Quitting Smoking Blog

CLINTON — A Polk County District Court judge heard preliminary arguments that the smoking ban in Iowa is unconstitutional during a hearing Friday morning.

The smoking ban went into effect in Iowa on July 1. That evening, the Clinton Organized Bar and Restaurant Association and the Iowa Bar Owners Coalition filed an injunction petition, asking the court to put a halt on the smoking ban until a ruling can be made on the law’s constitutionality. The two organizations also filed a lawsuit against the smoking ban in an effort to get the statewide ban overturned.

The petition names the Iowa Department of Public Health, IDPH Director Thomas Newton and the State of Iowa as defendants. Attorney George Eichhorn, of Stratford, is representing the plaintiffs in the case. Iowa Deputy Attorney General Jeff Thompson and Special Assistant Attorney General Donald Stanley Jr. presented the state’s argument.

In the petition, COBRA and IBOC argue that the smoking ban denies bar owners of their Fourth Amendment right against unreasonable search and seizure and the 14th Amendment right to due process.

District Judge Douglas Staskal noted at the beginning of the hearing that in a brief off-record discussion with opposing counsel a pending motion by the state citing jurisdictional issues and provisions requiring the petition be timely filed still were under review. Eichhorn commented the plaintiffs would file a response to the state’s challenges to the petition in the near future.

 Read full article http://www.clintonherald.com/local/local_story_215003822.html

WASHINGTON (AP) — If you smoke, start thinking of yourself as a decade older than you really are. A 55-year-old man who smokes has almost the same chance of dying in the next 10 years as a 65-year-old who’s never smoked — a stark example from newly published charts that aim to put some of Americans’ biggest health risks into context.

Risk is a difficult concept, mixing emotion and math — and people are bombarded with competing warnings of health dangers.

Read full article at http://ap.google.com/article/ALeqM5hPtgDGJEk9kQ3mOsq8mklIu2xjcwD917EL784

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It’s no surprise that you’re more likely to light up if your close friends do. But Nicholas Christakis of Harvard Medical School and James Fowler at University of California San Diego report that quitting smoking may be contagious as well. Even people who don’t necessarily know each other, but are connected in some distant way, tend to stop smoking at the same time. “People tend to quit smoking in droves, and this coordinated quitting is literally like a flock of birds changing direction,” says Christakis. “So smoking is not an individual behavior, but rather a collective process.”

Read full article http://www.time.com/time/health/article/0,8599,1808446,00.html

A new report from Perth’s Telethon Institute for Child Health Research has found a strong link between childhood ear infections and exposure to tobacco smoke.

The results are published in the latest edition of the Medical Journal of Australia.

The families of 100 Aboriginal children and 180 non-Aboriginal children participated in the Kalgoorlie Otitis Media Research Project, allowing the collection of social, demographic, environmental and biological data to investigate the causes of otitis media (middle ear infections). The children had regular ear examinations from birth until 2 years of age.

Chief Investigator Dr Deborah Lehmann, who heads the Institute’s infectious diseases research, said ear infections were the most common reason that young children see a doctor and can cause life-long problems.

“Up to 20 per cent of children have more than three ear infections between 1 and 2 years of age. If their hearing is damaged, it can seriously affect their educational outcomes and social circumstances in adulthood,” Dr Lehmann said.

“In Aboriginal children, these ear infections typically start at a younger age, are much more common and more likely to result in hearing loss.”

Key findings from the project include:

 
• Otitis media was diagnosed at least once in 74% of Aboriginal children and 45% of non-Aboriginal children. 

   

• 64% of Aboriginal children and 40% of non-Aboriginal children were exposed to environmental tobacco smoke. 

   

• If we eliminated exposure to tobacco smoke we estimate that we could reduce ear infections by 27% in Aboriginal children and 16% in non-Aboriginal children 

   

• The impact of passive smoking in the home on ear infections was reduced if the children also attended day care. 

Dr Lehmann said there is evidence that passive smoking can increase the adherence of bacteria in the respiratory passages and depress the immune system.

“These results highlight the importance of reducing children’s exposure to passive smoking, and this is particularly important for Aboriginal people where the rates of both smoking and otitis media are high,” she said.

“Few Aboriginal children have access to formal childcare despite studies showing that it is an effective way to improve early development and educational outcomes for disadvantaged children. The fact that it could also reduce the burden of ear infections in Aboriginal children adds weight to calls for appropriate childcare facilities to be provided.”

Source of article http://www.eurekalert.org/pub_releases/2008-05/ra-eil051808.php

Here is a piece of good news…

“Apparently one of the unforeseen but happy consequences of smoking bans is that they help discourage many teens from ever taking up the habit.

A new study from the Boston University School of Public Health has found that youths who live in communities with strict bans are 40 percent less likely to become regular smokers than those in communities with no bans or weak ones. Washington’s statewide ban, enacted in 2004 by voter initiative, prohibits smoking in public places as well as in bars and restaurants.”

Source http://www.thenewstribune.com/opinion/story/356927.html

By Graham Lanktree

The smoking cessation drug varenicline tartrate was touted as a magic bullet for nicotine addiction when it hit the market in Canada a year ago last month. But between its launch and late November 2007, Health Canada received 107 reports of adverse reactions linked to the drug, nearly half of which were psychiatric. Last month this led to a change in the drug’s labelling and a ‘Dear doctor’ advisory.

Though most adverse reactions were mild, there were 14 cases of aggression, depression and suicidal ideation. Several patients experienced suicidal thoughts while taking the medication, four of whom had no previous history of mental illness.

Of the 220,000 Canadians who have been prescribed varenicline, not one report of suicide has been linked to it here (34 suicides have been linked to the drug in the US). Because of these reports many of your patients may prefer to keep puffing rather than take this drug.

RISKY BUSINESS?
“The first thing you should tell them is that some of these adverse events may occur,” says Dr Peter Selby, the clinical director of the addictions program at the Centre for Addiction and Mental Health in Toronto. “But patients must be reminded these will be short-term discomforts versus the longterm gain of being smoke-free.” A reasonable risk he says, considering one in two smokers will die of a smoking related illness.

Compared to the total number of patients on varenicline, those who’ve experienced strong side effects make up about 0.048% of the total number, says Dr Selby. “That being said, you still have to be cautious with new medications and keep an eye out for common side effects. If any of your patients have strong mood changes they should discontinue treatment and be switched to another drug right away.”

Dr Andrew Pipe, a cardiologist at the University of Ottawa Heart Institute who was named to the Order of Canada for his work on smoking cessation, suggests switching these patients to the stop-smoking drug bupropion because of its antidepressant qualities. “The drug may make them feel nauseous, but that can be taken care of by reducing their dose to 150mg once-a-day from the usual 120mg twice-a-day,” he says.

Dr Pipe consulted for Pfizer during the clinical trials of varenicline and remains a strong proponent. He says 30% of smokers already have some psychological imbalances and that quitting smoking will often unmask those symptoms.

CHANGING BEHAVIOUR
Dr Pipe recommends sitting with each patient and identifying with him or her tangible benefits that smoking cessation will have on their health. They should also be made aware of varenicline’s stimulation of nicotine receptors, which gives them the feeling as though they’ve just smoked a cigarette. “Some patients might think ‘that was easy’ after the first few weeks and then quit the treatment,” he says. “They need to be told why they’re feeling the way they are and reminded to stay on the 12-week course.”

Counselling patients about picking a quit date and simple behavioural strategies and techniques will help too, says Dr Selby. “Counselling should include strategies for making their home environment smoke-free, manage their eating and weight gain, and how to engage with their friends who are still smokers.”

Physicians should also check in regularly with patients, says Dr Pipe. “If you’re dealing with a patient who has been depressed in the past and their attempts to quit have failed, then they might not be able to take varenicline. We should be careful about who we give this treatment to.”

Source http://www.nationalreviewofmedicine.com/issue/what_tell_patients/2008/5_tell_patients_5.html

Here is another story pushing prescriptions meds with potential serious side effects:

May 8 2008 - The drug Chantix has been recommended by the U.S. Public Health Service to help people quit smoking despite the fact that it comes with serious health risks. The drug has been linked with increased risks of depression as well as suicidal behavior, but despite this fact the drug is being recommended for use by people to help them quit smoking. “It is somewhat better than other therapies; on the other hand, it appears to have more risk,” said Dr. Sidney Wolfe of the watchdog group Public Citizen. According to doctors, the risks associated with the drug are nothing compared to the risks that are present in smokers, some of which including: lung cancer, heart disease and strokes. Dr. Nieca Goldberg, a cardiologist and medical director of New York University’s women’s heart program, stated that the drug is good, but it is definitely not for everybody. “This is a medication that probably is not for everyone,” she said. “But no medicine is for everyone.”  

Here is an interesting concept but it makes sense.  I don’t know how many times I have been motivated to do something, good or bad, because I was someone else doing it.

 ”Smokers tend to quit in groups, according to a new study. One person who quits can have ripple effects across his or her entire social network, prompting others to kick the habit.

The New York Times offers this delightfully evocative explanation of how the process works:

As the investigators watched the smokers and their social networks, they saw what they said was a striking effect — smokers had formed little social clusters and, as the years went by, entire clusters of smokers were stopping en masse. So were clusters of clusters that were only loosely connected. 

[Study co-author Dr. Nicholas Christakis] described watching the vanishing clusters as like lying on your back in a field, looking up at stars that were burning out. “It’s not like one little star turning off at a time,” he said. “Whole constellations are blinking off at once.”

As cluster after cluster of smokers disappeared, those that remained were pushed to the margins of society, isolated, with fewer friends, fewer social connections. “Smokers used to be the center of the party,” Dr. Fowler said, “but now they’ve become wallflowers.”

Source http://blog.seattlepi.nwsource.com/buzz/archives/139609.asp?from=blog_last3

Getting the cool kids to talk to their peers about the dangers of smoking cut the number of young people who started using cigarettes in one study by nearly 25 percent, British researchers said on Friday.The study published in the journal Lancet took a different approach than most tobacco cessation programmes aimed at youths by asking students to nominate others they viewed as influential or leaders to spread the anti-smoking message.

This peer selection proved more effective than conventional programmes and greatly reduced the number of students likely to start smoking, the researchers said.

“The important thing this shows is that young people can help each other from taking up the addictive habit of smoking,” said Rona Campbell, a health researcher at the University of Bristol who helped lead the study.

“If the programme was taken up widely it could cut the recruitment of new smokers significantly.”

Read full article http://uk.reuters.com/article/topNews/idUKL0811076420080508

Women who stop smoking greatly reduce their risk of early death and cardiovascular disease just five years after they quit, according to a new study released in the United States.The risk of death from smoking-related cancers also declines by about 20 percent over the same period, according to the authors of the study published in the May 7 Journal of the American Medical Association (JAMA).

Researchers detected a 13 percent reduction of all causes of mortality within the first five years of quitting smoking, compared with continuing to smoke.

And they found that, 20 years after quitting, the excess risk fell to the level of a person who never smoked, “with some causes taking more or less time,” they said in a statement.

Stacey Kenfield of Harvard School of Public Health, Boston, and colleagues looked at the relationship between cigarette smoking and stopping smoking on total and cause-specific mortality in women by reviewing data from the Nurses’ Health Study of 104,519 female participants covering the period from 1980 to 2004.

A total of 12,483 deaths occurred in this group, 4,485 (35.9 percent) among those who never smoked, 3,602 (28.9 percent) among current smokers, and 4,396 (35.2 percent) among women who had smoked in the past but quit.

“Significant trends were observed with increasing years since quitting for all major cause-specific outcomes. A more rapid decline in risk after quitting smoking compared with continuing to smoke was observed in the first five years for vascular diseases compared with other causes,” Kenfield said.

“Early age at initiation (to smoking) is associated with an increased mortality risk, so implementing and maintaining school tobacco prevention programs, in addition to enforcing youth access laws, are key preventive strategies,” the authors stressed.

“Effectively communicating risks to smokers and helping them quit successfully should be an integral part of public health programs,” they said.

 Source http://afp.google.com/article/ALeqM5goPIroZJi-J_dw3pgXcYwPS-gw2A