Thursday, November 29, 2012

Study Shows that the Whooping Cough Vaccine May Become Less Effective Over Time

Vaccination is a hot topic in today’s world.  It is often a debated and changing subject.  Vaccination is proven to safeguard children against diseases such as whooping cough, but new research has shown that the vaccine may become less effective over time. 

A recent outbreak of whooping cough, also known as pertussis, was in California in 2010.  The outbreak sickened more than 9,000 people and left 10 infants dead.  This outbreak is what compelled an examination into the effectiveness of the vaccine.  The study found that the vaccine is effective, but it does become less effective over time, especially leaving children 7 to 10 years old vulnerable.

Lara Misegades, an epidemiologist at the US Centers for Disease Control and Prevention in Atlanta said, “The pertussis vaccine is our best protection against disease.”  Misegades also said, “We found that unvaccinated children were eight times more likely to be a pertussis case than vaccinated children.  Parents should ensure children complete the childhood series and make sure your children get the adolescent booster too.”

Just this year alone, the US has had more than 36,000 whooping cough cases have been reported.  There were 16 deaths, mainly in infants younger than 3 months old, according to the CDC.

"We're continuing to evaluate the changing epidemiology [of pertussis], but it's too early to speculate if there's a need for an additional booster," Misegades said.

The results of the study are available in the November 28th issue of the Journal of American Medical Association.

The vaccine is commonly referred to as the DTaP vaccine.  It also includes immunizations for diphtheria and tetanus.  The vaccine is a 5 dose series that are administered at age 2 months, 2 months, 6 months, 15 months and between 4 and 6 years old. The CDC recommends a booster at the age of 11 or 12.

The research study was intended to evaluate how much time had elapsed since the last DTaP vaccination and the development of whooping cough in the patients in the California outbreak, which was the largest state outbreak in 60 years.

Included in the data for the study were 15 counties in California with a high incidence of pertussis cases.  A total of 682 children with ages ranging from 4 to 10 years old who developed pertussis were included and for each child in the this group, three children of the same age that did not have pertussis were also included for comparison.

The study found that in comparison to the controls, the children who had contracted pertussis were 89% less likely to have received all the recommended doses of the vaccine. Those children that developed the disease were more likely to be unvaccinated than those that did not have the disease 7.8% versus 0.9%.  The researchers also found that the vaccine became less effective with the more time that had passed.  

"Within the first few years, the vaccine's efficacy was around 98 percent," Misegades said. "Five or more years out, the vaccine effectiveness had dropped to about 71 percent."

The study also showed that the highest incidence of disease occurred in 7 to 10 year old children and that the incidence increased with age.  For example, about 3% of the cases occurred in 4 year olds and 31% of the cases were found in 10 year olds.  The current vaccine available is an acellular vaccine; it does not contain whole cells of the bacterium that is responsible for whooping cough infections.  The previous version of the vaccine did contain whole cells of the bacterium; however it was more likely to cause side effects, according to researchers.

The switch to the newer vaccine may explain the reemergence of pertussis, according to the editorial by Dr. Eugene Shapiro, accompanying the journal article.  Dr. Kenneth Bromberg, director of the Vaccine Study Center at the Brooklyn Hospital in New York City, agreed that the previous whole-cell vaccine might have been more effective than the current vaccine, but he pointed out that the whole-call vaccine did have production issues, including batch effectiveness variance. He also said that the components of the whole-cellular vaccine may have been the reason for the risk of side-effects.

The take-home message for parents, according to Bromberg is, “"the vaccine works. It's effective, so make sure everyone is appropriately vaccinated according to the current schedule." "We'll have to wait for further study to [determine if the current dosing schedule needs change]," he said. "Parents should stay tuned as to whether we recommend additional vaccinations for pertussis."

To learn more about pertussis, visit


Wednesday, November 28, 2012

Do You Know What’s in Your Food? Bacteria and Drugs found in US Pork

An analysis from Consumer Reports recently revealed that samples of US pork-chop and ground-pork were found to contain significant amounts of harmful and antibiotic-resistant bacteria, in addition to low levels of growth hormone used to increase growth in pigs. 

The analysis showed that 3% to 7% of the samples contained dangerous bacteria.  Among those found included: salmonella, staphylococcus aureus and listeria monocytogenes.  These are all known to cause serious and harmful food-borne illnesses.  Found in 69% of the samples was the bacterium Yersinia enterocolitica, known for causing fever diarrhea and abdominal pain. 

The analysis included 198 samples.  Consumer Reports found that among the bacteria discovered, there were some found to be antibiotic-resistant.  Consumer Reports suggested that this could be a result of the pork farming industry’s common practice of administering low-dose antibiotics to promote weight gain.  Antibiotic-resistant bacteria have been a hot topic in recent years because these “super bugs” are not able to be treated with our conventional antibiotics. 

In addition to the bacteria, the analysis also revealed that the pork products tested contained low levels of the drug ractopamine, which is commonly used in pigs that are raised for food in order to accelerate growth and leanness.  The drug is currently approved in the US but is banned in other countries, including the European Union, China and Taiwan. 

The overall analysis showed that the ground-pork samples were more likely to contain bacteria than the pork-chop samples.
Adapted from:

Wednesday, November 21, 2012

Make Your Thanksgiving a Healthy One: 5 Tips to Keep from Overindulging

The holidays are often a time filled with overconsumption.  The temptations of succulent turkey, tasty tarts and pies and savory side dishes can often times be lure that you just can’t resist.  But if you’re looking to eat healthy on Thanksgiving, it doesn’t mean you have to give up all your favorite foods, says Jennifer K. Nelson, a registered dietician and director of clinical dietetics at the Mayo Clinic in Rochester, MN. 

"If you've got your eating under control for the majority of the time, go ahead and have a piece of pie — just don't lose control entirely," Nelson told MyHealthNewsDaily. "Keep your willpower and your wits about you."

Here are 5 tips and tricks to help you eat avoid overindulgence this holiday.

1.       Stick to healthy portions.

Only one plate of food is all you get, says Nelson.  She advises to fill up half the plate with fruit, vegetables, and a whole wheat roll.  A quarter can be filled with either mashed or sweet potatoes and the other quarter with turkey or ham.  She also advises that the more colorful the arrangement on your plate, the better.  This means adding leafy greens, carrots, bell peppers, beets, cranberries and other vegetables as much as you can.

"If you fill up on those lower caloric density and higher nutrition things, you're going to feel full, but not bloated and tired, because it's a lighter fare," she said.

It is a holiday so if your diet allows, indulge a little bit.  Caution: if you’re going to eat desert, make sure you allow for the calories by decreasing them somewhere else. Don’t go back for a second helping of potatoes if you want to have a little dessert. Dee Sandquist, spokeswoman for the American Dietetic Association, advises to choose the cranberry salad if you are still hungry.

Sandquist also advises that if you are choosing pie, go for a fruit or pumpkin pie because they tend to have fewer calories rather than the chocolate or pecan pies.  She also says to try and stick to a single serving of your more unhealthy choices.  Aim for a half-cup of mashed potatoes and a 3 ounce serving of turkey.

2.       Eat before you indulge.

Don’t try and starve yourself throughout the early part of the Thanksgiving Day.  This is a recipe for overeating.  If you are going to a Thanksgiving lunch, make sure to eat breakfast before you go.  If you are going to a dinner, be sure to eat lunch or have a small snack.

"You definitely want to have your normal meals because otherwise, whenever we get over-hungry, we overeat," she said.

3.       Try to substitute healthy ingredients for the more unhealthy ones.

There are endless ways to make your Thanksgiving food healthier.  For your mashed potatoes, Nelson advises that mixing in chicken broth or herbs and garlic can add flavor without adding calories.  For your green bean casserole, substitute the friend onions for toasted almonds, adding protein and decreasing fat.  Sandquist also suggests that instead of a sugary cranberry sauce; instead opt to serve a cranberry salad.  For dips, substitute Greek yogurt for the sour cream; the consistency will be similar but less fat and more protein.  

Another easy way to cut fat and calories is to skip eating the skin on your turkey.  The dark meat has slightly more fat than the white meat, but limiting your unhealthy side choices will be more beneficial in the long run than choosing one meat over the other.

If you are making your pies from scratch, choose a whole wheat pie crust and substitute low-fat or skim milk instead of the evaporated milk. 

4.       Drink lots of water and go for a walk after your meal.

Sanquist says that many times people will mistake thirst for hunger.  By drinking water throughout the day you will decrease your odds of overeating.  It is also a good idea to take a walk after the big meal to help increase metabolism.

5.       Avoid snacking.

Sandquist says to abide by the “out of sight, out of mind” mantra.  She advises once you fill your plate with food, cover it up and put it away.

"It'll help you avoid mindless munching," she said.  When you snack throughout the day, you can lose track of how much you have eaten.
adapted from:

Monday, November 19, 2012

Let’s Talk Turkey: Tips to Eat Your Bird Safely This Thanksgiving

Thanksgiving is often times celebrated by overindulging in a delicious turkey dinner spread and counting blessings for the past year.  Before your bird hits the table there are a number of steps that need to be taken to ensure a succulent turkey and one free of disease causing organisms.

Ben Chapman, a food safety specialist and assistant professor of food science at North Carolina, said that fixings for the big meal are complicated.  But you if follow some simple advice, you can help yourself to ensure that your meal goes off without a hitch.

1.       Thaw your turkey.

·         If you are going to be frying your turkey, make sure that you thaw the bird.  Putting a frozen bird into a hot fryer can lead to a big mess, and a lot of danger, an event that can be due to the turkey’s temperature and the water content. "It has to do with the temperature change. You're putting something really cold into something really hot and that affects what the oil is going to do," Chapman said, adding that this "exploding turkey" phenomenon is outside his expertise.

·         "I had guessed that the water in the turkey, or whatever, boils very fast causing the surface to explode with bubbles, some of which could spray oil on the burner," John Coupland, associate professor of food science at Penn State, said in an e-mail to LiveScience. "So wet rather than cold is the key variable."

·         Thinking about where you might be able to defrost your bird for the big day?  Chapman recommends placing the turkey in the refrigerator, microwave, or under cool water.  Caution: all methods come with their own risks.  When using the fridge, you need to make sure that the turkey thaws all the way through, which means making sure the center doesn’t remain frozen. 

·         The United States Department of Agriculture guidelines for thawing your turkey in the fridge:

o   4 to 12 pounds: 1-3 days

o   12 to 16 pounds: 3-4 days

o   16 to 20 pounds: 4-5 days

o   20 to 24 pounds: 5-6 days

2.       Don’t wash the turkey!

·         "As soon as you have the pressure of the water hitting the turkey it can spray anything on the outside of that turkey around the kitchen," Chapman told LiveScience.

·         Researchers in the UK recently discovered that forceful water hitting the turkey has the potential to spray pathogens up to three feet.

·         Instead, Chapman recommends wiping the outside of the turkey with a damp rag and immediately throwing out the rag or putting it in the washing machine.  "Treat that damp rag like a raw chicken," he said, adding that it likely contains the pathogens you're trying to avoid.

3.       Cook your bird!

·         "The most important thing is cooking that turkey to 165 degrees Fahrenheit (74 degrees Celsius), and there's only one way to know whether you've cooked it safely and that is to use a thermometer." Campylobacter and Salmonella can’t grow until the temperature reaches 45 degrees Fahrenheit and are killed when the temperature reaches 165 degrees Fahrenheit.

·         Some think that the color of the juice can be an indicator that the meat is done, but this is not the case.  The juice color from the meat does change as the bird cooks but that does not mean that the bird is safe to eat.

·         To check if you turkey is done: place a tip-sensitive digital thermometer into 8-10 spots on the turkey.  When the thermometer reads at least 165 degrees all around, then it is time to come out. Chapman advises to target thick areas on the turkey, away from the cavity or bone because bone conducts heat better and can give a false reading.

4.       Hurry; put the turkey in the fridge!

·         As soon as you are done with the meal, Chapman advises putting the turkey in the fridge.  If any pathogens are left on the turkey they can begin to grow at 135 degrees Fahrenheit.  Even if you thoroughly cooked the bird in the oven, new pathogens could have taken up residence.  For example, Staphylococcus aureus lives on most of us around our eyes and noses. However, it doesn't release its toxins until it has a food source, such as the warm turkey meat. Rubbing your nose or an eye while handling the turkey could give the staph a free ride onto the food. The cold temperatures in your fridge will slow down growth, keeping the pathogen at safe levels.

·         Chapman also suggests dividing your meat into smaller portions to increase the surface area exposed to the cold temperatures and slow down pathogen growth.

5.       Have left overs? Repeat the above steps.

·         Chapman says that repeating the same steps for a raw turkey as a cooked turkey are important to keep your food safe.  Pull out the thermometer again to check the temperature of the meat.  Even if you warm your bird up in the microwave, still check that the temperature is at 165 degrees Fahrenheit to reduce the chance for disease.

Adapted from:

Friday, November 16, 2012

With Winter Approaching, When Was the Last Time You Check Your Carbon Monoxide Detector

Having a working carbon monoxide detector is important all year along, but it becomes especially important during the winter months. 

As the cold moves into your area, you need to check if you have inspected your detectors.

When the temperatures drop, many tend to close up the house, including the windows and doors, to try and save money on utilities.  The problem with this is, if you do have a carbon monoxide leak, you are allowing it to build up, with nowhere to go.  One of the most common sources of the toxic, odorless gas are heaters and furnaces, which are used more in the winter months.

Many issues can be avoided just by making sure you have regular maintenance done on all household heating appliances.  With winter on its way, this is the time to bring in a trained and certified technician to ensure that everything is in proper working order.  It is also important to make sure that if you are using a space heater or other portable heater, you exercise caution while using them.

Another danger that comes with the cold weather is that many people opt to heat up their cars in the garage.  If you do this with the garage doors closed, the gas from the running car has nowhere to escape and carbon monoxide will back up into the home.  If you do warm up your car, make sure to open the garage doors and windows.

It is a requirement to have a carbon monoxide detector on every level of a home and within 15 feet of all the sleeping areas.

Carbon monoxide poising can cause flu-like symptoms including headache, nausea, vomiting and dizziness.  In severe cases it can even cause death.  If you do experience any of these symptoms, seek medical attention immediately if suspect you might have been exposed to carbon monoxide.
Adapted from:

Monday, November 12, 2012

American Heart Association Warns; Beware of the “Salty Six”

The American Heart Association (AHA) is warning all people to be more aware of the “salty six.”

The “salty six” are common foods in Americans’ diets that are full of excess sodium.  The list includes some little known suspects, with chips not making the cut.

"Excess sodium in our diets has less to do with what we're adding to our food and more to do with what's already in the food," Dr. Linda Van Horn, a research nutritionist at Northwestern University who volunteers at the AHA, said in a press release. "The average individual is getting more than double the amount of sodium that they need, but there are ways to improve their sodium intake under their control."

The current U.S. dietary guidelines recommend that people consume no more than 2,300 milligrams of sodium each day.  The American Heart Association recommends an even lower amount of 1,500 milligrams per day.  A recent survey done by the AHA found that most Americans are consuming an average of 3,400 milligrams each day and most of this is from processed and restaurant foods.

This could potentially raise blood pressure and increase the risk for stroke and heart disease, according to the Centers for Disease Control and Prevention. 

The list includes:

1.       Bread and rolls

·         The AHA says that bread can be deceiving because it doesn’t taste salty but just one piece can contain as much as 230 milligrams of sodium, about 15% of the recommended amount. This can add up quickly throughout the day, especially if people are consuming sandwiches.

2.       Cold cuts and cured meat

3.       Pizza

·         Fat and calories might be two the biggest worries when it come to this food, but one slice of pizza might contain up to 760 milligrams of sodium, and eating two slices would put you over the daily AHA recommendation.

4.       Poultry

·         This meat may contain a wide range of sodium depending on the processing and preparation.  The AHA warns that even grilled, lean chicken may still contain added sodium solutions.  Bread chicken nuggets are also a major culprit: a 3 ounces serving may contain up to 600 milligrams of sodium.

5.       Soup

·         With the weather getting colder, many are looking to the soup to warm up and find comfort.  The AHA cautions those who are going to eat soup to make sure to look at the nutrition label before choosing, as soups can be laden with up to 940 milligrams of sodium.

6.       Sandwiches

·         The “salty six” list already includes bread and cured meats so it should not be surprising that other sandwiches, from burgers to subs, also make the list. The AHA says that adding condiments to the sandwich, including ketchup, mustard or dressing, can easily put the sandwich over 1,500 milligrams of sodium in one sitting.


Wednesday, November 7, 2012

Obama’s Second Term Means Major Health Changes in States

Although opposed by many Republicans, President Barak Obama’s re-election means that the overhaul of the US health-care system will move ahead in all 50 states.  Those state officials that have held off on implementing some aspects of the 2010 Patient Protection and Affordable Care Act will face pressure to act immediately.  State officials will now have 9 days to advise the federal government about how they plan to manage their state-run health-care exchanges that were created by the PPACA to help provide medical coverage to the uninsured.  If officials don’t comply, they face a de-facto US takeover of their insurance markets.

With Republican presidential candidate Mitt Romney promising to repeal the PPACA, all but 13 governors had waited to implement their plans.  Now those governors that “thumbed their nose” at the president must quickly regroup, said Mississippi Insurance Commissioner Mike Chaney, a Republican who said he will submit a plan for his state’s exchange by the Nov. 16 deadline.  

“The message to governors is the verdict is now in,” said Ron Pollack, executive director of Families USA, a consumer advocate that backs the law. “The Affordable Care Act is moving forward. Either they help cooperate with its implementation, or people in their state could be left out in the cold.” 

States not only have to play catch-up with Obama but with hospitals and insurance companies that are well-prepared for the new business.   Hospital chains and insurers have invested millions on new technology, marketing and plan development to compete in the new market. 

“Our priority for the organization is to get the organization ready to both comply with and play in target markets from an exchange standpoint,” David C. Cordani, chief executive officer of Bloomfield, Connecticut-based Cigna Corp. (CI), told analysts on a Nov. 1 conference call. “But we’re keenly focused on the amount of moving parts that exist within the regulatory environment and within the state and federal environment over the next two to three quarters.”

According to the U.S. Department of Health and Human Services, 34 states have accepted at least two grants from the federal government for the planning of their exchange.  This means that 20 states will be in a position to build an exchange or partner with the federal government on an exchange.  This is in addition to the 13, plus Washington, D.C., who have already stated that they will run their own exchange.  The rest “have either explicitly said ‘no’ or have taken so few steps that you can’t really see them shifting quickly enough to play an active role,” said Alan Weil, executive director of the National Academy for State Health Policy, which assists states implementing the health law, in an interview. 

Those governors who don’t comply and meet with the Obama administration’s deadline will see take over from the federal government to set up the exchanges in their states that will decide which insurers can sell plans to their citizens.  The federal exchange will also have control over enrollment of low-income people into the state Medicaid program.  

“We still haven’t seen proposed regulations in a couple of critical areas,” said Alissa Fox, senior vice president for lobbying and policy development at the Blue Cross Blue Shield Association in Washington, a trade association for 38 state Blue Cross and Blue Shield insurance companies. “What the states have to do and what the plans have to do, in designing and having products ready to market, a huge undertaking has to happen,” she said.

Obama’s win does away with any of the uncertainty about the PPACA that lingered since the law survived challenges in the U.S. Supreme Court.  Obama also has the advantage of retained control over the Senate, with a Democratic majority; which means anything legislation that attacks the PPACA passed by the Republican controlled house will be done away with in the Senate.  

Paul Keckley, the executive director of Deloitte LLP’s Center for Health Solutions research group in Washington said that with the threat of a repeal gone, Obama may be more lenient in the time lines and allow more flexibility.  Keckley also said that the administration might allow governors more time to set-up their exchanges or have a flexible definition for the exchanges to allow them to be set-up successfully.  He expects that few states will give up control of their exchange to the federal government.

“The federal government doesn’t want to run the exchange,” Keckley said in a telephone interview. “The federally run exchange was always meant as a backstop. To set up and run that federal exchange, they would have to go through the usual appropriations process in Congress. That’s a whole new battle, and I don’t think anyone in the administration is interested in that.”

Keckley says that one potential area of compromise may be what the benefit plans need to cover, currently allow states to use benchmark’s based on current small business plans. Obama may give states flexibility to define their benefits.

"President Obama has the opportunity to make bold leadership moves toward a bipartisan compromise on healthcare and the economy,” said Julie Barnes, director of healthcare policy at the Bipartisan Policy Center. "He has the standing to demand that each party see the investment all Americans have in reforming our broken healthcare system."

Tuesday, November 6, 2012

Redheads May be at Greater Risk for Melanoma Due to Genetics

Current genetic research is bringing to light a new concern for melanoma risk.

Research has shown for many years that those with red hair, fair skin, freckles and an inability to tan may be at a greater risk for developing melanoma.  A new study in mice, published in the journal Nature, suggests that even if they never are in sunlight, they may be at an increased risk for melanoma due to genetic factors.  They have linked this to a genetic mechanism that is also linked to fair coloring.

"We've known for a long time that people with red hair and fair skin have the highest melanoma risk of any skin type," study author Dr. David Fisher of Massachusetts General Hospital said in a statement. "The risk for people with this skin type has not changed, but now we know that blocking UV radiation -- which continues to be essential -- may not be enough."

The study suggests that the key seems to be the gene for the melanocortin 1 receptor, MC1R.  The variations in the gene can lead to different levels of two variants of melanin-- the brown-black eumelanin and the red-yellow form, pheomelanin.

Named after the red color associated with them, RHC polymorphisms were shown to lead to lower levels of eumelanin and higher levels of pheomelanin.  Pheomelanin is less able to protect against ultraviolet light, which is at least part of the reason redheads have a higher risk of skin cancer in general.

Fisher and colleagues noted that this cannot be the whole answer for melanoma.   Unlike other skin cancers, melanoma can appear on skin that is not exposed to sunlight.  The mutations that drive the disease have rarely been linked to UV damage.  In order to dig deeper, the researchers studied mice that were genetically identical with the exception of the MC1R gene and produced relatively high levels of pheomelanin and another that had a mutation that stopped pigment from being synthesized, although the MC1R gene was normal.

The three strains were named after their coat color: black, red and white.  They were crossed with mice that already expressed the BRafV600E gene, one of the most common mutations in melanoma, in their pigment-producing melanocytes.  When kept from UV light exposure, less than a quarter of the black and white mice showed signs of melanoma.  In contrast, half of the red mice developed melanoma by the end the research.  In other words, the mice with high levels of pheomelanin (the red mice) were more likely to develop melanoma than those with low or non-existent levels.

The researchers concluded that there may be “intrinsic carcinogenic features” of pheomelanin synthesis and possibly even the substance itself.  They also noted that “one possibility is damage caused by reactive oxygen species, the researchers noted, since there is evidence that pheomelanin amplifies ultraviolet-A-induced reactive oxygen species.”

They also cautioned that the study does not “diminish the importance of sun exposure” as a factor that can contribute to melanoma.  Fisher suggested that the findings may contribute to the development of better sunscreens and other protective measures "that directly address this pigmentation-associated risk while continuing to protect against UV radiation." 

According to Drs. Meenhard Herlyn and Mizuho Fukunaga-Kalabis of the Wistar institute in Philadelphia said that decreasing the risk is “perhaps the most pertinent question.”  They said that it is possible that in black mice (and their human counterparts) the high levels of eumelanin attacks the “reactive oxygen species” that are triggered by the pheomelanin.  They argued in their accompanying piece that researchers should consider topical compounds to increase eumelanin synthesis and even oral antioxidants to see if this may decrease the risk of melanoma for red heads.  In the meantime, they suggest that red heads continue to get regular check-ups and take precautions to prevent cancer.


Adapted form Michael Smith. “Melanoma Risk May Be Genetic for Redheads.” November 1, 2012. MedPage Today.

Monday, November 5, 2012

Smoking Bans Decrease the Incidence of Heart Attacks



Stepping out of your office for a quick smoke break?  You might now be praised as a public health icon.  Workplaces and restaurants that have put in place smoking bans limiting smoking to outside areas only have managed to improve Americans’ health, in spite of rising levels of obesity and Type 2 diabetes, says a new study.   The study was published Monday in the Annals of Internal Medicine.  It was focused on Olmsted County in Minnesota.  The study tracked the rate of heart attacks and sudden heart attack deaths in the aftermath of the smoking bans that cleared the Olmsted County restaurants, bars and workplaces of the potentially hazardous tobacco smoke.

Banning indoor use of tobacco smoke from restaurants and workplaces has driven down the rate of heart attacks by one-third in Olmsted County.  It has reduced the sudden cardiac death rates in Olmsted by 17%.  One interesting finding in the study was that banning smoking only in restaurants did not have an impact on the rate of heart attacks.  But once phase 2 was implemented, which banned smoking in the workplace and bars, it became clear that the rates of heart attacks were decreasing.

A hike in tobacco taxes and smoking-cessation campaigns encouraged many Minnesotans to quit smoking during the study period (2002-2007). 

“But those trends did not fully explain the drop in heart attacks and sudden cardiac deaths they wrote: Removing the exacerbating effect of second-hand-smoke appears to have accelerated a trend already in the making.”

Those who are taking their smoking outside may be “reluctant public heroes,” but the accompanying editorial in the Annals of Internal medicine makes it clear that those who choose to continue smoking do not smoke more at home to compensate for not being able to smoke indoors.  Instead, the trend has leaned toward implementing no smoking zones within homes as well.  The affect seems to be a decrease in the amount of smoking.

While this is good news, second-hand smoke is not disappearing.  Tobacco smoking is still allowed in multi-unit housing, where ventilation is shared and can travel between units.  Smoking still continues in cars, casinos and outdoors. 

UC San Francisco physicians Sara Kalkhoran and Pamela M. Lin have written, "We should prioritize the enforcement of smoke-free policies, eliminating loopholes in existing policies as well as encouraging the expansion of smoke-free policies" to include apartment buildings, cars, casinos and outdoor locations.  They also state that these places may house and employ lower-income people, whose health should not continue to be compromised by loopholes in the laws.

Thursday, November 1, 2012

Women who quit smoking before 40 may avoid earlier death


 October 30, 2012

Darlene Karoly, a graphics production artist from Cleveland, had been smoking for over 20 years -- and trying to quit for the last 15.

"I tried the patch, I tried the gum, I tried hypnosis, I tried willpower, I tried cutting down cold turkey, I tried Wellbutrin, I've tried Chantix. The American lung Association has a program, I tried that. I've tried everything and I've tried most things multiple times," the 49-year-old admitted.

She stopped about 70 days ago thanks to a smoking cessation counselor from Cleveland Clinic, and although a smoker since 20, a new study reveals that quitting may have added years to Karoly's life.

In possibly the largest study ever on the hazards of smoking and benefits of stopping, researchers found that smokers lose at least 10 years of their lives due to their habit. The good news is the earlier they quit the better. Women who successfully quit before 40 avoided 90 percent of the added risk of early death caused by smoking, while stopping before 30 helped women avoid 97 percent of the added risk.

"If women smoke like men, they die like men - but, whether they are men or women, smokers who stop before reaching middle age will on average gain about an extra ten years of life," co-author Richard Peto, professor of Medical Statistics and Epidemiology at the University of Oxford in Oxford, England, said in the press release.

The research looked at the Million Women Study, which involved1.3 women in the U.K. between the ages of 50 to 65 years during 1996 through 2001. Women were surveyed about their lifestyle, medical and social factors and then surveyed again three years after their first questionnaire.

They were also monitored via the National Health Services central register, which told researchers when patients died and cause of death. Researchers also followed-up with patients an average of 12 years after joining the study to see if they were alive.

Twenty percent of the study pool were smokers, 28 percent were ex-smokers and 52 percent had never smoked. Those who were still smoking at the time of the three-year follow-up questionnaire where three times more likely to die over the next nine years than nonsmokers, even though some had reduced their risk by temporarily quitting between the first and second survey.

According to the results, two-thirds of all the deaths of smokers in their 50s, 60s and 70s were caused by smoking: Risk of dying from a smoking-related disease like lung cancer, chronic lung disease, heart disease, or stroke went up with the amount of cigarettes they consumed. But, even light smokers who smoked one to nine cigarettes a day were twice as likely to die than those who didn't smoke at all.

Dr. Sumita Khatri , head of Cleveland Clinic's Asthma Center and board member for the American Lung Association said to that this study was unique not only because it looked at a large number of subjects, but because it focused on women whereas most smoking studies looked at men. The results however showed that smoking cuts years from your life, regardless if you are a man or a woman.

"Being an advocate for women, we deserve all the same rights as men, but this is one way we don't want to be the same as men," she said.

She said in addition to all the lung problems that smoking causes, it can also affect blood vessels, cause aneurisms in a person's chest and block blood flow, which most people don't realize,

The takeaway from the study is that it's never too late to quit, even if you reach middle years, she pointed out.

"The sooner you quit, the better," she said. "And, also, not smoking at all would be really good."

The study was published online on Oct. 27 in The Lancet.