancer. Previous research showed about 12 cases of cervical cancer per 100,000 women in the United States, with the incidence reaching a peak at age 40-44 and then leveling off. However, those estimates included women who had hysterectomies in which the cervix had been removed and the authors of the new study say excluding these women—who are no longer at risk of developing this cancer—from their analysis, changes the rate to 18.6 cases of cervical cancer per 100,000 women. The new study also found that incidence increased steadily with age and peaked at a higher rate and at an older age—in women 65-69. Read more on cancer.
ADHD Treatment Linked to Lower Smoking Rates
Treating attention deficit hyperactivity disorder (ADHD) with stimulant medication may reduce smoking risk, especially when the medication is taken consistently, according to an analysis of 14 studies published in Pediatrics. The studies evaluated by the researchers were longitudinal studies of cigarette smoking and ADHD treatment which included 2,360 individuals with ADHD; this is the largest meta-analysis on the issue to date, according to the study authors. The researchers looked at data on nicotine dependence, smoking frequency and whether study participants smoked at the time of the study, and found a significant association between stimulant treatment and lower smoking rates. The effect was larger in those with more severe ADHD and when participants took stimulant medications continuously. The researchers say more studies are needed to determine the recommended timing and duration of stimulant treatment to help lower smoking risk. Read more on tobacco.
Number of Nurse Practitioners Working in Primary Care Increases
Almost half of recently licensed U.S. nurse practitioners (NPs) have become part of the U.S. primary care workforce, according to a report released today by the Health Resources and Services Administration. The National Sample Survey of Nurse Practitioners shows that in 1992 approximately 59 percent of graduating NPs worked in primary care, decreasing to 42 percent between 2003 and 2007. However, the new survey shows that 47 percent of NPs graduating since 2008 have entered primary care. According to the report, 76 percent of the NP workforce has certification in a primary care specialty, including family, adult, pediatric, or gerontology care, and nearly half have a family NP certification. More than half of the NP workforce works in ambulatory care settings, while nearly a third work in hospitals. Read more on prevention.
Big Cities Health Coalition, Other Groups Push FDA to Expand Its Proposed Regulations on E-Cigarettes
A growing number of public health groups are urging the U.S. Food and Drug Administration (FDA) to go well beyond the new rules the agency proposed last month to expand its authority over tobacco, including e-cigarettes. Late last week the Big Cities Health Coalition, made up of twenty of the largest cities in the United States—including Boston, New York City, Chicago and Los Angeles—held a briefing in Washington, D.C. to address what they see as significant gaps in the recently released FDA tobacco regulations. The Coalition is a project of the National Association of County and City Health Officials (NACCHO). “What began as a sliver of the tobacco market is now predicted to eclipse traditional tobacco sales by mid-century,” said the Coalition in a letter to the agency last week.
The letter and Washington, D.C., briefing highlighted concerns about regulating e-cigarettes that the current FDA rules do not address:
- E-cigarettes are being marketed in ways that appeal to youth and could undermine existing tobacco regulations
- E-cigarette manufacturers are making unsubstantiated claims regarding health and safety
- E-cigarettes do not carry health warning labels
Marketing to children was a key concern during the Coalition’s briefing. “The FDA should aggressively limit access to minors and not allow marketing to them or flavorings,” said Barbara Ferrer, MPH, PhD, executive director of the Boston Public Health Commission. All of the commissioners at the briefing voiced a need to regulate flavorings, which can include flavors such as—bubble gum and watermelon—and which the commissioners say are a direct enticement for young people.
“Bubble gum is not a flavor that’s aimed at you or me,” said Mary Bassett, MD, MPH, Commissioner of the New York City Department of Health and Mental Hygiene.
Many of the Coalition member cities have already proposed or enacted laws regarding e-cigarettes that are stricter than the ones proposed by last month by the FDA. A sampling of city regulations regarding e-cigarettes includes:
- Boston — E-cigarettes are not permitted in the workplace; sales are not permitted to anyone under 18; and neither cigarette smoking nor e-cigarette “vaping” are permitted in the city’s public parks.
- New York City — Bans the sale of e-cigarettes to anyone under 21, and as of August 2014 “vaping” will not be permitted anywhere cigarette smoking is not allowed.
- Chicago — Requires retailers to obtain tobacco licenses in order to sell e-cigarettes, prohibits sales of e-cigarettes within 500 feet of schools, requires e-cigarettes to be sold behind store counters and prohibits use of e-cigarettes wherever smoking is prohibited.
- Los Angeles — E-cigarettes cannot be used in public buildings, in parks, at beaches and at other locations where cigarette and tobacco smoking is prohibited. Sales are not allowed to people under 18.
“City health commissioners and mayors are playing and will continue to play critical roles in regulating tobacco products, including e-cigarettes,” said Vince Willmore, vice president for communications at the Campaign for Tobacco-Free Kids in Washington, D.C. “Overall, the main things public health advocates can do is to comment on the FDA rule and urge that it be finalized as quickly as possible; push for action in their own states and communities to regulate e-cigarettes as tobacco products; and continue to focus attention on the problems posed by e-cigarettes.”
The FDA has proposed a 75-day comment period rather than the usual 90-day period, pointed out Robin Koval, president and CEO of Legacy. Last week the organization released a new report on e-cigarettes that looked at the rise of e-cigarette use among youth, as well as the entry of the major tobacco companies into the e-cigarette market.
Koval said she would like to see the FDA commit to a specific time frame for sending its proposed rules to Congress once the comment period is over because “there isn’t’ any time to lose in getting the regulations out...these markets are building growth aggressively.”
>>Bonus Link: Read about a new study in The New York Times, which found that e-cigarettes can become hot enough to release some carcinogens found in conventional cigarettes.