Showing posts with label big tobacco. Show all posts
Showing posts with label big tobacco. Show all posts

Thursday, January 13, 2011

Nurses to Help Thousands of Smokers Butt Out During National Non-Smoking Week - Nursing Link

When nurses intervene, smokers quit. That’s the message the Registered Nurses’ Association of Ontario (RNAO) wants to spread when National Non-Smoking Week (January 16 – 22, 2011) gets underway next week.

“Smoking is one of the most important public health threats of our time. We know that 37,000 deaths a year in Canada are linked to tobacco use. Research shows that reaching out to people is one of the most important steps in determining a smoker’s willingness to quit,” explains Irmajean Bajnok, an RN and Director of RNAO’s Best Practice Guidelines (BPG) program in Toronto.

“Nurses who spend as little as three minutes having conversations with smokers about quitting can make a difference,” says Bajnok adding arming nurses with the best available evidence from the RNAO’s Smoking Cessation BPG is the key to reducing smoking rates.

Click on the link above to read the full article:

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Tuesday, December 14, 2010

How adult smoking affects behavior in children, KevinMD.com

by Nancy Walsh

Both maternal and paternal cigarette smoking can contribute to adverse chronic conditions — physical and psychological — in children, two large studies found.

Writing in the July issue of Pediatrics, Marie-Jo Brion, PhD, of the University of Bristol in England, and colleagues reported that children in two cohorts whose mothers smoked were more likely to have conduct/externalizing behavior problems than were those who had no prenatal tobacco exposure:

* British cohort, OR 1.24 (95% CI 1.07 to 1.46, P=0.005)
* Brazilian cohort, OR 1.82 (95% CI 1.19 to 2.78, P=0.005)

In a second study in the same issue, Chinese researchers found that daily paternal pre- or postnatal smoking was associated with increased mean body mass index (BMI) Z-scores in offspring at seven years, with a mean difference of 0.10 (95% CI 0.02 to 0.19) and also at 11 years, when the mean difference was 0.16 (95% CI 0.07 to 0.26).

These studies “tighten the evidence around tobacco smoke exposure and chronic conditions of childhood,” observed Jonathan P. Winickoff, MD, of Massachusetts General Hospital for Children in Boston, and colleagues in an editorial accompanying the studies.

Winickoff and colleagues wrote that these studies contribute to a growing body of research findings linking tobacco smoke exposure and multiple childhood morbidities and mortality, ranging from miscarriage, stillbirth, and sudden infant death syndrome to decreased lung function and obesity.

Brion and colleagues sought to determine if maternal smoking also could be causally related to the widely reported psychological problems seen in offspring.

Their study included 6,735 children residing in southwest England born between April 1991 and December 1992, as well as 509 children from the city of Pelotas in southern Brazil who were born during 1993.

The prevalence of maternal smoking was almost twice as high in the Brazilian cohort (29.4% versus 15.9%), but consistency was observed otherwise in the two groups.

In unadjusted models, maternal smoking was associated with behaviors in children at four years of age including inattention/hyperactivity, conduct/externalizing problems, and peer/social difficulties, but not with emotional/internalizing problems.

After adjusting for multiple potential confounders, however, such as birth weight and gestational age, socioeconomic factors, and maternal-paternal smoking, only conduct/externalizing problems were seen in both cohorts.

These findings support the concept that these children’s behavioral problems may be mediated by the influence of intrauterine tobacco exposure, and particular

ly nicotine, on neurodevelopmental pathways, according to the investigators.

They acknowledged that the study had shortcomings. Information about potentially important confounders, such as maternal antisocial behavior, was not available, and different instruments were used to assess child behavior in the two cohorts.

Also, parental smoking was measured by self-report, which may represent an underestimation.

In the second study, C. Mary Schooling, PhD, and colleagues from the University of Hong Kong, examined the effects of secondhand smoke on 6,790 children born during 1997 whose mothers did not smoke, stratifying them according to degree of paternal smoking.

They found that children of daily paternal smokers were from lower socioeconomic backgrounds, had mothers not born in Hong Kong, and were less likely to be breastfed.

Unlike BMI, the children’s height was not affected by paternal smoking.

At age seven, the difference in height Z-scores was −0.01 (95% CI −0.08 to 0.06), and at age 11 the difference was 0.02 (95% CI −0.05 to 0.10).

“To date, most of the evidence for the association between parental smoking and offspring overweight comes from Western or long-term developed settings, where smoking and childhood BMI are socially patterned and usually associated with low socioeconomic position,” the investigators wrote.

They noted that in Hong Kong, few women smoke and about one-quarter of men do, and although the prevalence of overweight in childhood is comparable to that in Western countries, it may be less socially patterned.

“Therefore, currently developed Hong Kong may serve as an ideal, non-Western social laboratory in which to verify associations from Western societies that are potentially confounded by [socioeconomic position],” they wrote.

In this study, the data were collected prospectively but there still were limitations. Secondhand smoke exposure was determined by parental report, so underreporting was possible, and childhood adiposity was measured by proxy using BMI, which does not differentiate between body fat and lean mass.

Nonetheless, the study suggests that paternal smoking may contribute to excess weight in offspring. Possible explanations for this include the fact that infants in households of smokers were less likely to be breastfed, and parents may have been generally less health-conscious.

“Alternatively, our findings might reflect the physiologic effects of paternal smoking and perhaps prenatal [secondhand smoke] exposure,” they wrote.

For example, while nicotine exposure from secondhand smoke might not be sufficient to cause intrauterine growth restriction, it might lead to restricted brain development and changes in appetite and metabolism.

In the editorial, Winickoff and colleagues urged continuation of efforts to curb smoke exposure in workplaces, restaurants, homes, and cars, recommending that clinicians utilize office systems, family-centered approaches, and community outreach to further minimize exposures and improve the health of both parents and children.

“Parental tobacco dependence, itself a chronic condition, begets other chronic conditions of childhood,” they wrote.

Nancy Walsh is a MedPage Today contributing writer.

Originally published in MedPage Today. Visit MedPageToday.com for more smoking news.

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Sunday, December 5, 2010

E-cigarettes are not safe, and here's why

E-cigarettes, or electronic cigarettes, have been largely unregulated, and there have been many doctors questioning its safety.

MedPage Today recently reported on the FDA’s analysis of such products, and now we have some guidance as to how dangerous they can be.

E-cigarettes are battery operated, and contain nicotine and other flavors that the user can inhale. Advertisements claim they are safer since they don’t burn tobacco.

But according to the FDA, they “contain carcinogens such as diethylene glycol — used in antifreeze — and nitrosamines.”

To his credit, internist Matthew Mintz has been sounding the alarm for awhile. Not only does he point out they are largely unregulated, there are real questions as to whether they help with smoking cessation at all. He writes that, “e-cigarettes were designed to be tobacco cigarette replacement products, not smoking cessation aides. It is also possible that smokers will use e-cigarettes in place of SOME of their tobacco cigarettes. Although this does decrease exposure to known dangerous products, e-cigarettes might therefore actually prolong tobacco cigarette smoking.”

It’s encouraging to see the FDA start critically analyzing the claims of these types of alternative products, often advertised on late-night television. Hopefully there will be more to come.

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Monday, November 15, 2010

Should tobacco companies pay for smokers' CT scans to screen for lung cancer?

According to a potential ruling in Massachusetts, tobacco companies will have to pay for smokers’ screening CT scans.

The Boston Globe (via Doug Farrago) writes that the decision “would allow thousands of other Massachusetts smokers to join the lawsuit, which covers people 50 or older who have smoked at least one pack a day of Marlboro cigarettes for at least 20 years,” and, “if a jury sides with the smokers, Philip Morris could be required to pay for each patient’s low-dose computed tomography scan, which can detect early-stage lung cancer.”

Now, I’m all for penalizing tobacco companies, but there some unintended consequences here.

First, there is no evidence that CT scans for early detection of lung cancer saves lives. In fact, the USPSTF doesn’t recommend it.

Second, what happens if the CT scan detects all sorts incidental findings, like benign masses that necessitate further workup? Indeed, a lung biopsy may be needed to definitively exclude cancer, which itself can lead to bleeding, infection, or other complications.

Would the tobacco companies pay for the additional tests that stem from the screening CT scan? If not, this decision will only further fiscally burden our health system.

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Thursday, November 11, 2010

FDA Proposes Graphic Warnings For Cigarette Packs, Ads : Shots - Health News Blog : NPR

Shots - NPR's Health Blog

Shots - NPR's Health Blog

by Scott Hensley and Richard Knox

Proposed warnings for cigarette packages
FDA

Coming soon: Bold health warnings for cigarette packages and advertisements.

Now that the Food and Drug Administration has broad powers to regulate tobacco, it's starting to flex its muscles.

Today, the agency unveiled a proposal that would add large, dramatic warnings to cigarette packages and advertisements in a move to discourage people from smoking.

The Tobacco Control Act requires the FDA to come up with regulations for tougher labeling of cigarettes. Now you can see the agencies' ideas and comment on them through early January. Final regulations are due next June. Tobacco companies will have until September, 2012, to make the changes.

 

Under the law, these warnings will have to appear on both the front and back of cigarette packs, taking up half the real estate on each side of the label.

In big ads, they're supposed to occupy at least 20 percent of the space. For smaller ads, there will be alternative anti-smoking messages with bright logos.

Will they work? Some research shows that bold graphic warnings do a better job than text alone in communicating risks and affecting behavior. Other countries, such as Canada, have blazed this trail already.

As NPR's Richard Knox reports on All Things Considered, David Sweanor, a law professor at the University of Ottawa, says Canada's decade-old warnings do work — up to a point.

"What we see with these sorts of warnings is that it does increase motivation," Sweanor says. "People are more aware of the risks. They are wanting to quit. But that has to be combined with services that make it more likely."

Sweanor says smoking hasn't gone down as much as Canada as they'd hoped because the government hasn't provided enough access to smoking cessation programs.

The U.S. government's new campaign, powered by a new 2009 tobacco control law, does include more coverage of quit-smoking programs through Medicare, Medicaid and private insurance. But some wonder if the funding will materialize.

Others say the scare tactics can sometimes backfire. One study that tested warnings on a bunch of smokers, who happened to be psychology students, found that when smoking was a big part of someone's self-esteem, they weren't deterred by warnings that cigarettes could kill them. In fact, paradoxically, the death warnings might make them want to smoke more.

For those people, the researchers say, it might be more effective to dent that self-esteem with messages that say things like "Smoking makes you unattractive."

Almost two decades ago, comedian (and smoker) Denis Leary poked fun at smokers' ability to ignore warnings in a scathing, very unscientific and yet on-the-mark bit:

It doesn't matter how big the warnings are. You could have cigarettes that were called the warnings. You could have cigarettes that come in a black pack, with a skull and crossbone on the front, called "Tumors," and smokers would line up around the block saying, "I can't wait to get my hands on these [bleeping] things."

But the FDA is betting big that scare tactics will work on some of the 47 million Americans who still smoke – and deter more teenagers from starting. Smoking prevalence has stalled at 20 percent of adults – and, ominously, about the same proportion of high school seniors.

Tobacco companies didn't have much to say about the new warning labels – although a spokesman for R.J. Reynolds notes that the company has already filed a suit challenging the constitionality of the warning label requirements, on First Amendment grounds.

 

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abbey baskan (thinkstraight)

abbey baskan (thinkstraight) wrote:

@whoam(Inow): Of course smoke from cars bother me, too. But not only is that NOT the topic here, the analogy actually makes my point. We have limits on what can come out of the back of a car. That has allowed us to come a long way in cleaning up the air in many parts of the world. At least we did "regulate" that and it worked, albeit to varying degrees. Here, doing nothing is the worst alternative.

Thursday, November 11, 2010 2:27:37 PM

Rita Serrano (senorita)

Rita Serrano (senorita) wrote:

People will carry the cig pack in a holder of some type where the pictures will not be visible. This type of packaging will stop people from smoking.

Thursday, November 11, 2010 1:35:35 PM

Don Smith (veggiebreeze)

Don Smith (veggiebreeze) wrote:

Once the smoker is hooked there is little need to warn of the health risks. Anyone who awakens and hacks for 15 minutes, or who gets short of breath walking down the driveway to the mailbox, knows that cigarettes are slowly killing him. But it is up and coming smokers who might be disuaded by graphic warnings. I was once leaving a party and a young woman lit up. Her friend was dismayed and said, "Don't you know those things give you cancer?" The woman replied, "Yeah, but that stuff comes on slowly."
Parents (smokers or not) do whatever it takes to keep your kids from becoming fodder for tobacco profits.

Thursday, November 11, 2010 1:34:25 PM

Art Aficionado (Art_Aficionado)

Art Aficionado (Art_Aficionado) wrote:

An NPR moderator has removed this comment because it does not adhere to the discussion guidelines

Thursday, November 11, 2010 1:01:22 PM

m e (jmar19)

m e (jmar19) wrote:

@Amphitere of course there are some who don't know smoking is bad for their health, but the vast majority in the US do know and assume they will quit before it gets the better of them. For that matter, most people many not be aware that it isn't just lung cancer that afflicts smokers but also esophageal cancer, pancreatic cancer and not to mention 100s of other diseases more prevalent amongst smokers, or the fiscal impact it imparts on our healthcare system, but sadly even that knowledge and understanding won't speak as loudly as tobacco addiction. Quitting is hard, most people DON'T appreciate that. These labels aren't going to make a big impact, no more than the current written warnings or advertisement warnings or campaigns that flood the TVs and schools about the health impact of smoking. Public policy that gets at the heart of smoking convenience DOES make a difference, increasing the tax on tobacco products, making it illegal to smoke indoors, on patios and on the beach or near schools, for example, that makes a difference, albeit most smokers hate it and say they have the right to do whatever they want to their bodies, which is true to some extent, unless they ave kids or harm others with their second hand smoke.

Thursday, November 11, 2010 12:53:48 PM

Tell Me (WhatToThink)

Tell Me (WhatToThink) wrote:

Hard to imagine, but as a former smoker I can tell you that one does not need the FDA or anyone to tell you that smoking is bad for you, and no smoker would have believed that it wasn't harmful despite the industry's claims (as if stanley tools could tell me hitting myself on the head with a hammer was harmless and they'd somehow be culpable for me splitting my skull). Graphic pictures on packs is going to do nothing whatsoever.

Thursday, November 11, 2010 12:41:05 PM

James Broderick II (Amphitere)

James Broderick II (Amphitere) wrote:

jmar19: Sadly, what you say is not the case. There are still PLENTY of people who don't believe smoking is bad for you, and plenty MORE who don't believe smoking is /that/ bad for you. Sad, no?

Thursday, November 11, 2010 12:20:39 PM

who am (Inow)

who am (Inow) wrote:

PS as a smoker I am fine about the warnings. the stuff is way addictive. more so than opium according to the docs.

Thursday, November 11, 2010 12:19:37 PM

who am (Inow)

who am (Inow) wrote:

"Just today as I was walking down the street the man in front of me a couple of paces was smoking and I couldn't get out of the way without breathing in what came out of his lungs!"

lol but the cars didn't bother you?

Thursday, November 11, 2010 12:18:24 PM

who am (Inow)

who am (Inow) wrote:

and the tabacco industry is going to use "freedom of speech' to say "NO"

Thursday, November 11, 2010 12:16:04 PM

View all comments (157)»

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