Dentistry

Federal Appeals Court Strikes Down Graphic Smoking Warnings

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Undoubtedly this smoking flap will be headed to the United States Supreme Court.

A US court on Friday shot down orders to slap graphic anti-tobacco messages on cigarette packs, saying the government overstepped its authority by trying to “browbeat” smokers into quitting.

In line with campaigns in several other nations, the United States planned from September 22 to require images on cigarette packs including a man smoking through a hole in his throat and a body with chest staples on an autopsy table.

In a 2-1 decision, the US Court of Appeals in Washington said that the images planned on cigarette packs were not necessarily false but they went beyond “pure attempts to convey information to consumers.”

“They are unabashed attempts to evoke emotion (and perhaps embarrassment) and browbeat consumers into quitting,” Judge Janice Rogers Brown, who was appointed by former president George W. Bush, wrote for the majority.

She also said that the US Food and Drug Administration “has not provided a shred of evidence” that graphic warnings directly reduced rates of smoking.

The graphic ads, as I have said before, don’t really bother me. I, also, don’t think anyone will be deterred from smoking because of them.

Hopefully, the entire flap will be moot as more and more Americans abandon the smoking habit/addiction.

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Centers for Disease Control

CDC Using Scary Graphic Ads to Combat Smoking – Today Begins Ad Campaign

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If the ads work on getting folks to either quit or not start in the first place, go for them!

Federal health officials are unveiling Thursday a $54 million national media campaign to get smokers to quit and prevent anyone else, especially children, from starting.

The campaign, called “Tips From Former Smokers,” is intended to educate Americans about the dangers of smoking through the stories and graphic pictures of ex-smokers who have suffered severe health consequences of tobacco use.

The former smokers profiled have suffered ailments like stroke-related paralysis, limb amputation, lung removal and heart attack. One breathes through a stoma, a surgically created hole in the neck through which a person who has undergone larynx or voice box surgery can breathe.

The ads are the brainchild of the Centers for Disease Control and Prevention’s Office on Smoking and Health. The agency says smoking remains the country’s leading cause of disease and preventable death, resulting in more than 443,000 fatalities annually. More than 8 million Americans live with a smoking-related illness or conditions, according to the disease agency.

The combination of public service announcements and paid advertising for television, radio, newspapers and magazines, also spotlights the dangers of exposure to secondhand smoke. The ads will also be featured on billboards, in theaters and online–including on Facebook, Twitter and YouTube.

You cannot ban tobacco smoking, but education campaigns that truthfully portray the results of smoking may be a way to reduce the amount of it.

Let’s hope these are successful – although I have my doubts that the shift will be huge, unfortunately.

The campaign includes eight television ads (one of them in Spanish); seven radio spots in 30- and 60-second versions; seven print ads and five billboard and bus stop ads.

The campaign marks the first time the CDC has run a paid, comprehensive national anti-tobacco advertising effort. The primary target is smokers ages 18 to 54, but public health experts also hope it will dissuade children from adopting the habit.

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Health

Substituting Smokeless Tobacco for Smoking Will Save Lives?

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Samples of smokeless tobacco

Apparently yes, according to a new study – e-cigarettes too.

Substituting smokeless tobacco products can save smokers’ lives, and there is a scientific foundation that proves it.

That is the message Brad Rodu, D.D.S., professor of medicine at the University of Louisville (UofL) School of Medicine and the Endowed Chair in Tobacco Harm Reduction at UofL’s James Graham Brown Cancer Center, delivered at the Annual Meeting of the American Association for the Advancement of Science Feb. 18. Rodu spoke at the session, “Harm Reduction: Policy Change to Reduce the Global Toll of Smoking-Related Disease.”

“Quit or die: That’s been the brutal message delivered to 45 million American smokers, and it has helped contribute to 443,000 deaths per year, according to statistics from the Centers for Disease Control and Prevention,” Rodu said. “The truth, however, is that total nicotine and tobacco abstinence is unattainable and unnecessary for many smokers.”

There is one interesting part of the study.

“Nicotine is addictive, but it is not the cause of any smoking-related disease. Like caffeine, nicotine can be used safely by consumers,” Rodu said.

And, the evidence?

Decades of epidemiologic research bear out Rodu’s findings. While no tobacco product is completely safe, smokeless products have been shown to be 98 percent safer than cigarettes. In the United Kingdom, the Royal College of Physicians reported in 2002 that smokeless tobacco is up to 1,000 times less hazardous than smoking, and in 2007, further urged world governments to seriously consider instituting tobacco harm reduction strategies as a means to save lives.

To see the proof of what tobacco harm reduction can do, look to Sweden, Rodu said. “Over the past 50 years, Swedish men have had Europe’s highest per capita consumption of smokeless tobacco as well as Europe’s lowest cigarette use. During the same time, they also have the lowest rate of lung cancer than men in any other European country.”

While I would not recommend my patients to start smokeless tobacco or e-cigarettes, the evidence is there that if they cannot quit using smoking cessation programs at least recommend that they switch to another nicotine delivery system.

Rodu is well aware of the controversy his research findings generate. Opponents of any use of nicotine delivery products maintain that smokeless tobacco puts the user at great risk for oral cancer, a position not supported by research.

“The risk of mouth cancer among smokeless tobacco users is extremely low — certainly lower than the risk of smoking-related diseases among smokers,” he said. “The annual mortality rate among long-term dry snuff users is 12 deaths per 100,000 and the rate among users of more popular snus, moist snuff and chewing tobacco is much lower. For perspective, the death rate among automobile users is 11 per 100,000 according to a 2009 report from the National Highway Traffic Safety Administration. Compare those to the rate among smokers: more than 600 deaths per 100,000 every year.”

“The data clearly show that smokeless tobacco users have, at most, about the same risk of dying from mouth cancer as automobile users have of dying in a car wreck.”

In summary, as far as far as death is concerned: cigarettes (smoked tobacco)> smokeless tobacco> e-cigarettes> or = car wreck.

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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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Health

For Smokers Seeing Arterial Plaque Makes No Difference on Whether They Quit Smoking

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Coronary artery plaque in the heart

Unbelievable, I mean really?

If you were a smoker, would seeing an image of plaque building up in your neck artery help you quit?

That was the central question posed by a study of 536 smokers recently published online by the Archives of Internal Medicine. Researchers wanted to know whether using ultrasound images of the carotid artery could serve as a “teachable moment” and improve quit rates when added to an intensive smoking-cessation program.

Plaques in the carotid are a predictor of cardiovascular disease risk, explains Nicolas Rodondi, a professor at the University Hospital Inselspital, in Bern, Switzerland, and an author of the study. But screening for the plaques has been controversial, because it’s not clear whether it actually improves health.

The smokers — who were between 40 and 70 years of age and smoked an average of a pack a day — were randomized into two groups. One received carotid plaque screening, and the other didn’t. Both then participated in a one-year smoking cessation program that included six 20-minute individual counseling sessions and nicotine replacement therapy.

At the end of the year, the researchers got a surprise: the quit rates were high, but there was no significant difference between the groups (24.9% in the screening group and 22.1% in the non-screening group). Nor was there a difference in quit rates between the screened folks who had and did not have plaques.

Maybe this communication was not sufficient of a “teachable” moment. Or, maybe these folks were motivated to quit smoking, in any case.

Do smokers really need to be scared? Or, do physicians and dentists need better communication tools?

I would say the latter.

Watch the video below and weigh in with your thoughts in the comments section.

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