Patients with head and neck cancer linked to high risk human papillomavirus, or HPV, have worse outcomes if they are current or former tobacco users, according to a new study from researchers at the University of Michigan Comprehensive Cancer Center. High-risk HPVs are the same viruses that are associated with cancers of the uterine cervix. The research suggests that current or former tobacco users may need a more aggressive treatment regimen than patients who have never used tobacco. Past research shows that HPV-positive head and neck cancers tend to be more responsive to current treatments and these patients overall tend to have better outcomes than patients with HPV-negative tumors. However, the new study found that current tobacco users with HPV-positive tumors were five times more likely to have their cancer recur. Even former smokers had an increased risk of recurrence. "Because the effect of HPV is so strong in giving a very good prognostic picture, we were surprised to find that smoking remained a huge issue, and it actually affected the outcome in patients who smoked, " says senior study author Thomas Carey, Ph.
With the national trend toward quitting smoking flat, psychologists are finding some success with treatments aimed at helping smokers from underserved groups, including racial and ethnic minorities and those with psychiatric disorders. In a special section of this month's issue of the Journal of Consulting and Clinical Psychology, published by the American Psychological Association, researchers report on several effective treatments that may help these smokers in an effort to increase national smoking cessation rates. The percentage of American smokers rose from 19.8 percent in 2007 to 20.6 percent in 2008, after a 10-year steady decline in smoking rates, according to the latest figures from the Centers for Disease Control and Prevention. "One of the reasons smoking rates have remained stagnant is because these underserved groups of smokers have not been adequately targeted by research and treatment, " said the special section editor, Belinda Borrelli, PhD, who is with the Centers for Behavioral and Preventive Medicine at Brown University Medical School.
It pays to advertise. It especially pays to advertise in Spanish if you want Spanish speakers to use a telephone helpline to quit smoking. A study of usage of the Colorado QuitLine before and during a Spanish-language media campaign found that more Latinos called during and after the campaign and a greater percentage of those who called successfully quit smoking. Smoking cessation phone services offer counseling or coaching on how to quit smoking and sometimes offer nicotine replacement therapy products. The study published online and in the April supplement of the American Journal of Public Health took place in 2007. Spanish-language ads ran on television and radio and in movie theaters that catered to a Latino audience. The ads told viewers and listeners that the Colorado QuitLine was offering free nicotine replacement therapy and five telephone-coaching sessions to help smokers quit. Latinos who called the line because of the campaign were significantly younger and more likely to be uninsured and less educated than those who called earlier were.
Electronic cigarettes should be evaluated, regulated, labeled and packaged in a manner consistent with cartridge content and product effect even if that effect is a total failure to deliver nicotine as demonstrated in a study supported by the National Cancer Institute and led by a Virginia Commonwealth University researcher. The research was published in the Online First issue of the journal Tobacco Control. The article will appear in the February print issue of the journal. Electronic cigarettes consist of a battery, heater and cartridge containing a solution of nicotine, propylene glycol and other chemicals and have been marketed to deliver nicotine without tobacco toxicants. Despite no published data concerning safety or efficacy, these products are sold in shopping malls and online. Further, "electronic cigarettes" currently are unregulated in the U.S., unlike other products intended to deliver nicotine to smokers such as lozenges, gum and patches. "Consumers have a right to expect that products marketed to deliver a drug will work safely and as promised.
Reducing obesity and smoking have become national priorities in the United States. Research has shown that intensive counseling can positively impact each problem. However, because such counseling is typically not covered by medical insurance, cost can be a barrier. In a study published in the March 2010 issue of the American Journal of Preventive Medicine, researchers from Virginia Commonwealth University, Richmond, Virginia, found that when primary care clinicians and community counselors collaborated to offer free counseling services to patients, there was an overwhelming positive response. Yet, when the same services were offered at a cost to the patient, there was a significant drop in participation. An electronic linkage system (eLinkS) was used to prompt healthcare providers to suggest intensive healthcare counseling for adult patients with unhealthy behaviors. eLinkS then helped to facilitate and automate referrals and communication between primary care practices and community programs.
Smoking affects your cardiac health both before and after a major event like a heart attack. But how much? And does cutting back instead of quitting have a positive effect as well? There are definitive answers in a new study from Tel Aviv University, the largest and most comprehensive of its kind. The research found that quitting smoking after a heart attack has about the same positive effect as other major interventions such as lipid-lowering agents like statins or more invasive procedures. Study results were reported in the Journal of the American College of Cardiology. "It's really the most broad and eye-opening study of its kind, " says Dr. Yariv Gerber of TAU's Sackler School of Medicine. "Smoking really decreases your life expectancy after a heart attack. Those who have never smoked have a 43% lower risk of succumbing after a heart attack, compared to the persistent smoker." But even those with a history of smoking can see their risk sharply decline once they give up the habit.
1. Among Noninvasive Imaging Tests, CT More Accurate Than MRI for Ruling Out Coronary Artery Disease Coronary artery disease (CAD) is a major cause of death in the United States. Typically, CAD is diagnosed through conventional coronary angiography. However, this technique is invasive and potentially risky. While several less invasive tests can be used to view the coronary arteries, computed tomography (CT) and magnetic resonance imaging (MRI) are preferred because of their superior image quality. An obvious indication for these noninvasive tests would be to reliably rule out CAD in patients with a low-to-moderate likelihood of the disease, thus avoiding an unnecessary invasive test. Researchers reviewed studies that compared CT (89 studies) or MRI (20 studies) to conventional coronary angiography in patients with suspected or known CAD. The studies were comprised of 7, 516 and 989 patients, respectively. The researchers found that for ruling out CAD, CT is a more accurate noninvasive test than MRI.
The most comprehensive study to date of secondhand smoke exposure among children in England is published in the journal Addiction. The study, carried out by researchers from the University of Bath's School for Health, reveals that exposure to household secondhand smoke among children aged 4-15 has declined steadily since 1996. The researchers wanted to find out if there were ways to predict the levels of secondhand smoke encountered by children in private households, and whether those levels were changing over time. Using eight surveys conducted between 1996 and 2006, researchers took saliva samples from over 19, 000 children aged 4-15 years. The saliva samples were analyzed for a substance called cotinine, an indicator of tobacco smoke exposure. The results show that the average cotinine levels among non-smoking children declined by 59% from 1996 to 2006, indicating that children's exposure to secondhand smoke has decreased markedly since the mid-nineties. The researchers point out that the largest decline was between 2005 and 2006, a time of increased public debate and public information campaigns about secondhand smoke in the lead-up to the 2007 implementation of smoke-free legislation for public spaces.
California's state Senate Thursday voted for a bill creating a single-payer health system Thursday. The Associated Press : "The California Senate approved creating a government-run health care system for the nation's most populous state on Thursday, ignoring a veto threat from Gov. Arnold Schwarzenegger" (Thompson, 1/28) The New York Times : "While the move came as questions arose over the prospects of Congress adopting national health care legislation, the author of the California bill, State Senator Mark Leno, said that the timing was coincidental. ... 'Scott Brown did not push me to do this, ' said Mr. Leno, referring to the newly elected Republican senator from Massachusetts" (McKinley, 1/28). San Francisco Chronicle : "The 22-14 vote was nearly party-line, with one Democrat, Sen. Lou Correa, D-Santa Ana, voting no. It now moves to the Assembly." The plan would likely cost $200 billion a year (Buchanan, 1/29). Other state health news includes Medicaid, veterans issues and a tobacco settlement.
Researchers reviewing hundreds of recent studies found that most ex-smokers ceased smoking successfully without help and found it less difficult than expected: they urge health authorities to do more to highlight this message and so that smoker's perceptions are not dominated by messages put out by tobacco control advocates and pharmaceutical companies who are overpromoting the idea that smokers need support like nicotine replacement products to help them quit. The study was the work of Drs Simon Chapman and Ross MacKenzie from the School of Public Health at the University of Sydney, Australia and you can read a report about it in the 9 February issue of PLoS Medicine. In their background information, Chapman and MacKenzie wrote that the dominant theme of messages about quitting smoking campaigns emphasize that if smokers are serious about quitting they should seek professional help or use nicotine replacement therapy. This has led to the "medicalisation of smoking cessation", despite substantial evidence that most ex-smokers quit successfully either by going "cold turkey", that is giving up all at once, or by reducing their consumption gradually and then giving up.