Smoking

Health care for us

Teens Think Smoking

More Dangerous Than

Drinking, Drugs

Survey results suggest they might be more likely to try alcohol, illegal drugs

THURSDAY, Dec. 17 (HealthDay News) -- American teens believe that smoking cigarettes is riskier than using illicit drugs or binge drinking, a new government report shows.

That perception may increase the likelihood that they'll experiment with alcohol or illegal substances, the report authors said.

"We are on the right track with cigarette smoking and need to keep raising awareness among teens about the dangers of other substances," Pamela S. Hyde, administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA), said in a news release from the agency. "Understanding that perception of harm is a strong predictor of potential substance use among young people can help guide the development of substance prevention messages."

Responses from 44,979 adolescents, aged 12-17, who took part in the 2007 and 2008 SAMHSA National Survey on Drug Use and Health showed that teens' perception of cigarette-related risk was constant among all groups, but there was considerable age- and gender-related variation in perception of risk associated with other types of substances.

Among the key findings:

• Nearly 70 percent of all respondents believed smoking one or more packs of cigarettes per day posed a major health risk.
• Only 40 percent of participants believed binge drinking (having five or more drinks of alcohol once or twice a week) posed a major risk, and only 34.2 percent thought smoking marijuana once a month posed a major risk. Using cocaine once a month was seen as highly risky by 49.7 percent of the adolescents, while 50.9 percent believed using LSD once or twice a month was highly risky.
• Girls were more likely than boys to associate great risk with smoking one or more packs of cigarettes a day, having five or more drinks of alcohol once or twice a week, and smoking marijuana once a month.
• Boys were more likely than girls to perceive great risk from trying heroin once or twice.

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Smoking

Smoking Exposure Now Linked to Colon, Breast Cancers

New studies also find that children exposed to smoke are at risk of lung cancer

URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_92601.html (*this news item will not be available after 03/03/2010)

HealthDayThursday, December 3, 2009

THURSDAY, Dec. 3 (HealthDay News) -- Add colorectal cancer to the list of malignancies caused by smoking, with a new study strengthening the link between the two.

And other studies are providing more bad news for people who haven't managed to quit: Two papers published in the December issue of Epidemiology, Biomarkers & Prevention, a themed issue on tobacco, strengthen the case for the dangers of secondhand smoke for people exposed to fumes as children and as adults.

Inhaling those secondhand fumes may raise a woman's odds for breast cancer or a child's lifetime risk for lung malignancies, the studies found.

All of the findings, while grim, could be useful in the war against smoking, experts say.

"With the FDA [U.S. Food and Drug Administration], we're hoping this will be a significant tool to controlling tobacco, although it could get bogged down in so many different ways," said Dr. Peter Shields, deputy director of the Georgetown University Lombardi Comprehensive Cancer Center and senior editor of the journal in which these papers appeared. "The FDA is going to have to make a lot of tough decisions about how to regulate tobacco, and the more science they have will help them."

Is this latest round of revelations going to change current screening recommendations? Probably not, at least not yet, Shields added.

One study found that long-term smokers have a higher risk of developing colorectal cancer, a finding that factored into the recent decision by the International Agency for Research on Cancer (IARC) to assert that there is "sufficient" evidence to link the two, up from its previous "limited" evidence.

"It took a long time to figure this out because the relationship [between smoking and colorectal cancer] is not as strong [as for some other cancers]," said Dr. Michael Thun, senior author of the study and vice president emeritus of epidemiology and surveillance research at the American Cancer Society. "The question was, is the association we're seeing really caused by smoking?"

The researchers managed to adjust for other colorectal cancer risk factors, such as not getting screened, obesity, physical activity and eating a lot of red or processed meats. The issue is tricky because people who smoke are already more likely to engage in these types of behavior.

"When they took all of those other things out, smoking was still a small, elevated risk," said Dr. Michael John Hall, director of the gastrointestinal risk assessment program at Fox Chase Cancer Center in Philadelphia.

"We already know that smoking is bad. That doesn't change. A positive thing that comes out of this is that if you can stop smoking earlier, you eliminate your risk later on, but the more you smoke, the risk is higher."

This large prospective study, which followed almost 200,000 people over 13 years, found that current smokers had a 27 percent increased risk of colorectal cancer and former smokers a 23 percent increased risk compared with people who had never smoked.

People who had smoked for at least half a century had the highest risk -- 38 percent higher than never smokers -- of developing colorectal cancer

The good news is that people who tossed their cigarettes before the age of 40 or who had not smoked for 31 or more years had no increased risk.

Two other studies focused on the risk of secondhand smoke, or passive smoking. In one, children exposed to secondhand smoke had a higher risk of developing lung cancer as adults, researchers from institutions including the U.S. National Cancer Institute found. In another, California researchers found that adult non-smoking women who had spent long periods of time in smoking environments upped their odds of developing postmenopausal breast cancer.

The breast cancer findings were seen mostly in postmenopausal women, with a 17 percent higher risk for those who had had low exposure, a 19 percent increased risk for those with medium exposure and a 26 percent increased risk for those who had high long-term exposure over their lifetime.

Adult exposure, such as spending time in smoking lounges where others were smoking, carried the most risk, with childhood exposure appearing negligible.

For children exposed to smokers, the odds of developing lung cancer was notably higher among individuals with a specific mutation on the MBL2 gene, the other study found.

Passive smoking during early life more than doubled the risk of lung cancer among people who had never smoked, the researchers found. They noted that the risk from secondhand smoke was even higher than that noted in the U.S. Surgeon General's report. The risk was 2.5 times higher among those with this genetic signature.

In another study, people who smoked cigarettes and drank alcohol after a diagnosis of head and neck cancer had a worse prognosis than those who abstained from these habits, according to researchers at Yale University School of Medicine and Yale's School of Public Health, among others.

Previous research had shown that smoking and drinking alcohol before a diagnosis meant the patient was more likely to die from the cancer.

With the new classification on smoking causing colorectal cancer, 17 cancers are now attributed to smoking.

SOURCES: Michael J. Thun, M.D., vice president emeritus, epidemiology and surveillance research, American Cancer Society; Michael John Hall, M.D., director, gastrointestinal risk assessment program, Fox Chase Cancer Center, Philadelphia; Peter Shields, M.D., deputy director, Georgetown University Lombardi Comprehensive Cancer Center, Washington, D.C.; December 2009 Cancer Epidemiology, Biomarkers & Prevention

HealthDay
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Smoking

Switch to 'Light' Cigarettes Makes Quitting Tougher

Smokers may mistakenly believe they're 'healthier,' researchers say.

By Randy Dotinga
HealthDay Reporter

TUESDAY, Nov. 3 (HealthDay News) -- Experts have long known that "low-tar" and "light" cigarettes aren't any healthier than regular cigarettes, and new research suggests they have another drawback: People who switch to them are less likely to quit, even those who switch specifically because they want to stop smoking.

In fact, "switching to ['light' cigarettes] for any reason is associated with continuing to smoke," said study author Dr. Hilary Tindle, a researcher at the University of Pittsburgh's Division of General Internal Medicine.

However, she acknowledged that the research does not prove that switching leads directly to a lower rate of quitting.

According to the authors, an estimated 84 percent of cigarettes sold in the United States are so-called low-tar and low-nicotine, with many of them called "lights." Some smokers may assume they're healthier than other cigarettes, but medical researchers say smokers still suck in about the same level of carcinogens. And research has shown that "lighter" cigarettes don't reduce smoking-related illness and death.

Regardless of what brand they smoke, "the average smoker dies 13 to 14 years earlier than he or she would die if he or she did not smoke," Tindle said.

In the new study, published online Nov. 3 in the journal Tobacco Control, researchers examined the results of a 2003 survey of 30,800 people in the United States who had smoked within the past year. Thirty-eight percent of them had switched to "lighter" cigarettes, with the largest percentage of those -- 26 percent -- saying they'd done so for better flavor. Forty-three percent mentioned one, two or three reasons for switching, with quitting smoking being one of those reasons.

However, those who had switched were 46 percent less likely to have quit smoking.

Why might switchers be more likely to continue smoking? "Prior research suggests that switching may resolve smokers' cognitive dissonance about smoking -- something along the lines of, 'Well, since I'm smoking a [supposedly] healthier cigarette, I really don't have to worry about lung cancer, heart disease, impotence, wrinkles, early death [fill in the blank] because my health is not at risk,'" Tindle said. "This type of rationale may keep more health-conscious smokers smoking."

But there are other possible explanations, added Robert West, a researcher who studies tobacco use at University College London in England. It's possible, for example, that people who switch are already more dependent on cigarettes and less able to quit, he said.

What to do? "In Europe, tobacco companies are not allowed to call cigarettes low tar or imply that they are in any way safer," West said.

Regardless of how cigarettes are marketed, Tindle said, "the best solution for the problem of how to live longer and healthier is to quit smoking now."

In related news, a study published Nov. 3 in the Journal of Epidemiology and Community Health finds that smoking during pregnancy is linked to a higher level of behavioral problems in offspring later in life, even among those as young as 3.

A team from the University of York in the England tracked 14,000 mother-and-child pairs and found that maternal smoking during pregnancy was associated with significantly higher odds for attention-deficit hyperactivity disorder (ADHD) and other behavioral woes, compared to children born to nonsmoking mothers.

More information

Find out more about smoking and its consequences at the U.S. Centers for Disease Control and Prevention.

(SOURCES: Hilary Tindle, M.D., MPH, researcher, Center for Research on Healthcare, division of general internal medicine, University of Pittsburgh; Robert West, Ph.D., Health Behavior Research Center, department of epidemiology and public health, University College London, U.K.; Nov. 3, 2009, Tobacco Control, online)

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Smoking

Nicotine Patch Plus Lozenge Best for Quitting Smoking

This combo wins out in first head-to-head study of various smoking-cessation aids.

By Amanda Gardner
HealthDay Reporter

MONDAY, Nov. 2 (HealthDay News) -- The first head-to-head comparison of different quit-smoking products finds that a nicotine patch combined with a nicotine lozenge had the most success.

More than other methods, including antidepressants, this combination best mimics the actual highs and lows of smoking to help smokers kick their habit, experts said.

"The study shows that, yes, one therapy came out on top, the patch and the lozenge [together]," said Dr. Jonathan H. Whiteson, co-director of the Joan and Joel Smilow Cardiopulmonary Rehabilitation and Prevention Center at NYU Langone Medical Center in New York City.

"The reasoning behind it is that the patch supplies a steady supply of nicotine replacement and the lozenges give a boost of nicotine which you can use when you have an extra craving. It gives people control," said Whiteson, who was not involved in the research.

"If you combine these different types of nicotine replacement you're going to get the best bang for your buck," added Megan E. Piper, lead author of the new study and an assistant professor at the Center for Tobacco Research and Intervention at the University of Wisconsin, Madison. "But also remember that in this study people got a lot of counseling. It was that combination that resulted in a 40 percent quit rate [at six months out]."

In fact, coupling the patch with the lozenge was the only intervention that performed better than a placebo, reported the study, which appears in the November issue of the Archives of General Psychiatry.

The study adds insight to a field that's long suffered from too little research. "As each medication comes out, it is tested against a placebo," but not against other methods, Piper explained. "There just hasn't been the funding or the availability of a program to do something like that."

This research was funded by the U.S. National Institutes of Health. Medication was provided free by drug maker GlaxoSmithKline. Several of the study authors reported financial ties to different pharmaceutical companies.

For this study, 1,504 adults who had smoked at least half a pack a day for the past six months and wanted to quit were randomly assigned to a placebo or one of five different quit-smoking interventions: nicotine lozenge, nicotine patch, bupropion (Wellbutrin, an antidepressant), nicotine patch plus nicotine lozenge, and bupropion plus nicotine lozenge. All groups received six individual counseling sessions with a case manager.

The nicotine patch, which has been available for more than two decades, is currently the most widely used pharmacotherapy to help people quit smoking.

However, only the combination of the nicotine patch and the lozenge performed significantly better than placebo six months after the person smoked their last cigarette, the team found.

People taking the patch-lozenge combination were also more likely to have sworn off cigarettes after one week and were more likely to have attained one full day without smoking, the researchers said.

The 40 percent (at six months) success rate reported here will decline as time goes on, Whiteson noted. He added, however, that in the smoking cessation arena, "even the 30 percent range is very good."

Another expert said the study raised some key concerns. "The question is, how many of them had to continue on the lozenge in order to stay off cigarettes? I always tell people not to do the lozenge alone because it mimics the very thing that smoking does, which gives you a spike. Then, when you reach a trough, you pick up a lozenge -- or cigarette," said Dr. Len Horovitz, a pulmonary specialist with Lenox Hill Hospital in New York City. "Once they stopped everything, could they do without the spikes and troughs [of the lozenge], which mimics physiologically everything the cigarette is doing? Smoking is a two-pronged problem. There's nicotine dependence and a behavioral aspect to it."

Dr. Elliot Wineburg, assistant clinical professor of psychiatry at Mount Sinai School of Medicine in New York City, felt the study suffered from some limitations, namely lack of individual attention to individual smokers' habits.

"The authors said that they gave the patients lozenges according to the company's [instructions]," he said. But this doesn't take into account how much people smoke or how strong their cigarettes are. "They don't even look into the amount of nicotine a person takes."

More information

There's more tips on successfully quitting smoking at the American Cancer Society.

(SOURCES: Megan E. Piper, Ph.D., assistant professor, Center for Tobacco Research and Intervention, University of Wisconsin, Madison; Jonathan H. Whiteson, M.D., co-director, Joan and Joel Smilow Cardiopulmonary Rehabilitation and Prevention Center, NYU Langone Medical Center, New York City; Elliot Wineburg, M.D., assistant clinical professor of psychiatry, Mount Sinai School of Medicine, New York City; Len Horovitz, pulmonary specialist, Lenox Hill Hospital, New York City;
November 2009 Archives of General Psychiatry)