Category Archives: Tobacco
Rotavirus Vaccinations for Babies Also Reduce Disease in Older Children, Adults
Regular rotavirus vaccinations for babies have also helped lower the rate of rotavirus-related hospitalizations for older children and adults since 2006, according to a new study in the Journal of the American Medical Association. Rotavirus can cause gastroenteritis, leading to severe diarrhea, vomiting, fever and abdominal pain. Ben Lopman, who worked on the study at the U.S. Centers for Disease Control and Prevention, told Reuters that the improved rates for older children and adults was an unexpected benefit of the vaccinations. An oral form of the vaccination became routine in 2007, after which rotavirus-related hospital discharges dropped by 70 percent for children ages 5-14, by 53 percent for people ages 15-24 and by 43 percent for adults ages 25-44. "This is one example of what we call herd immunity," he said. "By vaccinating young children you prevent them from getting sick, but you also prevent them from transmitting (rotavirus) to their siblings and their parents." Read more on vaccines.
Report: Fewer Kids Illegally Buying Tobacco Products
The Synar Amendment Program was started 16 years ago in an effort to prevent the sale of tobacco products to people under the age of 18. A new report from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) shows that it’s working, with only about 9 percent of retailers violating the ban, the second lowest rate since the law was enacted and far better than SAMHSA’s goal of 20 percent. In addition, 33 states and the District of Columbia now have local violation rates below 10 percent; and nine states have statewide violation rates below 5 percent. Still, Frances Harding, director of SAMHSA's Center for Substance Abuse Prevention, said that "Far more needs to be done to prevent kids and young adults from using tobacco, which is still the nation's leading cause of preventable death.” Read more on tobacco.
High Cholesterol Levels Dramatically Increases Heart Attack Risk in Middle-aged Men
While high cholesterol levels are dangerous for both men and women, middle-aged men with high levels have three times the risk of heart attack, according to a new study in the journal Epidemiology. Lead researcher Erik Madssen, MD, of the department of circulation and medical imaging at the Norwegian University of Science and Technology, said this means men with high cholesterol levels should be receiving more aggressive treatment than is currently common. The reason for the difference in risk still isn’t known, though Madssen said one possibility is the positive effects of estrogen. Both men and women can reduce the risk of heart attack by making lifestyle changes such as improved diet and exercise, as well as through medication; preventative efforts are especially important for people with a family history of heart disease. Read more on heart health.
Many students staring or returning to college this fall may find something missing—exposure to tobacco products.
Last September the U.S. Department of Health and Human Services (HHS), together with several key partners, launched the National Tobacco-Free College Campus Initiative to promote and support the adoption and implementation of tobacco-free policies at universities, colleges, and other institutions of higher learning across the U.S. Initiative partners include the American College Health Association and the University of Michigan. Initiative staff members work closely with academic leaders, public health advocates, students, researchers, and others to help speed up the elimination of tobacco use on college campuses. “This is a lofty goal, but an attainable one, as we are witnessing exponential growth in the adoption of these policies by academic institutions in all regions of the country,” says Howard Koh, MD, MPH, the U.S. Assistant Secretary for Health who helped launch the initiative last year at the University of Michigan, which included an internationally webcast symposium at the University of Michigan School of Public Health.
The initiative includes a website created to serve as a clearinghouse of key information to assist educational communities in establishing tobacco-free environments. The University of Michigan’s comprehensive smoke-free policy went into effect in 2011.
Smoke-free and tobacco-free policies are not the same, according to HHS. Smoke-free policies refer to any lighted or heated tobacco or plant product intended for inhalation—including cigars, cigarettes and pipes. Tobacco-free policies cover these and all other forms of tobacco (although e-cigarettes are still exempt on some campuses due to the still-evolving nature of the regulations). HHS officials point out that although some campuses are smoke-free while others are tobacco-free, the ultimate goal is for all campuses to eventually be 100 percent tobacco-free.
With the start of the fall college imminent or already underway at most universities, NewPublicHealth spoke with Dr.Koh about the success of the Tobacco-Free College Campus Initiative so far, and what’s ahead in tobacco control efforts for young adults by the Department of Health and Human Services.
NewPublicHealth: What success has the initiative seen since it was launched last year?
Dr. Koh: We’re very proud that the Tobacco-Free College Campus Initiative has accelerated rapidly. When we formally announced this in September of 2012, there were 774 colleges and universities that were tobacco or smoke-free and as of right now, the number has risen to 1,159—that’s an increase of more than one-third in less than a year. We are gratified by the positive response from colleges and universities and leaders from across the country who want to make their environments healthier.
NPH: What are the short-term and long-term goals for the initiative?
Dr. Koh: The ultimate goal is to have all colleges and universities in the U.S. choose to become 100 percent tobacco-free and we’re making steady progress towards that goal because we fully understand that prevention efforts must focus not just on children, but also young adults. The number of smokers who are starting to smoke after age 18 has increased. That number was a million in 2010 when it used to be 600,000 in 2002. We have figures that show that one out of four full-time college students were current smokers in 2010, which is higher than the national prevalence of 19 percent. These numbers underscore why college is a critical age to influence health habits of young adults.
“Are they harm reduction or are they smoking cessation? It’s a tough situation because, on the one hand, you have what it does and on the other you have the claims are that are allowable under the law. It’s a strange situation where they are being regulated as tobacco products. But they are not tobacco products. There’s no tobacco in them.”
Many hard facts about e-cigarettes are still unclear. What is clear is that marketers are pushing hard to make the switch from smoking to “vaping” an ongoing trend. In the above quote from a TechCrunch article, Michael Siegel, MD, Professor at Boston University’s Public School of Health, mulled over some very real concerns about where we’re heading in terms of e-cigarette regulation.
The current debate between the manufactures and public health experts surrounds the health impacts of the nicotine product. The e-cigarette “boom” began around 2007, starting first with smaller companies. After making a dent in cigarette sales—unlike cessation therapies such as the patch and gums—tobacco companies took notice and are starting to jump onboard.
Today e-cigarettes are especially rising in popularity among what some may consider the “hip” crowd. From a recent article in The New York Times:
Kaiser Family Foundation Finds Modest Increase for Family’s Share of Employer-Sponsored Health Insurance
Annual premiums for employer-sponsored family health coverage reached $16,351 this year, up 4 percent from last year, with workers on average paying $4,565 toward the cost of their coverage, according to a new Kaiser Family Foundation survey of more than 2,000 employers. That rise is moderate by historical standards according to the survey; since 2003, premiums have increased 80 percent, nearly three times as fast as wages (31 percent) and inflation (27 percent).
The survey also found that large deductibles of at least $1,000 are common in employer-sponsored plans, especially for employees at smaller firms. This year, 38 percent of all covered workers face such a deductible. At small firms, 58 percent of covered workers now face deductibles of at least $1,000, including nearly a third (31 percent) who face deductibles of at least $2,000, up from 12 percent in 2008.
Additional findings of the survey:
- Nearly all large employers (at least 200 workers) offer at least one wellness program and more than a third (36 percent) of large employers who offer them also provide some kind of financial incentive for workers to participate, such as lower premiums or a lower deductible, receiving a larger contribution to a tax-preferred savings account, or gift cards, cash or other direct financial incentives.
- Among large firms offering health benefits, more than half (55 percent) offer some kind of biometric screenings to measure workers' health risks. Of these, 11 percent reward or penalize workers financially based on whether they achieve specific biometric outcomes.
"This will be an important issue to watch next year, as employers [under the Affordable Care Act can] ask workers to pay more because of their lifestyles and health conditions," said Kaiser Vice President Gary Claxton, the study's lead investigator and director of the Foundation's Health Care Marketplace Project.
Read more on access to health care.
CDC: $75.8M to Help Health Departments Prepare for, Respond to Infectious Diseases
The U.S. Centers for Disease Control and Prevention (CDC) has awarded approximately $75.8 million in grants to help state, territorial and certain local health departments prepare for—and respond quickly to—an array of infectious diseases. The grants are through the Epidemiology and Laboratory Capacity for Infectious Diseases Cooperative Agreement. They will go to such critical areas as surveillance, detection, and outbreak response efforts in infectious disease areas such as foodborne diseases, influenza and healthcare-associated infections. “With many infectious diseases first identified at the local level, this funding ensures that state health departments are able to effectively prevent, detect and respond to such public health threats,” said Beth P. Bell, MD, MPH, director of CDC’s National Center for Emerging and Zoonotic Infectious Diseases.” Read more on infectious diseases.
Study: Quitting Smoking Even After Becoming Pregnant Reduces Risk, Complications of Low Birth Weight
While women who quit smoking right before or right after becoming pregnant will on average gain more pregnancy-related weight, and are also less likely to have babies who are born small, according to a new study in the journal Obstetrics and Gynecology. Low birth weight increases the risk for infections; breathing and respiratory disorders; delayed growth and social development; and learning disabilities. Other studies have also linked smoking during pregnancy to premature birth, birth defects and stillbirth. "The big thing to get out of this study is that quitting early in pregnancy is as helpful in respect to the birth weight of your baby as never having smoked while you were pregnant," said Amber Samuel, MD, a maternal-fetal medicine expert at Emory University School of Medicine in Atlanta. "I think that can be an inspiration to moms who are looking to make a change in their lives." Read more on maternal and infant health.
Nine-state Study Shows Statewide Smoking Bans Would Not Hurt Restaurant, Bar Business
Despite the concerns of many proprietors, statewide smoke-free laws would not hurt business at restaurants and bars, according to a new study in the journal Preventing Chronic Disease. Bans on workplace and public area smoking reduce exposure to secondhand smoke, encourage smokers to quit, improve the health employees and reduce the risk for heart attack hospitalizations. The findings of the CDC Foundation study—the largest such analysis, with nine states—line up with previous research. The participating states were chosen because they do not have statewide smoking bans, but do have a good deal of local laws. “Smoke-free laws make good business sense—they improve health, save lives, increase productivity, and reduce health care costs,” said U.S. Centers for Disease and Control Prevention Director Tom Frieden, MD, MPH. Communities throughout the United States have made great strides in protecting workers and the public from secondhand smoke in the past decade, but too many Americans continue to be exposed to secondhand smoke on the job and in public places.”
Below is a related smoke-free video for the state of Texas. Watch all the videos here.
Read more on tobacco.
FDA Sets New Standards for ‘Gluten-free’ Food Labeling
The U.S. Food and Drug Administration (FDA) has set a new standard to define “gluten-free” for voluntary food labeling. People with the autoimmune digestive condition of celiac disease—about 3 million Americans—can manage the condition by eating a diet free of gluten, which is found in naturally in wheat, rye, barley and cross-bred hybrids of these grains. Under the new rules, “gluten-free” labeling is restricted to products that meet all of the FDA requirements, including that the food contains less than 20 parts per million of gluten. The standards also apply to products that claim “no gluten,” “free of gluten” and “without gluten.” FDA is giving food manufacturers one year to come in line with the new standard. “Adherence to a gluten-free diet is the key to treating celiac disease, which can be very disruptive to everyday life,” said FDA Commissioner Margaret A. Hamburg, MD. “The FDA’s new ‘gluten-free’ definition will help people with this condition make food choices with confidence and allow them to better manage their health.” Read more on food safety.
CDC: Murders from Guns Down, But Suicide Rate is Up
The latest Morbidity and Mortality Weekly Report from the U.S. Centers for Disease Control and Prevention (CDC) has both good and bad news on gun violence—and both stress the need for further measures to reduce gun violence, especially early prevention. According to the CDC, gun-murder rate is down, but the suicide rate is up. The murder rate dropped around 15 percent from 2006-07 to 2009-10 in the majority of the fifty largest U.S. cities, but the suicide rate climbed as much as 15 percent in about 75 percent of the cities. In 2009-10 there were approximately 22,500 murders and 38,000 suicides involving a gun. "If there is any question that gun control is a big problem, here's a good example of why," said Victor Fornari, MD, chief of child and adolescent psychiatry at Zucker Hillside Hospital in Glen Oaks, N.Y. "Access to firearms is a serious public health problem. Limiting access to firearms would reduce homicide as well as suicide. As long as guns are available there are going to be these violent outcomes." Read more on violence.
Task Force Calls for Regular Lung Cancer Screening for Older, High-risk Patients
New recommendations from the U.S. Preventive Services Task Force call for annual lung cancer screenings for people ages 55-79 who smoked at least a pack of cigarettes a day for 30 years, or the equivalent (e.g., two packs a day for 15 years). Low-dose computed tomography (CT) scans utilize an X-ray machine to take a series of detailed pictures that can help identify smaller tumors earlier, allowing for earlier treatment and improved health outcomes. “Lung cancer is the leading cause of cancer death in the United States and a devastating diagnosis for more than two hundred thousand people each year,” says Task Force chair Virginia Moyer, MD, MPH. “Sadly, nearly 90 percent of people who develop lung cancer die from the disease, in part because it often is not found until it is at an advanced stage. By screening those at high risk, we can find lung cancer at earlier stages when it is more likely to be treatable.” Lung cancer kills about 160,000 Americans each year. Read more on tobacco.
Study Links Breastfeeding, Higher Intelligence in Kids
Children who breastfeed score higher on intelligence tests later in life, according to a new study in JAMA Pediatrics. Researchers found that for each month spent breastfeeding there were slightly higher results on the intelligence tests at ages three and seven, though not on tests of motor skills or memory. Mandy Belfort, MD, who led the study at Boston Children's Hospital, said the study accounted for parental intelligence and other home factors and provides parents with one more piece of important information when making a decision on the complex question of whether to breastfeed. "Given the size of the benefit, I think this should be helpful for women who are trying to make decisions about how long to breastfeed… because there are many factors that go into that decision," said Belfort. "You have to weigh that against the time that it takes, maybe the time that it takes away from work and your other family duties." Previous studies have linked breastfeeding to lower risk of ear and stomach infections, as well as eczema. Read more on infant and maternal health.
NCI: ‘Cancer’ May Need to Be Redefined
The dramatic increase in cancer screenings over the past few decades has resulted in overdiagnosis and overtreatment, in part because of confusion—by both patients and physicians—over which types of cancer are actually lethal and require immediate treatment. As a result, a panel of experts commissioned by the U.S. National Cancer Institute has recommended that the word “cancer” may need to be redefined to differentiate between lethal and indolent cancers. The recommendations were published in the Journal of the American Medical Association. "We're still having trouble convincing people that the things that get found as a consequence of mammography and PSA testing and other screening devices are not always malignancies in the classical sense that will kill you," said Harold Varmus, MD, director of the National Cancer Institute, to The New York Times. "Just as the general public is catching up to this idea, there are scientists who are catching up, too." Over the past several years the U.S. Preventive Services Task Force has also called for an end to regular mammography screening for women under 50, as well as the widespread use of PSA tests to identify prostate cancer. Read more on cancer.
Smoking During Pregnancy, Kids Behavioral Problems Linked
Women who smoked during pregnancy are more likely to have children with behavioral disorders, according to a new study in the journal JAMA Psychiatry. Researchers analyzed data from three separate studies, findings that the kids of smokers exhibited a noticeable increase in negative behaviors such as getting in fights or having difficulty paying attention. Possible explanations include being born smaller or experiencing impaired brain development. "It's illuminating the prenatal period as having an ongoing influence on outcomes," said Gordon Harold, the study's senior author from the University of Leicester in the U.K. "We're not saying life after birth is no longer relevant… Rather, both influences are clearly important." Read more on tobacco.
Study: Family History of One Cancer Type Can Also Raise the Risk of Other Tumor Types
Health care professionals already knew that people are at increased risk for developing the same type of cancer as a close relative. A new study in the journal Annals of Oncology shows that they are also at increased risk for developing cancer in general, including types of tumors dramatically different than those developed by relatives, which could provide physicians with new ways to identify cancers earlier. Previous genetic studies have shown that certain gene mutations can increase the risk of multiple types of cancer. The new findings include:
- A 1.5-fold increased risk of breast cancer in women with a history of colorectal cancer in the family.
- A 3.3-fold increased risk of oral and pharyngeal cancer among people who had a first-degree relative with cancer of the larynx.
- A four-fold increased risk of cancer of the esophagus among people with a first-degree relative who had oral or pharyngeal cancer.
- A 2.3-fold increased risk of ovarian cancer among those with a first-degree relative who had breast cancer.
- A 3.4-fold increased risk of prostate cancer if a first-degree relative had bladder cancer.
"These findings may help researchers and clinicians to focus on the identification of additional genetic causes of selected cancers and on optimizing screening and diagnosis, particularly in people with a family history of cancer at a young age," said study co-author Eva Negri, MD, head of the laboratory of epidemiologic methods at the Mario Negri Institute for Pharmacological Research in Milan, Italy. Read more on cancer.
Weight Discrimination Increases the Likelihood of Obesity
People who face discrimination for being overweight may be as much as two and a half times more likely to become or stay obese, according to a new study in the journal PLoS One. "Discrimination is hurtful and demeaning, and has real implications for physical health," said lead researcher Angelina Sutin, an assistant professor of psychology at Florida State University. "In the case of weight discrimination, people often rationalize that it is OK to do because it will motivate the victim to lose weight. Our findings suggest the opposite." The experience of “weightism” damages self-esteem and undermines efforts to maintain a healthy weight. Researchers said the observed increase in the likelihood of obesity was independent of factors such as age, sex, ethnicity and education. Experts say that approaches to improving the treatment of obesity could include working with patients to develop adaptive ways to cope with discrimination, public messaging campaigns to raise awareness of the negative effects of “weightism” and even working with health care professionals to ensure they are not exhibiting discriminatory behaviors which could actually damage their patients’ health. Read more on obesity.
FDA Invites Public Comment on Menthol Cigarettes
The U.S. Food and Drug Administration (FDA) is taking a closer look at menthol cigarettes. The health agency issued an Advance Notice of Proposed Rulemaking (ANPRM) to gather more information to guide potential regulatory options, such as setting new tobacco standards. The ANPRM is available for public comment for 60 days. “Menthol cigarettes raise critical public health questions,” said FDA Commissioner Margaret A. Hamburg, MD. “The FDA is committed to a science-based approach that addresses the public health issues raised by menthol cigarettes, and public input will help us make more informed decisions about how best to tackle this important issue moving forward.” About 30 percent of U.S. adult smokers and about 40 percent of youth smokers use menthol cigarettes, according to the FDA. Read more on tobacco.
Skipping Breakfast, Increased Risk for Heart Disease Linked in Men
Skipping breakfast is linked to a dramatic increase in the risk for heart disease in men, according to a new study in the journal Circulation. Researchers found that the men who miss the morning meal are more likely to gain weight, develop diabetes and have hypertension. That all adds up to a 27 percent higher risk of heart attack or heart disease. Possible reasons include a likelihood to “feast” on higher calorie meals later in the day or that fact that the breakfast food skipped includes, on average, healthier types of food that lower the risk for heart disease. "We've focused so much on the quality of food and what kind of diet everyone should be eating, and we don't talk as often on the manner of eating," said Suzanne Steinbaum, MD, a preventive cardiologist at Lenox Hill Hospital in New York City. "This study is not even discussing the type of food. It's just talking about behavior and lifestyle choice. Part of heart-healthy living is eating breakfast because that prevents you from doing a lot of other unhealthy things." Read more on heart health.
CDC Investigating Multi-state Intestinal Infection; 200 Sick so Far
The U.S. Centers for Disease Control and Prevention (CDC) is looking into a multi-state outbreak of cyclosporiasis, an intestinal infection that can cause watery diarrhea, vomiting and body ache, as well as headache, fever, weight loss and fatigue. CDC has identified more than 200 cases in states including Iowa, Nebraska, Texas and Wisconsin. The agency has yet to identify a cause. If left untreated it can last for up to a month; most immune systems can handle the infection without treatment, but older adults and people with weakened immune systems are at increased risk. Read more on infectious disease.
Just a few metro stops can mean the difference between an extra five to ten years added to your lifespan. Using new city maps, the Commission to Build a Healthier America, which reconvened recently after a four year hiatus, is illustrating the dramatic disparity between the life expectancies of communities mere miles away from each other. Where we live, learn, work and play can have a greater impact on our health than we realize.
For too many people, making healthy choices can be difficult because the barriers in their communities are too high—poor access to affordable healthy foods and limited opportunities for exercise, for example. The focus for the Commission’s 2013 deliberations will be on how to increase opportunities for low-income populations to make healthier choices.
The two maps of the Washington, D.C. area and New Orleans help to quantify the differences between living in certain parts of the region versus others.
Living in Northern Virginia’s Fairfax and Arlington Counties instead of the nearby District of Columbia, a distance of no more than 14 miles, can mean about six or seven more years in life expectancy. The same disparity exists between babies born at the end of the Washington Metropolitan Transit Authority’s (known as the Metro) Red Line in Montgomery County—ranked second out of 24 counties in the County Health Rankings, metrics developed by the Robert Wood Johnson Foundation and the University of Wisconsin to show the health of different counties—and those born and living at the end of the Metro’s Blue Line in Prince George’s County, which ranked 17th in the County Health Rankings.