Cancer

Many Patients Continue to Smoke Even After Being Diagnosed With Cancer

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Commercial for the California Dept of Health Services

Unbelievable, isn’t it?

A new analysis has found that a substantial number of lung and colorectal cancer patients continue to smoke after being diagnosed. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the study provides valuable information on which cancer patients might need help to quit smoking.

When a patient receives a cancer diagnosis, the main focus is to treat the disease. But stopping smoking after a cancer diagnosis is also important because continuing to smoke can negatively affect patients’ responses to treatments, their subsequent cancer risk, and, potentially, their survival. Elyse R. Park, PhD, MPH, of the Massachusetts General Hospital/Harvard Medical School in Boston, led a team that looked to see how many patients quit smoking around the time of a cancer diagnosis, and which smokers were most likely to quit.

The investigators determined smoking rates around the time of diagnosis and five months after diagnosis in 5,338 lung and colorectal cancer patients. At diagnosis, 39 percent of lung cancer patients and 14 percent of colorectal cancer patients were smoking; five months later, 14 percent of lung cancer patients and 9 percent of colorectal cancer patients were still smoking. These results indicate that a substantial minority of cancer patients continue to smoke after being diagnosed. Also, although lung cancer patients have higher rates of smoking at diagnosis and following diagnosis, colorectal cancer patients are less likely to quit smoking following diagnosis.

Obviously, some patients, even after having cancer, have a hard time breaking the addictive cycle of nicotine.

Physicians and dentists must develop strategies to help these patients quit and quit for good.

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Food and Drug Administration

Federal Judge Blocks Graphic Ads on Cigarette Packages

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The ads don’t bother me, but I suppose the law is clear about advocacy and the role of government.

A judge on Monday blocked a federal requirement that would have begun forcing tobacco companies next year to put graphic images including dead and diseased smokers on their cigarette packages.

U.S. District Judge Richard Leon ruled that it’s likely the cigarette makers will succeed in a lawsuit to block the requirement. He stopped the requirement until the lawsuit is resolved, which could take years.

Leon found the nine graphic images approved by the Food and Drug Administration in June go beyond conveying the facts about the health risks of smoking or go beyond that into advocacy – a critical distinction in a case over free speech.

More than likely there will be an appeal, but the images will not be placed on cigarette packages for the foreseeable future.

Matthew Myers, president of the Campaign for Tobacco-Free Kids, urged the Obama administration to appeal the ruling that he said “is wrong on the science and wrong on the law.” He said a delay would only serve the financial interests of tobacco companies that spend billions to downplay the health risks of smoking and glamorize tobacco use.

“Studies around the world and evidence presented to the FDA have repeatedly shown that large, graphic warnings, like those adopted by the FDA, are most effective at informing consumers about the health risks of smoking, discouraging children and other nonsmokers from starting to smoke, and motivating smokers to quit,” Myers said in a statement. “Because of that evidence, at least 43 other countries now require large, graphic cigarette warnings.”

Congress instructed the FDA to require the labels, following the lead of the Canadian regulations that require similarly graphic images on cigarette packs. The cigarette makers say their products have had Surgeon General warnings for more than 45 years, but that they never filed a legal challenge against them until these images were approved.

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Smoking

2.5 Million Children Exposed to Secondhand Smoke in California?

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The answer is yes, according to a new policy brief from the UCLA Center for Health Policy Research.

Despite having the second-lowest smoking rate in the nation, California is still home to nearly 2.5 million children under the age of 12 who are exposed to secondhand smoke, according to a new policy brief from the UCLA Center for Health Policy Research.

Using data from several cycles of the California Health Interview Survey, the study’s authors estimate that 561,000 children are directly exposed to secondhand smoke in the home. Another 1.9 million are at risk because they live in a home where another family member is a smoker, even though smoking may not be allowed in the home itself.

Secondhand smoke exposes children to a greater risk of developing asthma, respiratory infections and countless other ailments. Research shows that children raised by smokers have a greater risk of becoming smokers themselves.

“The next frontier in the campaign against smoking is to reduce smoking at home,” said Sue Holtby, the study’s lead author and a senior researcher at the Public Health Institute, which works with the UCLA Center for Health Policy Research in conducting the California Health Interview Survey. “California’s fight against tobacco has been a major public health success story, but we still need to spread awareness and ensure that every family knows the dire consequences of addiction.”

Other findings:

  • African American children three times more likely to live with smokers
  • Children living in households at or above 300 percent of the federal poverty level (FPL) are far less likely to be exposed to secondhand smoke
  • Rural children at greater risk than urban
  • Although Los Angeles doesn’t have the highest percentage of smoking households (10.8 percent) it has a surprisingly high percentage (4.1 percent) of households with children where smoking in the home is allowed, relative to other regions.

The entire policy brief is here.

Again, please for your health, quit smoking or better yet – never start.

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Health

Smokers Suffer Heart Attacks at a Younger Age

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According to a new study.

Smokers tend to suffer heart attacks years earlier than non-smokers, suggests a new study from Michigan.

“Individuals who smoke are much more likely to have a heart attack, and will present with a heart attack a decade or more earlier,” said Dr. Gregg Fonarow, a cardiologist at the David Geffen School of Medicine at the University of California, Los Angeles, who wasn’t involved in the new study.

The findings, he said, also show that people who smoke “could have a heart attack in the absence of other risk factors.”

Researchers led by Dr. Michael Howe from the University of Michigan Health System in Ann Arbor studied about 3,600 people who were hospitalized with a heart attack or unstable angina.

One-quarter of the patients were current smokers. And on average, they were younger with fewer health problems than non-smokers with heart trouble.

The mean ages at hospital admission were 64 for non-smoking men vs 55 for male smokers. For women, mean ages were 70 for non-smokers and 57 for smokers.

Smokers were less likely to have other health problems that are linked to cardiac risks, including high cholesterol, high blood pressure and diabetes.

That and their younger age explained why researchers also found that smokers were less likely to die in the six months following the index event than non-smokers.

That “smoker’s paradox” — the idea that smokers who have a heart attack have better outcomes, including a lower risk of death — didn’t last. The difference in death over the next six months was explained by age and other risk factors.

Dr. Fonarow said the findings are just one more example of the heart dangers posed by smoking, but emphasized that kicking the habit can erase those extra risks.

“Even within a few days of stopping smoking, there is a reduction in (heart) risk. As time goes by, within one to two years much of that risk is gone for heart attacks,” he told Reuters Health. “From a coronary risk standpoint, there is an immediate benefit and that continues to extend over time.”

Smoking is just a very bad risk factor for cardiac disease.

You know how I feel.

Please quit if you can and don’t start…..

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Health

Tobacco Companies Knew Cigarettes Contained Radioactive Cancer Causing Particles

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According to a new paper.

Tobacco companies knew that cigarette smoke contained radioactive alpha particles for more than four decades and developed “deep and intimate” knowledge of these particles’ cancer-causing potential, but they deliberately kept their findings from the public, according to a new study by UCLA researchers.

The analysis of dozens of previously unexamined internal tobacco industry documents, made available in 1998 as the result of a legal settlement, reveals that the industry was aware of cigarette radioactivity some five years earlier than previously thought and that tobacco companies, concerned about the potential lung cancer risk, began in-depth investigations into the possible effects of radioactivity on smokers as early as the 1960s.

“The documents show that the industry was well aware of the presence of a radioactive substance in tobacco as early as 1959,” the authors write. “Furthermore, the industry was not only cognizant of the potential ‘cancerous growth’ in the lungs of regular smokers, but also did quantitative radiobiological calculations to estimate the long-term lung radiation absorption dose of ionizing alpha particles emitted from cigarette smoke.” The study, published online Sept. 27 in Nicotine & Tobacco Research, the peer-reviewed journal of the Society for Research on Nicotine and Tobacco, adds to a growing body of research detailing the industry’s knowledge of cigarette smoke radioactivity and its efforts to suppress that information.

“They knew that the cigarette smoke was radioactive way back then and that it could potentially result in cancer, and they deliberately kept that information under wraps,” said the study’s first author, Hrayr S. Karagueuzian, a professor of cardiology who conducts research at UCLA’s Cardiovascular Research Laboratory, part of the David Geffen School of Medicine at UCLA. “Specifically, we show here that the industry used misleading statements to obfuscate the hazard of ionizing alpha particles to the lungs of smokers and, more importantly, banned any and all publication on tobacco smoke radioactivity.”

The radioactive substance — which the UCLA study shows was first brought to the attention of the tobacco industry in 1959 — was identified in 1964 as the isotope polonium-210, which emits carcinogenic alpha radiation. Polonium-210 can be found in all commercially available domestic and foreign cigarette brands, Karagueuzian said, and is absorbed by tobacco leaves through naturally occurring radon gas in the atmosphere and through high-phosphate chemical fertilizers used by tobacco growers. The substance is eventually inhaled by smokers into the lungs.

The study outlines the industry’s growing concerns about the cancer risk posed by polonium-210 inhalation and the research that industry scientists conducted over the decades to assess the radioactive isotope’s potential effect on smokers — including one study that quantitatively measured the potential lung burden from radiation exposure in a two-pack-a-day smoker over a two-decade period.

The cigarette companies knew about the lung cancer causing radiation, studied it and said nothing. And. despite knowing about the risk to its customers, declined to adopt techniques that could have helped eliminate the polonium-210 from the tobacco.

Despite the potential risk of lung cancer, tobacco companies declined to adopt a technique discovered in 1959 and then another developed in 1980 that could have helped eliminate polonium-210 from tobacco, the researchers said. The 1980 technique, known as an acid-wash, was found to be highly effective in removing the radioisotope from tobacco plants, where it forms a water-insoluble complex with the sticky, hair-like structures called trichomes that cover the leaves.

And while the industry frequently cited concerns over the cost and the possible environmental impact as rationales for not using the acid wash, UCLA researchers uncovered documents that they say indicate the real reason may have been far different.

“The industry was concerned that the acid media would ionize the nicotine, making it more difficult to be absorbed into the brains of smokers and depriving them of that instant nicotine rush that fuels their addiction,” Karagueuzian said. “The industry also were well aware that the curing of the tobacco leaves for more than a one-year period also would not eliminate the polonium-210, which has a half-life of 135 days, from the tobacco leaves because it was derived from its parent, lead-210, which has a half-life of 22 years.”

The Food and Drug Administration under the 2009 Family Smoking Prevention and Tobacco Control Act should force the cigarette companies to cleanse their product of these radioactive isotopes, emitting alpha particles.

Period.

Frankly, I don’t care if their product doesn’t deliver the nicotine kick or keeps their customers addicted. I do care that people are dying needlessly because of lung cancer caused by the product.

Karagueuzian said the earliest causal link between alpha particles and cancer was made in around 1920, when alpha particle-emitting radium paint was used to paint luminescent numbers on watch dials. The painting was done by hand, and the workers commonly used their lips to produce a point on the tip of the paint brush. Many workers accumulated significant burdens of alpha particles through ingestion and absorption of radium-226 into the bones and subsequently developed jaw and mouth cancers. The practice was eventually discontinued.

Another example involves liver cancer in patients exposed to chronic low-dose internal alpha particles emitted from the poorly soluble deposits of thorium dioxide after receiving the contrast agent Thorotrast. It has been suggested that the liver cancers resulted from point mutations of the tumor suppressor gene p53 by the accumulated alpha particles present in the contrast media. The use of Thorotrast as contrast agent was stopped in the 1950s.

Here is the abstract of the paper.

Introduction: To determine the tobacco industry’s policy and action with respect to radioactive polonium 210 (210Po) in cigarette smoke and to assess the long-term risk of lung cancer caused by alpha particle deposits in the lungs of regular smokers.

Methods: Analysis of major tobacco industries’ internal secret documents on cigarette radioactivity made available online by the Master Settlement Agreement in 1998.

Results:
The documents show that the industry was well aware of the presence of a radioactive substance in tobacco as early as 1959. Furthermore, the industry was not only cognizant of the potential “cancerous growth” in the lungs of regular smokers but also did quantitative radiobiological calculations to estimate the long-term (25 years) lung radiation absorption dose (rad) of ionizing alpha particles emitted from the cigarette smoke. Our own calculations of lung rad of alpha particles match closely the rad estimated by the industry. According to the Environmental Protection Agency, the industry’s and our estimate of long-term lung rad of alpha particles causes 120–138 lung cancer deaths per year per 1,000 regular smokers. Acid wash was discovered in 1980 to be highly effectively in removing 210Po from the tobacco leaves; however, the industry avoided its use for concerns that acid media would ionize nicotine converting it into a poorly absorbable form into the brain of smokers thus depriving them of the much sought after instant “nicotine kick” sensation.

Conclusions:
The evidence of lung cancer risk caused by cigarette smoke radioactivity is compelling enough to warrant its removal.

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