Idea #305 for December 20th, 2009: Saving Money In The Long-Run or Paying For Medicaid Patients to Quit Smoking

A change in Medicaid led to a significant drop in smoking among Medicaid patients in Massachusetts, and federal legislators have taken notice. The state began paying for counseling and drugs for smoking cessation two years ago. Since then, the smoking rate among Medicaid patients has fallen by 25%. At the same time, the smoking rate among uninsured patients in that state remained unchanged. Two senators have introduced an amendment to the healthcare bill that would require Medicaid to cover similar anti-smoking treatments. Based on the success in Massachusetts, it’s a sensible step to take in the fight against smoking nation-wide.

Read more about this 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.

 

Idea #257 for November 2nd, 2009: Not Just Cold Turkey or Testing The Most Effective Smoking Cessation Products

People looking to quit smoking are faced with choosing among several different smoking cessation products. There are multiple patches, lozenges, and pills available for the treatment of nicotine addiction. But which are most effective? Researchers from the University of Wisconsin attempted to find that out in a study of 1,500 smokers.

The study separated smokers into five different treatment groups. The five treatments were nicotine patch, nicotine lozenge, Bupropion (an antidepressant), patch plus lozenge, and Bupropion plus lozenge. After six months, all five of the treatments were found to result in more nonsmokers than a placebo. The best method, though, was the patch plus lozenge, which led to participants having a 234% better chance abstaining from cigarettes. That group was also less likely to eventually relapse and start smoking again.

The reason the patch/lozenge method is effective is likely because a patch provides a constant amount of nicotine, while the lozenge can be used at times when there is a craving for even more nicotine. For people who are motivated to quit smoking, using the patch along with nicotine lozenges appears to be an effective combination for kicking the habit — more so than Bupropion.

Read more about the study here.

Idea #254 for October 30th, 2009: Another Reason To Quit or Smoking a Single Cigarette Can Harden Arteries

A few days ago, this blog dealt with the issue of occasional smokers, and how that particular group is often overlooked by researchers and providers alike. Now there’s more evidence that even the occasional cigarette is indeed harmful. The study found that even one cigarette will temporarily harden the arteries of young adults by 25%.

The study specifically looked at the effects of smoking before exercise and involved subjects between 18-30 years old who smoked about five cigarettes daily as well as non-smokers. Before exercising, both the smokers and non-smokers had the same level of arterial stiffness. Prior to exercise, the smoking group was allowed to smoke a single cigarette, and all participants were assessed on the hardness of their arteries afterward.

In non-smokers, arterial stiffness actually decreased slightly after exercise. In smokers, the stiffness increased by 25%. Even for members of the smoking group who did not have a cigarette before exercise, their arterial stiffness still rose slightly following exercise. The effects of this hardening can make the vascular system less able to deal with physical stress, like running. This is further evidence that occasional smoking — even in young adults — can have quantifiable negative effects on health. Smoking just a few cigarettes a day is a harmful activity, despite what the occasional smoker may believe.

Read more about this issue here.

Idea #249 for October 25th, 2009: A Small Habit or Occasional Smokers Deserve More Attention

Much effort has been made in recent years to curb smoking in this country. Studies and statistics in this area often define people as smokers or non-smokers. But there is another group that sometimes gets lost in the mix: occasional smokers. People in this group might smoke on a non-daily basis or just in social situations, but are involved in an unhealthy habit nonetheless.

Occasional smokers have increased in number coinciding with the rise of smoking bans in restaurants and workplaces, probably because some former full-time smokers have had to cut back to the point of smoking only on occasion. They tend to be younger than other smokers, with many in their twenties. They often do not label themselves smokers and feel that the health risks associated with daily smokers do not necessarily apply to them. Studies have shown that occasional smokers are at a higher risk of cardiovascular disease and other problems, though.

The main point is that this group is often overlooked in medical research on smokers because they don’t solidly fit in any group. And they are sometimes overlooked by providers trying to screen for smokers, because they may not label themselves as such. If occasional smokers are included in more smoking studies, we will be able to devise smoking cessation programs to meet the needs of this particular group in the future.

Read more about the issue in the LA Times.

Idea #245 for October 21st, 2009: Quitting While You’re Ahead or Getting More Cancer Survivors to Give Up Smoking

For whatever reason, there is a sizable population of cancer survivors who choose to smoke. Surprisingly, more than a quarter of those post-cancer smokers have not been advised by their healthcare providers to quit the habit, says a new paper in the Journal of General Internal Medicine. The survey involved nearly 2000 subjects who had been diagnosed with cancer at least one year prior to the study, and 18% were current smokers.

Of those subjects did smoke, 72% reported that their provider had advised them to quit. What’s more — two thirds of the smokers in the group reported that they had the desire to quit, with over a third having attempted quitting in the prior year. Providers should make every effort to reach out to these individuals, who are in a high-risk group, about smoking cessation. Patients do listen to advice on quitting smoking, and providers can help guide the process. With a large proportion seemingly eager to quit anyway, this could be a big missed opportunity for providers to get more cancer survivors off cigarettes.

Read more about the findings in the LA Times.

Idea #235 for October 11th, 2009: Dial “N” for Nicotine or New Telephone Therapy Helps Teens Quit Smoking

New research suggests that an effective way to help teens quit smoking involves counseling over the phone. In a study involving 2,000 high school students in Washington, teens who received motivational and cognitive behavioral skills training telephone counseling fared better than those in the control group. Ten percent of teens who were daily smokers quit for a period of at least six months (a year after beginning the program), while that rate was six percent for the control group.

For the teen smokers, the methods used over the phone included help with anticipating and dealing with stress, identifying the need to quit, and making plans to quit. The telephone intervention showed evidence of being successful within just 7 days for some subjects. Such methods may make more sense than prescribing anti-smoking medications to teens, and phone counseling is more convenient than visits to a psychologist. Still, only ten percent of the smokers in the study quit within a year. But any ground gained in the fight against teen smoking is a major victory in preventing smoking-related ailments in the future.

For more, read this article about the subject.

Idea #216 for September 22nd, 2009: Snuffed Out or FDA Bans Flavored Cigarettes

The FDA made the right choice Tuesday in banning the sale of flavored cigarettes. Flavors like chocolate, strawberry, and vanilla have been known to attract young people to tobacco products. In fact, studies show 17 year old smokers are three times more likely than those over 25 to smoke flavored cigarettes. Not allowing tobacco companies to sell flavored tobacco products should cut down on teenage smoking rates and save many lives down the line.

The FDA now has the authority to regulate tobacco products, thanks to a bill signed into law a few months ago, and this is their first major move against the tobacco industry since then. The move, though, may not be broad enough; it currently only bans flavored cigarettes while cigarillos and small cigars can still legally be sold with flavoring. Menthol cigarettes are also spared from the ban. Nonetheless, the ban is definitely a positive step forward for our nation’s health that will reap benefits for generations to come.

Read more about this news story in the New York Times.

Idea #186 for August 23rd: Don’t Inhale or Smoking and Tuberculosis Risk

By now, most people are aware of cigarette smoking’s link to cancer and heart disease. But there are many other less-known diseases related to smoking as well. For instance, researchers in Taiwan claim that smokers are twice as likely to develop active tuberculosis as non-smokers. That study, which involved 18,000 people, found that 17% of tuberculosis cases in that group were attributable to smoking.

The authors suggest that smokers’ don’t have the same ability to fend off pathogens, including tuberculosis, that non-smokers have. Nearly 2 million worldwide die from the disease each year. Globally, tuberculosis is believed to infect one in three individuals, with the vast majority of cases being latent. However, latent cases can develop into active cases in people with weak immune systems. TB is responsible for many deaths among people who suffer from AIDS. This study may prove especially important to AIDS patients, whose weak immune systems may be further compromised by smoking. For the general population, it’s just another entry on a growing list of reasons not to smoke.

Read the story about this in the news here.

Idea #183 for August 20th, 2009: Reading Between the Lines or Changing Cigarette Packaging

New evidence suggests that regulations placed on cigarette packaging may not go far enough. Many countries including the US have banned the use of terms like “low-tar” in tobacco marketing, but a Canadian study has found that other, seemingly innocuous words also may be giving smokers false impressions about the healthfulness of tobacco use.

The study showed that consumers took words appearing on cigarette packs like “smooth” and “silver” to mean that the product was less harmful than other cigarettes. Other subtle hints also had an effect on consumers, such as the color of the packaging. When presented with cigarette packs in different shades of blue, eighty percent of people in the study believed the light blue pack’s cigarettes were less harmful than the dark blue one. The same number of participants also believed that a cigarette pack displaying an image of a filter contained less harmful cigarettes than a normal pack.

It’s illegal in the US for tobacco companies to use “low-tar” in advertisements, but there are clearly alternative words and styles that can sway consumers in the same manner, yet they have not been specifically banned. In the future, the best solution may be requiring cigarette packaging to be more-or-less blank, aside from the brand name and warning labels. Tobacco companies will likely fight any such rule, but this study suggests that current regulations are not stro.ng enough, and thousands of lives could be in the balance.

Read more about the study in  this Reuters article