New Book Examines Impact of the U.S. Tobacco Industry

HomeNewsNew Book Examines Impact of the U.S. Tobacco Industry

February 14, 2012   Anthropologist Peter Benson, PhD, released a new book titled “Tobacco Capitalism” that examines the impact of tobacco production in the United States on farmers, workers, and the public. He explains that the tobacco industry is increasingly purchasing their tobacco leaves from developing countries, pressuring American farmers to lower their prices to compete with overseas producers.  Many American farmers are hiring undocumented migrant farm workers to compete economically, putting them at the center of contentious political debates about illegal immigration. These migrant workers live in “labor camps” with poor living conditions, and have little access to resources like health care, legal services, and employment benefits. Benson also discusses tobacco industry marketing strategies, which have undergone what he calls a “corporate social responsibility makeover,” shifting responsibility from the companies (for making a harmful product) to consumers (for supposedly choosing it) and claiming to create “safer” tobacco products.

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http://www.healthnewsdigest.com/news/Book_Review_440/New_Book_Examines_Impact_of_U_S_Tobacco_Industry_printer.shtml

Feb 14, 2012
New Book Examines Impact of the U.S. Tobacco Industry
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Smoke-Free Laws Lead to Less Smoking At Home
Read the full story Feb 13, 2012
UM Tobacco Ban Yields Only 3 Referrals Since Becoming Mandatory Jan. 1
Read the full story Feb 13, 2012
Largest Addiction Treatment Facility in Central Texas Says, ‘No smoking’
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Largest Addiction Treatment Facility in Central Texas Says, ‘No smoking’

HomeNewsLargest Addiction Treatment Facility in Central Texas Says, ‘No smoking’

February 13, 2012   The image of chain-smoking patients in treatment for drug addiction is no myth, but an Austin nonprofit hopes to make it history. Austin Recovery, the largest inpatient addiction treatment center in Central Texas and one of the biggest in the state, is going smoke-free April 30.

“When you’re in residential treatment, what better time to address your other deadly addiction, which is tobacco use?” said Jonathan Ross , president and CEO of Austin Recovery. The nonprofit treats 3,200 clients annually and has three residential campuses. Ross and his staff hope to dispel the old-school notion that it’s too hard to get people to quit smoking when they are trying to kick a drug or alcohol problem. “Not only are you continuing an addictive behavior and putting yourself at risk of relapse, you’re also killing yourself,” he said.

For More Information:
http://www.statesman.com/news/local/largest-addiction-treatment-facility-in-central-texas-says-2164142.html

Feb 14, 2012
New Book Examines Impact of the U.S. Tobacco Industry
Read the full story Feb 14, 2012
Smoke-Free Laws Lead to Less Smoking At Home
Read the full story Feb 13, 2012
UM Tobacco Ban Yields Only 3 Referrals Since Becoming Mandatory Jan. 1
Read the full story Feb 13, 2012
Largest Addiction Treatment Facility in Central Texas Says, ‘No smoking’
Read the full story

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Comparing Alcohol Use And Other Disorders Between The United States And South Korea

Main Category: Alcohol / Addiction / Illegal Drugs
Also Included In: Depression;  Smoking / Quit Smoking
Article Date: 18 Jan 2012 – 0:00 PST

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Hazardous alcohol use and depression are among the 10 leading causes of disability and premature death worldwide, according to the World Health Organization. Many low- to middle-income countries have begun to see a steady increase in alcohol use and have entered the early stages of a tobacco epidemic. A study of alcohol use disorders (AUDs), nicotine dependence (ND), and mood and anxiety disorders in the United States and South Korea has found that while AUDs are substantially more common among Americans than South Koreans, alcohol-dependent Americans are significantly more likely to seek treatment.

Results will be published in the April 2012 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

“People in low to middle-income countries are experiencing a lot of stress due to rapid industrialization and urbanization and are therefore likely to use substances more to relieve their stress,” explained Hae Kook Lee, associate professor at the Catholic University of Korea and corresponding author for the study. “Furthermore, westernization might weaken the taboo for female drinking, especially in Eastern countries.”

“Cross-cultural epidemiologic studies like this one are extremely valuable,” added Howard B. Moss, associate director for clinical and translational research at NIAAA. “Despite over thirty years of research emphasizing the biopsychosocial nature of a wide variety of mental disorders, we see an over-emphasis of the neurobiological underpinnings of addictive disorders. Of course alcohol and other drugs of abuse do significantly impact upon brain processes through mechanisms of reward, plasticity, and adaptation leading from use, intoxication, and tolerance to physical dependence. However, the human process of addiction is much more complex than dopamine release in the reward pathways of the brain or the binding occupancy of the endogenous opiate receptors. Cross-cultural studies like this one reveal that we should also appreciate that the personal distress felt by addicted patients, and their frequently challenging illness behaviors, are manifestations of complex psychological processes that may be culturally bound and exist within a sociocultural paradigm. Thus, research like this reminds the scientific community of the complexity of alcoholism and comorbid conditions.”

Lee and his colleagues used nationally representative samples of the U.S. and South Korean general populations to compare rates of AUDs, ND, and mood and anxiety disorders between the two countries. Study authors also examined the rates and comorbidity patterns among individuals with AUDs who sought treatment in the preceding 12 months.

“Results showed that the prevalence of AUDs among Americans was substantially greater than among South Koreans,” said Lee. More specifically, the 12-month prevalences of AUDs, ND, and any mood and any anxiety disorders were 9.7, 14.4, 9.5 and 11.9 percent among Americans, compared to 7.1, 6.6, 2.0, and 5.2 percent among South Koreans. “The differences in overall prevalence of AUD rates between the two countries was largely due to prevalence among females, that is, drinking by women has historically been tempered by Confucian culture in Korea even though it is increasing rapidly now.”

“America has a longer cultural history with alcohol than do South Koreans,” added Moss. “At the time of the colonization of North America, most European colonists came from countries with strong cultural ties to regular and heavy alcohol consumption. While the Korean people historically used alcohol, its use was limited during the colonial period. Alcohol use was then stimulated in 1986 by a government policy to identify and support culturally important Korean alcoholic beverages. While Prohibition, in theory, limited American access to legal drinking for 13 years, Americans did not have a prolonged abstinence period that shifted cultural norms as occurred in Korea.”

“Even though we found a greater prevalence of alcoholism, mood and anxiety disorders among Americans in comparison to South Koreans,” said Lee, “alcohol-dependent Americans were four times more likely to seek treatment compared to their Korean counterparts, which may indicate the influence of a social stigma toward substance-abuse or mental-health problems despite national health insurance in Korea.”

While Moss agreed that it is clear that South Koreans are less likely to seek treatment for their alcohol problems than Americans, he questioned that this is because of stigma and saving face. “Americans with alcohol dependence and psychiatric comorbidity are more likely to seek treatment than those with alcohol dependence alone,” he observed. “I think seeking treatment has more to do with the degree of discomfort and suffering experienced by the individual, perhaps combined with issues of stigma and face-saving.”

Another finding, comorbidity of mood and anxiety disorders and alcohol use disorders, is the norm rather than the exception, added Lee. “These patterns were similar among American and Korean alcoholics,” he said. “Further, socio-cultural factors might also affect treatment seeking and rates of comorbidity as the higher social stigma of psychiatric treatment might make the patients with mood disorders drink more to relieve their symptoms.”

However, added Moss, the patterns of comorbid psychiatric disorders were different among Korean smokers versus American smokers as American smokers displayed more comorbid mood and anxiety disorders than did Korean smokers.

“Fundamentally,” said Moss, “I think this study forces us to think more about cultural and environmental influences on the etiology of alcohol dependence in conjunction with the neurobiology and genetics of addiction. This study reminds us that neither biological determinism nor social determinism is the whole story. Human behavior is extremely complex, and reductionism of any sort is, more often than not, incorrect.”

Article adapted by Medical News Today from original press release. Click ‘references’ tab above for source.
Visit our alcohol / addiction / illegal drugs section for the latest news on this subject. Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, “Alcohol Use Disorders, Nicotine Dependence and Co-Occurring Mood and Anxiety Disorders in the United States and South Korea: A Cross-National Comparison,” were: S. Patricia Chou, Deborah A. Dawson, and Bridget F. Grant of the National Institute on Alcohol Abuse and Alcoholism; Maeng Je Cho of the Department of Psychiatry and Behavioral Science in the Institute of Behavioral Medicine at Seoul National University; and Jong-Ik Park of the Department of Psychiatry at Kangwon National University College of Medicine in Korea. This release is supported by the Addiction Technology Transfer Center Network at http://www.attcnetwork.org/.
The Catholic University of Korea
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
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Important Target Playing Role In Tobacco-Related Lung Cancers Discovered By Researchers

Main Category: Lung Cancer
Also Included In: Smoking / Quit Smoking;  Immune System / Vaccines
Article Date: 13 Feb 2012 – 0:00 PST

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Researchers at Moffitt Cancer Center in Tampa, Fla., have discovered that the immune response regulator IKBKE (serine/threonine kinase) plays two roles in tobacco-related non-small cell lung cancers. Tobacco carcinogens induce IKBKE and, in turn, IKBKE induces chemotherapy resistance.

The study was published in a recent issue of Oncogene.

“IKBKE is a newly identified oconogene, a gene linked to cancer,” said study lead author Jin Q. Cheng, Ph.D., M.D., who studies genetic alterations and their molecular mechanisms in cancer. “In our study, we demonstrated that IKBKE is a STAT 3 target gene and is induced by tobacco. STAT3 is a signaling and transcription gene that is activated in various types of cancer and is required for cell transformation.”

As a “transcription factor” STAT3 plays a key role in many cellular processes, such as cell growth and programmed cell death, or “apoptosis.”

“It has been well documented that STAT3 is activated by growth factors and environmental carcinogenesis, such as nicotine,” said Cheng. “STAT3 directly binds to the IKBKE promoter and induces IKBKE transcription.”

Tobacco smoke is the strongest documented tumor initiator and promoter in lung cancer. The underlying molecular mechanism is still largely unknown.

“IKBKE is induced by tobacco carcinogens and mediates tobacco action in promoting lung cancer cell survival,” said Cheng. “Armed with this knowledge, interventions targeting the IKBKE pathway could be developed.”

Cheng and his colleagues found that when STAT3 induces IKBKE expression, IKBKE’s expression induces chemotherapy resistance. Conversely, “knocking down” IKBKE sensitizes cells to chemotherapy, suggesting that there is a therapeutic role for targeting IKBKE.

While IKBKE has been found to be “over expressed” in ovarian, breast and prostate cancers, in this study IKBKE has for the first time been associated with non-small cell lung cancer in patients with a history of tobacco use, and particularly by tobacco’s nicotine component. The researchers stated that upon exposure to nicotine, cells express high levels of IKBKE protein. In their study co-expression of STAT3 and IKBKE was “observed in primary non-small cell lung cancer.”

“Current treatments for non-small cell lung cancer include surgery, radiotherapy and chemotherapy,” explained Cheng. “Advanced patients generally develop chemotherapy and radiotherapy resistance, so there is a great need to understand the molecular mechanism of therapy resistance in order to find ‘targets’ to overcome resistance.”

The discovery that STAT3 appears to regulate IKBKE in response to nicotine induced by tobacco carcinogen may also help develop a strategy for an intervention in non-small cell lung cancer by targeting IKBKE.

Article adapted by Medical News Today from original press release. Click ‘references’ tab above for source.
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Youths’ Smoking Influenced By Sports Teammates

Main Category: Smoking / Quit Smoking
Also Included In: Pediatrics / Children’s Health
Article Date: 10 Feb 2012 – 0:00 PST

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Young people’s choices about using drugs and alcohol are influenced by peers – not only close friends, but also sports teammates. A new study of middle schoolers and their social networks has found that teammates’ smoking plays a big role in youths’ decisions about smoking, but adolescents who take part in a lot of sports smoke less.

The study was conducted at the University of Southern California (USC) and appears in the journal Child Development.

Researchers looked at 1,260 ethnically diverse, urban, middle-class sixth through eighth graders. They asked the students about their own smoking behavior, and they asked them to name friends at school as well as the organized sports they took part in at school. Then, using a social network method they developed, they examined how participation in sports with teammates who smoked affected adolescents’ smoking behavior.

They found that youths were more likely to smoke as they were increasingly exposed to teammates who smoked, and that this tendency may be stronger among girls than boys. But they also found that youths who took part in a greater number of sports were less likely to smoke than those who participated in fewer.

“This result suggests that peers on athletic teams influence the smoking behavior of others even though there might be a protective effect overall of increased participation in athletics on smoking,” according to Kayo Fujimoto, assistant professor of health promotion and behavioral sciences at the University of Texas Health Science Center at Houston, who led the study when she was at USC.

The study has implications for programs aimed at preventing teens from smoking. “Current guidelines recommend the use of peer leaders selected within the class to implement such programs,” Fujimoto points out. “The findings of this study suggest that peer-led interactive programs should be expanded to include sports teams as well.”

Article adapted by Medical News Today from original press release. Click ‘references’ tab above for source.
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Society for Research in Child Development. “Youths’ Smoking Influenced By Sports Teammates.” Medical News Today. MediLexicon, Intl., 10 Feb. 2012. Web.
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Gay, Lesbian, Bisexual And Transgendered Adults Have Twice The Level Of Smoking And Half The Level Of Plans To Quit

Main Category: Smoking / Quit Smoking
Also Included In: Public Health
Article Date: 10 Feb 2012 – 0:00 PST

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Gay, lesbian, bisexual and transgendered Coloradans who smoke are not thinking about quitting or getting ready to quit, and a quarter are uncomfortable approaching their doctors for help, report University of Colorado Cancer Center researchers in a recent article published in Nicotine & Tobacco Research.

These and other findings from the study may help identify new approaches to encourage GLBT smokers to quit.

“Among most smoking populations, we almost always find 20 percent getting ready to quit and another 40 percent are thinking about quitting,” says Arnold Levinson, PhD, MJ, investigator at the CU Cancer Center and the paper’s senior author. “But the rates from our study were half of what we expected.”

For more than 70 percent of the GLBT smokers who were surveyed in Colorado, quitting was not on their agenda. GLBT adults are roughly twice as likely as heterosexual adults to smoke cigarettes. And little research has been done to determine which smoking cessation methods the group might prefer.

The GLBT Community Center of Colorado and other GLBT organizations across Colorado approached Levinson to create the survey of 1,633 Colorado GLBT smokers to see if they were less likely than other smokers to use “proven” cessation methods such as nicotine replacement therapy or telephone counseling.

Prior to the study, advocates thought GLBT smokers wouldn’t use smoking cessation strategies that didn’t take sexual orientation into account. But the surveys, collected at more than 120 GLBT-identified venues in Colorado, showed that GLBT smokers generally use the same strategies that other smokers use.

“More than a quarter of the GBLT smokers we surveyed had used proven methods to try to quit in the past, which is similar to what other populations report,” says Levinson, who is also an associate professor at the Colorado School of Public Health. “There was a minority, though, who wanted programs offering GLBT-identified cessation counselors and advice based on GLBT identity.

“This diversity of preferences makes the GLBT smoker population just like any other smoker population – a group of individuals with varying needs and preferences for cessation strategies.”

In contrast to other smoking populations however, more than 25 percent of respondents were uncomfortable asking their doctor for smoking cessation advice, which is one of four factors significantly associated with preparing to quit. Other factors include daily smoking, previous nicotine replacement therapy use and a smoke-free home rule.

Last month, the One Colorado Education Fund found similar widespread physician distrust among GLBT adults in a report titled Invisible: The State of GLBT Health in Colorado.

Taken together, these findings suggest that public health professionals have an opportunity to develop nonsmoking promotion campaigns in non-clinical settings. For example, a majority of survey respondents said they frequent GLBT bars and events and read GLBT publications. Additionally, promoting smoke-free homes could make a significant impact.

“Only half of our survey respondents had a smoke-free home,” Levinson says. “Since a smoker who lives in a smoke-free household is more likely to try quitting, we need to encourage more GLBT households to adopt this policy.”

“Before we worry too much about how to help GLBT smokers quit, we need public health campaigns to get the GLBT smoker population thinking about quitting,” he says.

Article adapted by Medical News Today from original press release. Click ‘references’ tab above for source.
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University of Colorado Denver. “Gay, Lesbian, Bisexual And Transgendered Adults Have Twice The Level Of Smoking And Half The Level Of Plans To Quit.” Medical News Today. MediLexicon, Intl., 10 Feb. 2012. Web.
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University of Colorado Denver. (2012, February 10). “Gay, Lesbian, Bisexual And Transgendered Adults Have Twice The Level Of Smoking And Half The Level Of Plans To Quit.” Medical News Today. Retrieved from
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Erlotinib Dose-Adjusted For Smoking Status Effective As First Treatment For Head And Neck Cancer

Main Category: Cancer / Oncology
Also Included In: Ear, Nose and Throat;  Smoking / Quit Smoking
Article Date: 27 Jan 2012 – 4:00 PST

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Head and neck cancers respond well to the anti-cancer drug erlotinib when it is administered before surgery and a stronger dose is given to patients who smoke, according to a study presented at the Multidisciplinary Head and Neck Cancer Symposium, sponsored by AHNS, ASCO, ASTRO and SNM.

Erlotinib is an oral anti-cancer drug that can slow a tumor’s growth and spread by inhibiting specific growth receptors on the surface of the cancer cells. Early detection of a patient’s response to EGFR inhibitors, such as erlotinib, is critical to personalizing head and neck cancer treatments.

In a first of its kind study in patients with head and neck cancer, researchers sought to determine how well tumors unaffected by other therapies respond to erlotinib, when the drug dose was adjusted according to the patient’s smoking status. It has been recently shown that smokers metabolize the drug faster than nonsmokers.

Nonsmokers received 150 mg per day and smokers received 300 mg per day for at least 14 days before surgery. A FDG-PET scan and neck CT was performed before treatment and at the end of erlotinib administration. In addition, an early FDG-PET was performed after four to six days of treatment.

The results showed that erlotinib is effective as a first line of therapy when the dose is adjusted per smoking status, even when used for a limited duration. Both smokers and nonsmokers tolerated the dose of erlotinib and neither experienced serious adverse effects. The study also showed that the FDG-PET scan taken early can show changes in the standard uptake value and predict a patient’s response to erlotinib.

“We hope our results will motivate clinicians to consider and investigate further the use of erlotinib in patients with head and neck cancer and adjust the dose for smoking status,” Mercedes Porosnicu, MD, lead author of the study and an assistant professor of internal medicine at Wake Forest Baptist Medical Center in Winston Salem, N.C., said. “We also hope that our study will help better select the patients expected to respond to erlotinib.”

Article adapted by Medical News Today from original press release. Click ‘references’ tab above for source.
Visit our cancer / oncology section for the latest news on this subject. The abstract, “Pilot study to evaluation the effect of erlotinib administered before surgery in operable patients with squamous cell carcinoma of the head and neck (SCCHN),” was presented as a poster presentation.
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American Society for Radiation Oncology. “Erlotinib Dose-Adjusted For Smoking Status Effective As First Treatment For Head And Neck Cancer.” Medical News Today. MediLexicon, Intl., 27 Jan. 2012. Web.
14 Feb. 2012. APA

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Teen Secondhand Smoke Exposure Down, But Not Enough

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Academic Journal
Main Category: Smoking / Quit Smoking
Also Included In: Pediatrics / Children’s Health
Article Date: 06 Feb 2012 – 9:00 PST

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Secondhand Smoke (SHS) exposure among middle and high school students in the USA has dropped over the last ten years, researchers from the National Center for Chronic Disease Prevention and Health Promotion and the CDC (Centers for Disease Control and Prevention) reported in the March edition of Pediatrics. The authors explained that passengers in cars who accompany smokers run significant health risks, especially if they are children and teenagers.

Even though exposure has gone down over the last decade, 22.8% of students who did not smoke reported that they had breathed in environmental tobacco smoke during the previous seven days – 75.3% of smoking students had done so too.

Secondhand smoke, also known as environmental tobacco smoke, or passive smoking, refers to the unintended inhalation of tobacco smoke by other people, apart from the intended active smoker.

The authors explain that passive smoking can lead to: middle ear diseasedelayed lung growthexacerbations of asthma symptomsacute respiratory infectionsBrian A. King, PhD, MPH, and team set out to determine how much exposure there was among teenagers to secondhand smoke in nonpublic areas, especially cars and other motor vehicles. The authors explained that most previous studies had focused on environmental tobacco smoke exposure in the home.

Ich.Autofahrend.2006.MB
Non-smokers who sit with a smoking driver/passanger will inhale secondhand smoke

They gathered data from the National Youth Tobacco Survey for the years, 2009, 2006, 2004, 2002 and 2000. The survey is said to be a nationally representative one of sixth to twelfth graders. They assessed SHS exposure in motor vehicles across school years, gender and race/ethnicity.

They found that: SHS exposure dropped from 39% among non smokers in 2000, to 22.8% in 2009.SHS exposure fell from 82.3% among smokers in 2000, to 75.3% in 2009.In an Abstract in the journal, the authors concluded:

“SHS exposure in cars decreased significantly among US middle and high school students from 2000 to 2009. Nevertheless, in 2009, over one-fifth of nonsmoking students were exposed to SHS in cars. Jurisdictions should expand comprehensive smoke-free policies that prohibit smoking in worksites and public places to also prohibit smoking in motor vehicles occupied by youth.”

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our smoking / quit smoking section for the latest news on this subject. “Secondhand Smoke Exposure in Cars Among Middle and High School Students – United States, 2000-2009”
Brian A. King, PhD, MPH, Shanta R. Dube, PhD, MPH, and Michael A. Tynan, BA
Pediatrics February 6, 2012. doi: 10.1542/peds.2011-2307 Please use one of the following formats to cite this article in your essay, paper or report:

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Christian Nordqvist. “Teen Secondhand Smoke Exposure Down, But Not Enough.” Medical News Today. MediLexicon, Intl., 6 Feb. 2012. Web.
14 Feb. 2012. APA

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posted by Jesse on 6 Feb 2012 at 9:53 am

Will anyone think of the children? OMG please think of the children, poor children, such a tragedy. I’m going to call my state representatives to come up with new laws to forbid anything that harms the children. That includes forbidding them from running in the park because they can fall and get hurt. OMG the children.

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posted by Candace Krestel on 7 Feb 2012 at 6:00 am

I smoke but always am considerate of others. I always ask if they mind my smoking. I don’t smoke in other peoples houses and I think it’s wrong to smoke with kids in the car. As far as making it a law this is just another way to control what people are doing. Why don’t they ban drinking because that’s a killer too but it’s still legal because it makes money.

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Male Smoking Leads To Faster Cognitive Decline

Editor’s Choice
Academic Journal
Main Category: Smoking / Quit Smoking
Also Included In: Psychology / Psychiatry;  Alzheimer’s / Dementia
Article Date: 10 Feb 2012 – 6:00 PST

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Findings of a report published Online First in the Archives of General Psychiatry, one of the JAMA/Archives journals shows that men who smoke seem to be linked with a more rapid cognitive decline.

According to background information, smoking is more and more renown as a risk factor for dementia in the elderly. In 2010, the number of dementia diagnoses around the world was estimated at 36 million with numbers increasing and predicted to double every 20 years.

Séverine Sabia, Ph.D., of the University College London and her team assessed the link between smoking history and cognitive decline during the transition from midlife to old age by obtaining data from 5,099 men and 2,137 women from the Whitehall II cohort study, which is based on employees of the British Civil Service. The average age of the participants was 56 years at the first cognitive assessment.

In their new study, the researchers evaluated data from six assessments of smoking status over a 25 year-duration and three cognitive assessments over 10 years and established four major findings, which indicate that men who smoked are linked to a more rapid cognitive decline, and that those who continued smoking over the follow-up period had a bigger decline in all cognitive tests.

They also observed that those who quit smoking in the 10 years before the first cognitive measure were still at risk of greater cognitive decline, in particular in executive function, an overall term for various complex cognitive processes involved in achieving a particular goal, whereas there was no faster cognitive decline in long-term ex-smokers.

The researchers conclude:

“Finally, our results show that the association between smoking and cognition, particularly at older ages, is likely to be underestimated owing to higher risk of death and dropout among smokers.”

They also observed no link between smoking and cognitive decline in women, even though the underlying reasons remain unclear, and hypothesize that one explanation for the sex difference could be that men smoke greater quantities of tobacco.

Written by Petra Rattue
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Rise In Heart Disease Prevalence In The Gulf States Linked To Rapid Urbanisation As Well As Cultural Habits

Main Category: Heart Disease
Also Included In: Obesity / Weight Loss / Fitness;  Smoking / Quit Smoking;  Conferences
Article Date: 27 Jan 2012 – 0:00 PST

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While the rapid improvement in socio-economic conditions is thought responsible for the high rates of cardiovascular disease in the Gulf states, deep-rooted cultural factors also play a part. “We’re sitting on a time bomb,” says Professor Hani Najm, Vice-President of the Saudi Heart Association, whose annual conference begins Friday 27 January. “We will see a lot of heart disease over the next 15 to 20 years. Already, services are saturated. We now have to direct our resources to the primary prevention of risk factors throughout the entire Middle East.”

World Health Organization figures show that up to 60% of males in Arab countries and up to 70% of females are overweight and obese. Prevalence rates of diabetes and hypertension are around 25%, while inactivity rates among the over-20s are even higher. But the explanation, says Professor Najm, is not just rapid urbanisation and ubiquitous travel by car. There are, in addition, many social and cultural barriers to exercise, especially among women, who find it difficult to find the opportunities and encouragement to take organised exercise.

Smoking – cigarettes and waterpipe

And now there is further evidence that the cultural heritage of the Middle East may present yet another growing risk factor in the region’s battle against heart disease. The waterpipe – also know as the hookah or shisha – is now said to be used by up to 34% of Middle Eastern adolescents. Despite a perception that the risk of the waterpipe may be less than those of cigarettes, a recent report suggests that its “harmful effects are similar to those of cigarettes”, and that the waterpipe may offer “a bridge” to cigarette smoking.(1) The greatest prevalence of use – with up to 34% reported – is currently among adolescents and women.

A recent study from the Gulf Registry of Acute Coronary Events (GRACE), the region’s largest, found that 38% of patients registered were cigarette smokers and 4.4% waterpipe smokers.(2) The study, which included 6,701 consecutive acute coronary patients in Bahrain, Kuwait, Qatar, Oman, United Arab Emirates, and Yemen, found that the waterpipe smokers were older than the cigarette smokers and more likely to be female.

However, despite the relatively low rate of waterpipe smoking among the patients in this registry study, other studies report more widespread use throughout the region, and especially among the younger age groups. A study from 2004 found that 22% of men in two villages of Egypt reported current or past use of waterpipes, and the habit is increasingly evident even among student communities in the USA, Canada and Germany. The GRACE investigators said: “Although the prevalence of waterpipe smoking in the current registry was low (4.4%), with the current trend of popularity it is expected that physicians and specifically cardiologists across the globe can expect increasing number of their patients with Acute Coronary Syndromes to be waterpipe tobacco smokers.”

They attribute this rising popularity to the introduction of a sweet processed tobacco, the mistaken belief that any harmful effect is less than that of cigarettes, and a dearth of health warnings (as well as a dearth of data). Yet the investigators propose that waterpipe smoking may be associated with greater toxin exposure (because of longer episodes of use as well as more and larger “puffs”, with smoke inhalation as much as 100 times more than from a cigarette). They explain that a single waterpipe episode lasts between 30 and 60 minutes and may involve more than 100 inhalations, each approximately 500 ml in volume (with the smoke passing first through water). “Thus,” they write, “while smoking a single cigarette might produce a total of approximately 500 – 600 ml of smoke, a single waterpipe use episode might produce about 50,000 ml of smoke.”

The primary prevention of cardiovascular disease in the Middle East will occupy a full session of this year’s Annual Conference of the Saudi Heart Association, which, for the second year, will also feature a one-day collaborative programme with the European Society of Cardiology. Professor Najm highlights the efforts of the Association (and many regional health ministries) to develop prevention programmes, and regrets that the smoking policies of many countries – including Saudi Arabia – are not fully enforced. “The basic messages still need to be delivered,” he says. “With such a high prevalence of risk factors in our populations, especially among the young, I still expect rates of cardiovascular disease to increase even further over the next 20 years.”

Article adapted by Medical News Today from original press release. Click ‘references’ tab above for source.
Visit our heart disease section for the latest news on this subject. (1) Maziak W. The global epidemic of waterpipe smoking. Addictive Behaviors 2011; 36: 1-5.
(2) Al Suwaidi J, Zubaid M, El-Menyar AA, et al. Prevalence and outcome of cigarette and waterpipe smoking among patients with acute coronary syndrome in six Middle-Eastern countries. Eur J Cardiovasc Prevent Rehab 2011; DOI: 10.1177/1741826710393992
(3). Maziak W, Ward KD, Soweid RAA, Eissenberg T. Tobacco smoking using a waterpipe: a re-emerging strain in a global epidemic. Tobacco Control 2004; 13: 327–333.
* Details of the ESC’s programme can be found at http://www.escardio.org/congresses/global-activities/saudi-arabia/saudi-heart/Pages/welcome.aspx
* Details of the SHA congress can be found at http://www.sha-conferences.com/
European Society of Cardiology Please use one of the following formats to cite this article in your essay, paper or report:

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European Society of Cardiology. “Rise In Heart Disease Prevalence In The Gulf States Linked To Rapid Urbanisation As Well As Cultural Habits.” Medical News Today. MediLexicon, Intl., 27 Jan. 2012. Web.
14 Feb. 2012. APA

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