ASH Daily News for 03 September 2008

Women smokers 'cut their lives by 14 years' and risk heart attack at 66

Women who smoke are likely to suffer a heart attack nearly 15 years earlier than those who don't, claim researchers. Smokers can expect to have a heart attack on average around the age of 66 - although it can occur at a much younger age for some women, says a new study. But a non-smoking woman could celebrate her 80th birthday before succumbing to an attack. In contrast, men who smoke have a heart attack on average just six years earlier than male non-smokers.

New evidence shows the stark difference in the health of women in later life when heart disease becomes increasingly important as a cause of lost years through death and disability. Smoking is the biggest cause of premature death from heart disease, claiming the lives of at least 50,000 women a year. More than one in five adults in Great Britain is a smoker, with 23 per cent of men and 21 per cent of women smoking regularly.

The latest study looked at almost 1,800 patients admitted to Lillehammer Hospital, Norway, for a first heart attack from which they recovered and were discharged, or died in hospital between 1998 and 2005. About one in three patients were women, ranging in age from 27 years to 103 years. The researchers found the average age for a first attack among women who did not smoke was 80.7 years. But women smokers were struck down at the age of 66.2 years - a difference of 14.5 years.

In men, the average age for a first heart attack among non-smokers was 72.2 years and 64 years in smokers - a difference of 6.2 years. The age differences between smokers and non-smokers were 'highly significant' in both men and women, said lead researcher Dr Morten Grundtvig, who released the data yesterday at the European Society of Cardiology congress in Munich. He said the number of years lost because of smoking - years when women would have expected to be free of heart problems - was doubled in women compared with men. He said 'Smoking caused the first heart attack to occur significantly more prematurely in women than in men, implying that twice as many years were lost by women smokers as by men smokers. Smoking incurs a strong additional risk in women.'

The study appeared to settle the debate about whether smoking increases the risk of heart disease relatively more in women than men, he said. 'Women adopted the smoking habit historically later than men and the findings strongly indicate that a sex difference exists in the effect of smoking on coronary arteries' he added. Although women have been giving up smoking, it is at a slower rate than men and there is concern about the number of girls who smoke. Between 1992 and 2006 the proportion of women taking up the habit before their 16th birthday went up from 28 per cent to 36 per cent.

Dr Jeremy Pearson, associate medical director of the British Heart Foundation, said 'Smoking is the most significant cause of premature heart attack, so it must have a much greater impact on women. This study shows that it is even more important for women not to smoke, and they may be affected at ages much younger than their 60s. The good news is that stopping cuts the risk immediately and five years after quitting the heart disease risk is almost back to that of women who have never smoked.The best advice is not to start smoking but it's never too late to get the health benefits from quitting.'

Source: The Daily Mail, 02 September 2008
Link: http://tiny.cc/q2TV1  

World Cancer Declaration sets ambitious targets for 2020

A summit of more than 60 high-level policymakers, leaders and health experts have adopted a global plan aimed at tackling the growing cancer crisis in developing countries. The plan, contained in the World Cancer Declaration, recommends a set of 11 cancer-busting targets for 2020 and outlines priority steps that need to be taken in order to meet them. It was presented Sunday at the close of the World Cancer Congress in Geneva and offered as a global template for governments and other groups to tailor as they devise their own plans to guide local efforts.

"The rise of cancer in less affluent countries is an impending disaster," WHO director-general Dr Margaret Chan told delegates at the opening of the congress this week. "The time is right to make cancer control a development priority." Chan said she believed that several recent trends in public health make the international community especially receptive to the arguments made in the declaration and responsive to its call to action.

Former UN commissioner for human rights Mary Robinson, who chaired the summit, said cancer control is a human rights issue, tied to the right to health through access to an effective health system. "Ultimately, it is a question of human rights and above all, it is a question of human dignity. Adoption of the World Cancer Declaration is another step in a real commitment - a vision - of how to tackle this huge world health issue," said Robinson, who is now president of Realizing Rights, a New York-based human rights organization.

Much can be done to tackle cancer in the developing world, the experts said. About one-third of cancer cases can be prevented and another third can be cured if detected early and treated properly. Targets recommended in the declaration include significant drops in global tobacco consumption, obesity and alcohol intake; universal vaccination programmes for hepatitis B and human papilloma virus to prevent liver and cervical cancer; dramatic reduction in the emigration of health workers with specialist cancer training; universal availability of effective pain medication and the dispelling of myths and misconceptions about the disease.

During the summit, participants made several suggestions for how to meet the targets in the declaration and emphasized certain priorities. The importance of myth reduction and proper pain relief for cancer patients were emphasized. The idea of a global fund for cancer, similar to the Global Fund to fight AIDS, tuberculosis and malaria, was tabled as a possible goal, given that cancer kills more people than those three diseases combined.

Source: mediLexicon, 02 September 2008
Link: http://tiny.cc/sl9J5  

Champion boxer James Oyebola ‘shot dead in nightclub row over smoking’

A former heavyweight boxing champion was shot dead after asking a group of men to put out their cigarettes in a West London club three weeks after the smoking ban came into force, a court heard yesterday.  James Oyebola, 46, died four days after being shot in the neck and the leg during a confrontation at the Chateau 6 nightclub in Fulham Broadway in July last year. Mr Oyebola was a former British heavyweight champion. He also won a bronze medal in the 1986 Commonwealth Games, losing to Lennox Lewis in the semi-final.

Jeremy Donne, QC, for the prosecution, said: “The reason for the killing was particularly senseless. James Oyebola had become involved in a dispute over smoking inside the club.” He said that in a confrontation with four men, one of them produced a gun and fired four bullets, two of which hit Mr Oyebola. He was sitting in a small courtyard at the back of the building. “This space has a retracting roof and, even though it can appear to be an open space, it is in fact part of the enclosed premises and therefore subject to the smoking ban,” Mr Donne said. “A number of witnesses who saw him [Mr Oyebola] assumed he was a bouncer, partly because of his size – 6ft 9in and powerfully built – and partly because he was asking people not to smoke.”

Kanyanta Mulenga, 23, of Putney; Rene McKoy, 20, of Battersea; Cyle Carth, 18, of Wimbledon; and Dean Francis, 24, of Wandsworth, all southwest London, deny murder and affray. Mr Donne said that the defendants were among 50 people at a party night. It was alleged that Mr Mulenga had concealed a gun in his trousers in case he was searched as he came in. One of the defendants, Mr Francis, said that he had been in the bar and lit a cigarette in the garden area but put it out when he saw security staff coming towards him. He told detectives: “I didn’t want any trouble.” He added that he had left when he heard shots fired and did not know who was firing them.

Mr Donne said that only one person, Mr Mulenga, was likely to have pulled the trigger, but that the other three were equally guilty of murder because they knew that he was carrying a loaded handgun and might use it. The trial continues.

Source: The Times, 03 September 2008
Link: http://tiny.cc/0hqCf  

Canada: Anti-smoking campaigns apparently have little effect on youth

Smoking rates in Alberta remain above the national average, particularly among youth, even though the province has spent millions of dollars trying to get people to quit, new figures released by Health Canada suggest. Data from the 2007 Canadian Tobacco Use Monitoring Survey suggest the number of overall smokers in Alberta has remained steady around the 21 per cent range over the past three years. The national average has hovered around the 19 per cent range over that same time period. But the number of young smokers in Alberta appears to have increased: 20.1 per cent of surveyed Albertans between the ages of 15 of 19 said they smoke. The national average for that age range is 15.2 per cent.

In 2006, Alberta's average for 15-to-19-year-olds was also 15.2 per cent, nearly matching the national average. However, the statistical confidence intervals for the 2006 and 2007 figures overlap, meaning the observed jump in the youth smoking rate could derive simply from a statistical anomaly. "We are definitely concerned about the rate of smoking among young people aged 15 to 19. It should be much lower than the smoking rate of the general population, in my view, and it should not be the same rate as adult smoking," said Les Hagen, executive director of Action on Smoking and Health, an Alberta anti-smoking organization.

Alberta has spent more than $50 million on anti-smoking programs since 2000. The province also has one of the strongest tobacco control laws in Canada. The legislation, which took effect on Jan. 1, bans smoking in any public building, including restaurants and bars. It also bans the use of so-called tobacco power-walls in retail outlets in the province. Hagen said the province's economic boom is making it easier for young people to afford cigarettes. He wants the Alberta government to hike the price of cigarettes by $2 a pack, a measure he said has the greatest effect on curbing smoking among youth. "For some people, health information will not motivate them to quit, but perhaps a price increase will," Hagen said.

Alberta is not the only province where educational campaigns appear to be ineffective. The national overall smoking rate has hovered around 19 per cent for the past three years. The Alberta government and the Alberta Alcohol and Drug Abuse Commission are both rethinking their anti-smoking strategies. Raj Sherman, the parliamentary secretary to Alberta's health minister, defended the millions the province has spent on education campaigns but admitted the province could do more. "Are we where we would like to be? No. Can we do better? Yes. Do we need to do better? Yes," he said.

Source: CBC News, 02 September 2008
Link: http://tiny.cc/Kw486