Idea #317 for January 1st, 2010: Smoke Free 2010 or New Year’s Resolution For Health

With the new year upon us, there may be no better time to begin a smoking cessation program. Quitting smoking is one of the most popular new year’s resolutions, and with good reason. To help ensure success, there are a few things smokers should keep in mind before starting the process. For starters, seeking the advice of a healthcare provider and considering medications to ease the withdrawal symptoms may prove beneficial. Also, exercising can help reduce stress and prevent weight gain associated with quitting. And joining a support group may make the process easier to deal with. No matter what method is used to get there, quitting smoking is one of the healthiest choices you can make in 2010.

Read more about quitting here.

Idea #308 for December 23rd, 2009: Emphasizing The Diagnostic Power of Breast MRI

In addition to mammograms, breast MRI is an important tool in detecting breast cancer. Yet many women turn down that type of imaging, even when it’s offered at no cost. Johns Hopkins researchers found that 42% of the 1,200 women that were offered breast MRI turned them down. The reasons included claustrophobia, time constraints, and concerns about the IV contrast associated with the test.

The researchers believe that patients are also unaware of the diagnostic power of breast MRI. Efforts should be made to convince more women that MRI can be as important as mammograms in some cases. Claustrophobia seems to be a major sticking point also, as 25% of women who refused the test cited that condition as their main concern. In those cases, it might be best to offer MRI machines that are not enclosed, or failing that, offer support for managing issues of claustrophobia.

Read more about this news story here.

Idea #307 for December 22nd, 2009: Any Time Is The Right Time or Quitting Smoking Offers Benefits Even After Lung Cancer Diagnosis

It’s never too late to quit smoking. New research finds that quitting smoking even after being diagnosed with lung cancer can improve the chances of survival. In fact, patients who quit smoking after an early stage lung cancer diagnosis double their 5-year survival rate. However, only 20% of lung cancers are caught at this early stage, so early detection is still the most important part. The benefits of quitting smoking may not apply to patients in later stages of the disease. Still, this finding offers hope to thousands who may have otherwise figured it was too late to quit. Smoking cessation programs should be strongly encouraged for all cancer patients — and especially those in the early stages of lung cancer.

Read more about this study here.

Idea #302 for December 17th, 2009: A Clearer Message or Using Video To Better Communicate End-of-Life Care Options

Patients with terminal illnesses face many difficult choices when it comes to coordinating end-of-life care. Usually those options are spelled out on paper, but the majority of patients do not complete all the necessary documentation. Researchers have found that using video rather than documentation to convey the message resulted in better understanding on the part of the patients.

Terminal cancer patients in the study were shown either a video that illustrated the options for end-of-life care, or were given the traditional documentation for that purpose. Patients who viewed the video were much more likely to choose less aggressive care, and also scored better on assessments that gauged their understanding of the different options. This seems like a pretty simple fix for a problem that plagues patients with terminal illness, and hospitals should pay close attention to further studies on the matter.

Read more about this study here.

Idea #299 for December 14th, 2009: Glowing In The Dark or The Alarming Variability in CT Scan Radiation

The potentially harmful levels of radiation exposure associated with undergoing CT scans have been well-documented. What’s surprising, though, is how widely the amount of radiation emitted by CT scans varies. The amount of radiation can vary by a factor of ten for a given scan, new research suggests.

The study involved 1,000 patients who received scans at four hospitals, and there was significant variability in radiation exposure from patient-to-patient receiving the same scans. While some variation is expected, the amount of variation in these cases was considered unacceptable. Researchers estimate that 1 in 270 women who receive a coronary CT angiography at age 40 will develop cancer as a result of the scan, and that number is 1 in 600 for men.

Patients should expect some slight risk of potential cancer as a result of CT scans, and that is normally outweighed by the diagnostic benefit of the scan itself. However, high levels of variation in levels of radiation are unacceptable when they provide no additional diagnostic benefits. Hospitals must monitor and address the problem, as they are unnecessarily exposing patients to unknown levels of radiation for no reason.

Read more about this issue in the Wall St Journal.

Idea #294 for December 9th, 2009: A Missed Opportunity or States Cutting Anti-Smoking Program Funding

I’ve written before about the embarrassingly low percentage of tobacco settlement funds that states have actually used for tobacco prevention programs, as they were intended to be used. Now there’s news that the percentage has been cut back even smaller by many states. Faced with budget crises, states have cut tobacco prevention funding by 15% in the last year, with New York leading the way with a more than 30% decrease in spending for the programs.

Overall, states are projected to spend about half a billion dollars on anti-tobacco programs in 2010. That represents only 2.3% of the $25 billion in tobacco tax and settlement funds they pull in. To put that in perspective, the tobacco industries will spend twenty times that amount in the coming year on marketing their products. While it’s not expected that states spend 100% — or even 50% — of the tobacco revenue on smoking prevention programs, they have to do a lot better than 2%. It’s even more important now that smoking rates have leveled off after years of decline.

Read more about this issue here.

Idea #288 for December 3rd, 2009: Many CT Scans May Be Unneccessary

CT scans are a valuable for tool in detecting a number of different medical conditions. Relying on them too heavily or using them unnecessarily, however, can needlessly expose patients to dangerous amounts of radiation. In a study of pelvic and abdominal CT scans in 500 patients, researchers found that over half the patients received unnecessary scans.

In the study, the mean amount of radiation received by patients for each unnecessary scan was equivalent to over 100 chest X-rays. That amount is also roughly what you would accumulate over three years of background radiation we are exposed to every day. Scans in the study were determined either necessary or not by comparing them to American College of Radiology guidelines. The researchers claim that the amount of radiation in these unneccessary scans could cause cancer in about 1 in 1000 patients. Providers should stay within recommended guidelines to avoid overexposing patients to radiation, and patients should be voice their concerns before scans as well.

Read more about this study in this Reuters article.

Idea #287 for December 2nd, 2009: Making It Count or Life Expectancy May Drop In The Future

Smoking rates in this country are expected to continue to decline, which under normal circumstances would be accompanied by an increase in life expectancy for Americans. However, experts say life expectancy will actually fall in the future. What gives? Again, it comes back to obesity. The incidence of obesity is expected to rise, which will wipe out any gains made by decreasing smoking.

It’s heartening that we’ve made a lot of progress in smoking cessation, and it would be a shame if all that effort was canceled out by another one of our vices: over-eating. By now, we all realize that obesity is a huge problem that threatens to shorten our lives and bankrupt our healthcare system. Fixing it will be difficult, and will have to be fought on many fronts. This new data is just another reminder about how dire the situation is if we remain content with the status quo.

Read more about this issue here.

Idea #270 for November 15th, 2009: Pick Up The Phone or The Best Way To Conduct Telephone Counseling For Smoking Cessation

Telephone counseling can be a helpful tool in combating smoking. However, the way in which the calls are carried out is a vital factor in their success. New research shows that counseling that requires the smoker to take the initiative and place the telephone call is not as effective as pro-active counseling that involves counselors calling patients on a set schedule.

The new study involved about 1,000 smokers who were either mailed smoking cessation materials, or who were given the opportunity to initiate phone counseling calls. The schedule of the calls were up to the smokers to determine. After a year, there was no significant difference in smoking abstinence rates between the two groups, indicating that this type of counseling is no more effective than mailing out anti-smoking documents. Past research, though, has demonstrated the effectiveness of pro-active phone counseling that follows a set schedule and is initiated by the counselor.

All this is important because every state now has smoking cessation phone lines. While many do follow the pro-active model, there is no standard and methods vary widely. This study suggests that those that do not employ pro-active techniques are likely wasting time and money. Another problem is that only 1% of smokers actually use the lines. More publicity of these phone lines is needed, as well as consistent methodology that greatly improves patients’ chances of quitting.

Read more about this study here.

Idea #267 for November 12th, 2009: Stalled Progress or Making Sure Smoking Rates Continue to Decline

We’ve made a lot of progress in smoking cessation over the last several decades, but over the last five years, the smoking rate has stopped declining in the US. Over the decade ending in 2008, the CDC reports that the percentage of people who smoked dropped from 24.1% to 20.6%. However, in 2007 the rate was 19.8%, so there was a slight rise in the rate of smoking from 2007 to 2008. It’s a trend that we have to focus on changing.

Part of the problem is being traced to insufficient state spending on anti-tobacco programs. In the last decade, states have received over $200 billion in tobacco revenue, yet only 3% of that has gone towards anti-smoking programs. If that amount was bumped up to 15% — still just a fraction of the overall revenue — then anti-smoking programs could be funded at levels the CDC recommends. Additionally, states that have made laws regarding smoke-free restaurants and other areas have seen smoking rates drop. While much has been accomplished over the last few decades as far as smoking cessation, there is still a lot more we could be doing, especially considering how little of our states’ tobacco revenue is going towards anti-smoking causes.

Read more about this here.