Breaking news: Smoking is bad for your health

TeeJay · 24 Aug 06 :: 09:52

Can I just hold up my non-smoking flag for a minute? I read this article in a medical journal the other day and I think we can't show this to people often enough. Not that it really helps, most smokers I know just shrug it off and don't care. And kinda ironic to post this here, too. Because we know pretty sure now that Chris smokes. But anyway...

The heart-breaking news about tobacco: it's all bad

During the present century, about 1 billion people will die of smoking-related conditions if current trends persist; a substantial proportion due to cardiovascular disease.1 In today's Lancet, Koon Teo and colleagues provide a wealth of new data documenting the causal link between smoking and acute myocardial infarction in over 12 000 cases from around the world. Their INTERHEART study used a standardised protocol to select cases and controls, and gather uniform information from 262 sites in 52 countries. The study represents a model for international cooperation, and shows the unique global coverage that permitted investigators to assess a wide range of patterns of tobacco use. The large sample sheds new light on many specific subgroups on the basis of region, age, sex, and form of exposure. The overwhelming conclusion from this mass of data is that tobacco exposure—be it cigarettes, pipes, cigars, beedies, sheesha, or smokeless; second-hand or primary; filtered or non-filtered, even at low levels—causes a large proportion of myocardial infarcts in men and women around the world.

Some aspects of this remarkable study merit special attention. First is the global perspective. Although the adverse effects of tobacco use on cardiovascular disease are well documented in developed countries, far less data are available from developing countries where tobacco use has increased in recent decades. In south Asia, beedies (bidis), tobacco rolled in a dried temburini leaf and tied with a string, are commonly used, but few studies have documented their hazards for heart disease. Rastogi and colleagues reported a relative risk of 8・1 for myocardial infarction from smoking more than ten beedies a day in men in India. Extending the data on beedies, Teo and colleagues found that sheesha, tobacco smoked through a water pipe, has effects similar to other forms of tobacco. Sheesha tobacco had been thought by some as possibly safer, but this view is now refuted.

A second key finding was the close link between amount of exposure and level of risk, which persisted down to very low levels of exposure. Thus even just a few cigarettes a day doubled the risk of myocardial infarction. An increased risk with as few as one to four cigarettes a day has been previously reported, but Teo and colleagues' study extends those findings with greater precision. This result has important clinical and public-health implications for counselling patients. Moreover, the finding that very low levels of active smoking substantially increase risk lends further credence to the plausibility of second-hand smoke also being a major risk factor. The INTERHEART study adds important information documenting the hazards of second-hand smoke, and confers considerable weight to additional regulations to restrict such exposures. Yusuf and colleagues' report is timely, and complements the 2006 US Surgeon General's report on involuntary exposure to tobacco smoke, which came to similar conclusions.

A third major finding was that much of the excess risk dissipates a year or two after quitting. Some excess risk persists for many years, especially for those who previously were heavy smokers; however, the heavy smokers enjoyed the sharpest decline in risk upon cessation. This non-linear decline in risk over time suggests that at least two different mechanisms are operating to cause myocardial infarction. Further exploration of the details of the decline in risk in this dataset might prove rewarding. The case-control design is superior to most prospective studies in the assessment of the effects of short-term changes in exposure.

The calculations of population-attributable risks from this global study are particularly important. Overall, the population attributable risk for current smoking was 38%. The attributable risk was higher in men than women, despite similar odds ratios in both sexes. This difference in attributable risk reflects the lower smoking prevalence in women. The odds ratios were higher in younger than older individuals, perhaps indicating the lower underlying risk of myocardial infarction in younger persons apart from the risk from smoking, and perhaps also showing some survivor-cohort effect in the older smokers. The latest findings from INTERHEART should stimulate are doubling of our efforts to rid the planet of the scourge of smoking.

Sarah A Rosner, *Meir J Stampfer
Department of Epidemiology, Harvard School of Public Health,
Boston, MA 02115, USA
stampfer@hsph.harvard.edu
From: The Lancet (Volume 368, Issue 9536, 19 August 2006-25 August 2006)

We declare that we have no conflict of interest.
1 Peto R, Lopez A. The future worldwide health effects of current smoking patterns. In: Koop CE, Pearson CE, Schwarz MR, eds. Critical issues in global health. San Francisco: Jossey-Bass, 2000: 151–61.
2 Teo KK, Ounpuu S, Hawken S, on behalf of the INTERHEART Study Investigators. Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study: a case-control study. Lancet 2006; 368: 647–58.
3 US Department of Health and Human Services. The health consequences of smoking: a report of the United States Surgeon General. 2004: http://www.cdc.gov/tobacco/sgr/sgr_2004/index.htm (accessed Aug 2, 2006).
4 Rastogi T, Jha P, Reddy KS, et al. Bidi and cigarette smoking and risk of acute myocardial infarction among males in urban India. Tob Control 2005; 14: 356–58.
5 Willett WC, Green A, Stampfer MJ, et al. Relative and absolute excess risks of coronary heart disease among women who smoke cigarettes. N Engl J Med 1987; 317: 1303–09.
6 US Department of Health and Human Services. The health consequences of involuntary exposure to tobacco smoke: a report of the United States Surgeon General. June 27, 2006: http://www.cdc.gov/tobacco/sgr/sgr_2006/index.htm (accessed Aug 2, 2006).

I also need to go upload my Adam/Judith no-smoking banner here, but I only have it at home. I'll look for it later.

-TeeJay

domesticelefant · 24 Aug 06 :: 10:03

O-kay, but I already know that smoking is not healthy. Maybe Chris should read that sometime.

TheCentralScrutinizer · 24 Aug 06 :: 16:11

Lots of young people do reckless things. He'll learn. Too smart not to.

Deb

TeeJay · 24 Aug 06 :: 21:46

Yeah, he better learn!

And here's my Adam/Judith non-smoking banner:

-TeeJay

TheCentralScrutinizer · 24 Aug 06 :: 22:20

You go girl!

Deb

domesticelefant · 25 Aug 06 :: 16:30

Let`s hope he'll learn quickly ... I was going through the threads on the Educatin of Charlie Banks imdb site and somebody posted this:

i was about to talk to him until he walked away for a cigarette

as an answer to Deb's question.

Chris, please: STOP SMOKING! Reading this is hurting my eyes.

TeeJay · 25 Aug 06 :: 18:42

Ooooh, I used to have this really disgusting picture of a human's body parts that can "go bad" if you smoke. It was really disgusting. Don't think I have it anymore, but posting this would make any smoker frown, at the very least. I'm not claiming it'll stop a smoker from smoking, because it's the same thing as losing weight or any other form of addiction. You gotta want to quit first, otherwise it just won't do any good.

Deb, when I was in Atlanta in May, they had the "Bodies" exhibition there. Heard of it? I've seen it when it was in Cologne, a couple of years ago. It's plasticized dead human bodies, prepared so they show different parts and systems of the body. Some people were disgusted and appalled by it. I found it very interesting. They showed a healthy lung there next to a smoker's lung. Disgusting. The smoker's lung was all black. Unbelievable how much tar you can accumulate in your lung. I also think it said that when you smoke ~20 cigarettes a day every day for a year, the amount of tar that accumulates in your lung can fill a coffee mug. Ewww. (If the exhibition is still there in September/October and you're interested in that kind of thing, I'll take you.)

Yes, sure I'd love Chris and every other smoker to quit smoking, but what leverage do I have? All I can do is hold up my non-smoking flag and wave it in people's faces, annoying the hell out of them. And that's what I'm doing right now.

PS: I found a few cool and maybe also controversial ads on an Australian anti-smoking site:

Also found the disgusting "Smoker's Body" image. Look at it at your own risk, it's very very disgusting. Don't say you haven't been warned:
http://www.globalink.org/tobacco/images/wsd.jpg

-TeeJay

domesticelefant · 25 Aug 06 :: 18:53

TeeJay wrote:

Unbelievable how much tar you can accumulate in your lung. I also think it said that when you smoke ~20 cigarettes a day every day for a year, the amount of tar that accumulates in your lung can fill a coffee mug. Ewww.

Wow. That I have to tell my brother and his girlfriend. They are smokers and I hate it. She's not even 18 years old and smokes a lot already.
And ha, I'll print out the first of these pics. It's kind of funny, I think.

TheCentralScrutinizer · 25 Aug 06 :: 20:29

Wow, this is turning into a full-fledged crusade, isn't it? Well, smoking killed my mom and dad, so carry on!

Deb

domesticelefant · 25 Aug 06 :: 20:39

Smoking also killed my mom's best friend. She got a tumor on her aorta, which could not be removed by an operation. She was a chain smoker for more than 20 years before she died.

TeeJay · 25 Aug 06 :: 20:44

Chris better not read this (as if he ever would). Yeah, well, I hate smoking and my dad smokes a lot. So I can help but utter that in public every now and then. Not that it makes a difference...

-TeeJay

TheCentralScrutinizer · 26 Aug 06 :: 01:19

You know, something suddenly hit me on the way home. If we're going to have this very strong anti-smoking post on the boards, maybe we should replace that picture of James smoking on the index page of the site. Wouldn't want us to look like hypocrites, touting this cool character smoking and then railing against doing so on the boards.

Deb

TeeJay · 26 Aug 06 :: 17:13

Yeah, I guess you're kinda right about the smoking pic. But I have to admit that I don't really wanna replace it. I love the slightly grungy, with-an-edge look he has on that pic. Sure, I don't like that he smokes, on or off camera, but it's not like we can change it, so I'm okay with that pic staying where it is. You think it's gonna promote smoking in any way? Don't think so... And I might want to wave the non-smoking flag every now and then, but I wouldn't go as far as banning everything that has to do with cigarettes or other smoking-related things from the site.

And call me a hypocrite for using that pic and then ragging on smokers, but it's not like I go out there and protest against smoking in the streets. I just don't like smoking and people doing it, but I do tolerate it if I have to. Otherwise I couldn't go out to restaurants or bars or pubs at all anymore, because in Germany they haven't banned smoking in public places yet. I wish they would, though. One thing I won't tolerate is people smoking in my apartment or car. And that counts for everyone. Martin Lindow didn't ask if he could smoke when he was in my apartment, but if he had asked, I would have said no. If he'd just smoked and not asked (which he wouldn't have, but I'm talking theoretics here), I would have told him to put it out. Simple as that.

-TeeJay

domesticelefant · 26 Aug 06 :: 20:32

TeeJay wrote:

Yeah, I guess you're kinda right about the smoking pic. But I have to admit that I don't really wanna replace it. I love the slightly grungy, with-an-edge look he has on that pic. Sure, I don't like that he smokes, on or off camera, but it's not like we can change it, so I'm okay with that pic staying where it is. You think it's gonna promote smoking in any way? Don't think so... And I might want to wave the non-smoking flag every now and then, but I wouldn't go as far as banning everything that has to do with cigarettes or other smoking-related things from the site.

Same here.

I don`t like smoking either. I hate it when my brother and his girlfriend are here and smoke. But at least they go out to the balcony. If it was my apartment, I would not allow them to smoke in there. Well, I can't because of my illness. My best friend smokes a lot, too. He often talks about quitting but he never does. I wish he would! Smoking is not healthy for everyone, but for me it is twice dangerous because of my illness.

TheCentralScrutinizer · 27 Aug 06 :: 07:27

That pic wouldn't bother me so much if it wasn't on the front page. Just sayin'.

Deb

TeeJay · 27 Aug 06 :: 08:51

I'll think about changing that pic. If I can find one without the cigarette where he looks equally grungy and menacing.

-TeeJay

TheCentralScrutinizer · 27 Aug 06 :: 21:00

Yeah, definitely keep the grungy and menacing. Love that!

Deb

TeeJay · 10 Sep 06 :: 23:30

Okay, so here's some more Tina standing up and talking about addiction and drugs. Because I just found this article I copied a while ago because I thought it was interesting. If you get bored, here's some reading material for you. (If you find mistakes, that's not my fault but the fault of my OCR text recognition software.) Well, most of this is about drugs to help with addiction, but maybe you still find it interesting.

Eye On: Addiction

Addiction and substance abuse are increasing not only in frequency but in medical complications and direct and indirect costs. In the United States, 7.1% of the population used illicit drugs in 2001, up from 6.3% in 1999 and 2000. During the same time period, there were statistically significant increases in use of marijuana, cocaine, pain relievers and tranquilizers, and the prevalence of substance dependence or abuse increased from 14.5 million (6.5% of the population) to 16.6 million (7.3%). Drug use led to more than 600,000 emergency department visits in 2000, most often for alcohol in combination with other drugs (204,524), cocaine (174,896), heroin/morphine (97,287), and marijuana (96,446). In 1999, there were 19,102 deaths related to use of legal and illegal drugs.

In the workplace, medical and worker compensation claims for employed drug abusers are about double that for drug-free employees. Tobacco use alone is the single leading preventable cause of death in the United States, causing more than 440,000 deaths annually. The U.S. Centers for Disease Control and Prevention estimates that 49 million adults and 6 million teenagers smoke, causing $75.5 billion in excess medical costs and $81.9 billion in mortality-related productivity losses annually.

Recent advances in the science of addiction have shown that drugs interfere with normal brain function, creating short-term sensations of pleasure or euphoria, as well as long-term effects on brain metabolism and activity. These changes in the brain may herald the turning point from drug abuse to addiction, which is a chronic, relapsing illness requiring treatment typically including pharmacotherapy. Examples of currently available agents for treatment of addiction include methadone for heroin abuse, and the anti-depressant bupropion or nicotine replacement therapy via transdermal patches, chewing gum and/or inhalers for smoking cessation.

CenterWatch has identified a pipeline of 12 drugs in various stages of development for treatment of smoking, opiate, alcohol and marijuana addiction. Many of these agents target specific receptors at which the abused substance is active, whereas a few act as immune system modulators. Alkermes has submitted a new drug application (NDA) for Vivitrol (medisorb naltrexone). This narcotic antagonist is a sustained-release, injectable formulation of naltrexone using encapsulation in polymeric microspheres, allowing it to be given only once monthly. Indications may include alcoholism as well as opiate addiction. In a phase III, multicenter, double-blind clinical trial, 624 patients with alcoholism were randomized to receive either one of two doses of Vivitrol or placebo injected once monthly for six months, along with standardized, low-intensity counseling twice monthly. Compared with placebo, 380 mg of Vivitrol was associated with a 25% decrease in heavy drinking days. The drug was generally well-tolerated, with a discontinuation rate due to adverse events of 14.1%.

Another form of injectable, sustained-release naltrexone is Naltrel, in phase III testing by DrugAbuse Sciences for alcoholism and heroin addiction. Like Vivitrol, it uses microsphere technology based on polylac-tide polymers, and it is formulated for once monthly intramuscular injection. Slow release of naltrexone into the bloodstream allows it to trickle into the central nervous system (CNS), where it blocks endorphin receptors. Maintaining an effective concentration in the CNS for an entire month reduces noncompliance, which has previously been a major hindrance to effective addiction pharmacotherapy. Clinical trials to date have yielded convincing efficacy and safety data, with a statistically significant improvement over placebo in total abstinence and in cumulative days of abstinence. However, the primary efficacy variable of cumulative days of non-heavy drinking at three months showed no significant differences between Naltrel and placebo.

Pfizer has submitted an NDA for its anti-smoking drug varenicline (CP-526555), which is a partial agonist at the alpha-4 beta-2 nicotinic receptor. After seven weeks of treatment, about half of the several hundred smokers involved in clinical trials were able to quit smoking. An alternative approach to treating nicotine dependence is the glycine receptor antagonist GW 468816, in phase III development by GlaxoSmith-Kline. Yet another novel strategy to prevent and treat nicotine addiction is NicVAX, a vaccine against nicotine in phase II testing by Nabi Biopharmaceuticals. This vaccine triggers the immune system to produce antibodies binding to nicotine, thereby preventing it from entering the CNS. In this fashion, NicVax would prevent the positive stimulus in the brain normally associated with nicotine. In preclinical studies, NicVAX vaccination appears to block the effects of nicotine that can lead to addiction or that can reinforce and maintain addiction.

Other agents using nicotine-specific antibody-generating technology are CYT-002-NicQb (Nicotine-Qbeta), in phase I development by Cytos Biotechnology, and TA-NIC, in phase I testing by Xenova. In two phase I studies of TA-NIC, the dose groups with the highest levels of anti-nicotine antibodies had a clear increase in smoking cessation rates compared with the lowest dose and placebo groups.

A similar approach applied to a different addiction is Xenova's phase II product TA-CD (IPC-1010), a protein conjugate therapeutic vaccine that stimulates the production of antibodies against cocaine. It is administered by intramuscular injection, and it will probably require a short course of injections to induce antibody formation. In two clinical studies conducted to date, TA-CD vaccine was well tolerated both locally and systemically, with no severe or moderate adverse events. Anti-cocaine antibody levels rose proportionately with the dose of vaccine and with the number of vaccinations. Antibodies first appeared after the second injection, peaked about 12 weeks after the initial injection, and then decreased until one year.

In two dose-escalation phase II studies, the maximum mean antibody response to TA-CD occurred between 70 and 90 days following vaccination, and cocaine-specific antibodies persisted for at least six months. The probability of cocaine use decreased in subjects who received a more intense vaccination schedule and who produced higher levels of anti-cocaine antibodies. Even subjects who relapsed within six months reported a decrease in the euphoric effects of cocaine.

Sanofi-aventis is in phase III testing of rimonabant (Accomplia, SR 141716), a selective CB1 cannabinoid receptor antagonist targeting the brain's reward system. This drug was originally shown to be effective for weight loss or smoking cessation, but it also appears to show promise in treating drug addiction. In addition to blocking the effects of marijuana, it may help prevent relapses into alcohol and cocaine addiction. Lofexidine (BritLofex) is an alpha-2 adrenoceptor agonist, in phase III development by Britannia Pharmaceuticals and NIDA for treatment of opiate withdrawal symptoms in patients undergoing opiate detoxification. Lofexidine has been shown to be effective in reducing withdrawal symptoms including chills, sweating, stomach cramps, diarrhea, muscle pain, rhinor-rhea and watery eyes. Because it is not an opiate and does not cause addiction, it is not associated with any withdrawal symptoms of its own. However, it does not reduce cravings, and it is only helpful in overcoming the physical symptoms of opiate withdrawal.

Probuphine, in phase I testing by Titan Pharmaceuticals, is a six-month subcutaneous implant formulation of buprenor-phine designed for treatment of opiate addiction. Continuous long-term delivery of buprenorphine may reduce poor compliance, variable blood levels, risk of misuse, and other problems associated with daily oral therapy. The ProNeura drug delivery system, which is placed subcutaneously in the upper arm, consists of a small, solid rod made from a mixture of ethylene vinyl acetate (EVA) and buprenorphine, creating a solid matrix from which buprenorphine slowly diffuses.

In preclinical studies, Probuphine was able to deliver targeted therapeutic levels of buprenorphine for up to eight months without adverse effects. In an open label phase I/II clinical study, 12 opiate-dependent patients were successfully switched from daily sublingual buprenorphine to Probuphine without significant signs of withdrawal or craving, and without adverse effects.

For the treatment of methamphetamine addiction, Yaupon Therapeutics is in phase I development of lobeline, a nicotinic acetyl-choline agonist and dopamine modulator. Preclinical studies show that lobeline also protects dopamine-producing neurons, suggesting potential applicability to Parkinson's disease, and that it may improve learning, which could be useful in the treatment of attention deficit disorder. Greater understanding of the patho-physiology of reward centers in the brain and specific receptor types involved in mediating the effects of substances of abuse has spurred the development of new drugs targeting these pathways. Because recent evidence suggests that some brain changes associated with substance abuse may be irreversible, however, the long-term efficacy of these new agents may remain problematic.

—Laurie Barclay, M.D.

from: CenterWatch, April 2006

-TeeJay

domesticelefant · 10 Sep 06 :: 23:32

Okay ...

TheCentralScrutinizer · 11 Sep 06 :: 16:13

You don't need to read all that. Addiction = bad. There, see? Simple.

Deb

TeeJay · 15 Oct 06 :: 12:59

Some small thing to add to this one: While we were on the set of ROTN, we never saw Chris smoking even once. Not on screen, not during breaks. Maybe he quit. I sure hope he did, for his sake. Because, and I can only underline it once more: It is bad for your own health and also bad for the health of the people around you in a smoking environment. (A lot of the production crew people smoked, though...)

And I swear to you, if he had wanted to smoke in our presence and would have asked if we minded, I would have said, "You know, actually I would."

-TeeJay

domesticelefant · 15 Oct 06 :: 13:08

Yeah, let's hope he quit.

TeeJay wrote:

And I swear to you, if he had wanted to smoke in our presence and would have asked if we minded, I would have said, "You know, actually I would."

You know since I have SWS I had to learn to ask people to stop smoking in my presence ... so I surely would have asked him to stop, too.

TheCentralScrutinizer · 15 Oct 06 :: 19:16

I think maybe he's not doing that anymore. He was around pepople smoking all day, including Ryan Pinkston. He never lit up. What's more, he didn't smell at all like a smoker. He smelled really nice, like he was wearing one of those body sprays like Axe, or something. It was just a very subtle, nice scent. I was so glad. And somebody should've told Pinkston that smoking would stunt his growth! Not to be mean, but he's like 4 foot 9 and not likely to get any bigger, poor guy.

Deb

TeeJay · 20 Oct 06 :: 13:17

I know I don't really need to continue my crusade, but I found some more interesting articles, among them one that this is from:

The tobacco industry maintained, for many years, that it was unaware of research about the toxic effects of smoking. By the 1970s, however, the industry decided that it needed this information but they were unwilling to seek it in a way that was open to public scrutiny. By means of material from internal industry documents it can be revealed that one company, Philip Morris, acquired a research facility, INBIFO, in Germany and created a complex mechanism seeking to ensure that the work done in the facility could not be linked to Philip Morris. In particular it involved the appointment of a Swedish professor as a 'co-ordinator', who would synthesise reports for onward transmission to the USA. Various arrangements were made to conceal this process, not only from the wider public, but also from many within Philip Morris, although it was known to some senior executives. INBIFO appears to have published only a small amount of its research and what was published appears to differ considerably from what was not. In particular, the unpublished reports provided evidence of the greater toxicity of sidestream than mainstream smoke, a finding of particular relevance given the industry's continuing denial of the harmful effects of passive smoking. By contrast, much of its published work comprises papers that convey a message that could be considered useful to the industry, in particular casting doubt on methods used to assess the effects of passive smoking.

For several decades the tobacco industry maintained that evidence of adverse health consequences of its products was at best inconclusive and that they were actually socially responsible companies concerned about the health of their customers, a view first expressed in a statement published in American newspapers in 1954 stating that "We accept an interest in people's health as a basic responsibility, paramount to every other consideration in our business". More recently, however, even the tobacco industry has recognised that its position with regard to the health effects of active smoking has been untenable, as summarised by the UK House of Commons Health Committee in 2000: "It seems to us that the companies have sought to undermine the scientific consensus until such time as that position appears ridiculous."

In a few words: The tobacco industry is evil. And smoking is still bad for your health. And this article will shed some more light on it just how so.

-TeeJay

TeeJay · 06 Feb 07 :: 12:29

Found another article that I think is quite interesting. Hope I'm not boring you to death with my anti-smoking crusade, but no one's forced to read everything I post.

Brain damage reveals new avenue for smoking cessation

Smokers who have damage to a specific part of the brain, the insula, are 136 times more likely to lose their addictin to nicotine than those with injuries in other brain areas, according to a new study that could point the way to new smoking cessation therapies.

The findings by researchers at the US National Institute on Drug Abuse (NIDA) suggest that medications targeting this brain region could help people quit smoking, said NIDA director Dr Nora Volkow.

The insula is connected to areas of the brain that are involved in emotion, and is known to play a role in the urge to smoke by anticipating pleasurable physical effects of smoking. Lead researcher Dr Antoine Bechara said that damage to this region could lead smokers to feel they have "forgotten" the urge to smoke.

The regression analysis reported in Science (January 6th, p 531) found that smokers with damage to the insula were significantly more likely to experience a disruption of smoking addiction than those with other brain damage (p=0.0005). This was measured by four behavioural criteria: quitting less than one day after brain injury; rating the difficulty of quitting as less than three on a scale of one to seven; reporting that they did not resume smoking after quitting; and reporting that they had no urge to smoke after quitting.

[...]

As well as identifying a new target for drug therapies, the new study suggests that monitoring activity in the insula with various smoking cessation therapies could be useful for research. In addition, its results support the use of therapies that reduce the urge to smoke, such as denicotinised cigarettes.

Scrip, Issue No 3230, Feb 2nd 2007

-TeeJay

Chris Marquette Message Board

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Breaking news: Smoking is bad for your health

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