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ASH Daily News for 14 November 2007

Research body calls for more government intervention to tackle public health problems

A report by the well respected Nuffield Council on Bioethics concludes that the Government and industry are not doing enough to prevent binge drinking or obesity and should promote healthy lifestyles through stricter measures and deterrents.

The authors, a group of doctors, lawyers, philosophers and other experts, argue that the much maligned “nanny state” should be replaced by a new, more sensitive idea of “stewardship”.

The council, which considers ethical questions raised by advances in medical research, looked at alcohol, obesity, smoking, infectious disease and fluoridation of water.

Lord Krebs, who chaired the report committee, said yesterday: “People often reject the idea of a nanny state but the Government has a duty to look after the health of everyone and sometimes that means guiding or restricting our choices.”

The central concept of stewardship differed from the nanny state by being “more sensitive to the balances between public good and individual freedom,” he said. The report concludes: “The stewardship model provides justification for the UK Government to introduce measures that are more coercive than those which currently feature in the National Alcohol Strategy.”

The report, in preparation since February last year, says that the arguments used to justify banning smoking in enclosed public spaces would also apply to banning smoking in homes. This would be extremely difficult to enforce, but local authorities and the courts could preside over exceptional cases where children with a respiratory illness could be at such a risk that intervention may be ethically acceptable.

The UK Public Health Association welcomed the report, saying that it represented an evidence-based approach that could counter health inequalities. But Simon Clark, director of the smokers’ lobby group FOREST, said: “Politicians should take care not to overindulge in social engineering. Potentially, this report is a manifesto for a bully state in which people are increasingly forced to behave in a manner approved by politicians and evangelical health campaigners who want unprecedented control over our daily lives.”

Source: The Times Online, 13 November 2007
Link: http://tinyurl.com/2yy9dv

Smoking associated with rectal cancer

Cigarette smoking may be a risk factor for rectal cancer.

Electra Paskett, Ph.D., of Ohio State University in Columbus and colleagues investigated the association between smoking history and colorectal cancer among nearly 147,000 participants in the Women's Health Initiative.

After an average follow up of 8 years, 1,242 women were diagnosed with colorectal cancer. Increased colorectal cancer incidence was associated with more cigarettes smoked per day, more years as a smoker, and the age when quitting.  

Current smokers were at an increased risk for rectal cancer, but not colon cancer, compared with never smokers.

The authors wrote, "Our data adds to the extensive evidence indicating that preventing smoking initiation and decreasing the duration of smoking might reduce colorectal cancer risk." 

Source: Science Daily, 14 November 2007
Link: http://tinyurl.com/2n3mof

USA: New study suggests that low-nicotine cigarettes could help smokers quit

A new study suggests that forcing tobacco companies to cut the level of nicotine in cigarettes can help smokers shake off their addiction.

It was assumed that low nicotine cigarettes would simply encourage people to smoke more. Instead, a quarter of those taking part in the study quit smoking completely, while others reduced the number of cigarettes they smoked by more than a third.

Experts had feared a reduced nicotine strategy would be self-defeating, since increasing the numbers of cigarettes smokers would then be exposed to even greater levels of dangerous tobacco chemicals.

This is already known to occur with so called mild cigarette brands which contain normal nicotine levels, but are engineered to burn faster and have ventilation holes above the filter.

The new findings provide support for plans now under discussion in Congress to allow tobacco products to be regulated in the US in the same way as medicines.

Under the proposals, the US Food and Drink Administration (FDA) would be empowered to develop and enforce standards designed to make cigarettes safer, which could include reducing nicotine yields so that cigarettes are less addictive.

In the study, adult smokers were asked to smoke their usual brand for a week. They were then put on a six week regimen of smoking cigarettes with progressively lower levels of nicotine. At the end of the six weeks, they were free to return to their usual brand and most did. But tested a month later, they were smoking forty per cent fewer cigarettes per day than they did before the study. Furthermore, a quarter of the smokers quit their habit entirely while the study was in progress.

Professor Neal Benowitz, who led the research team from the University of California at San Francisco, said: "This study supports the idea that if tobacco companies were required to reduce the levels of nicotine in cigarette tobacco, young people who start smoking could avoid becoming addicted, and current smokers could reduce or end their smoking."

Source: Channel 4, 14 November 2007
Link: http://tinyurl.com/2vbdze

India: Smoking increasing

As smoking is registering a steady decline in western countries, experts estimate that it is increasing in India.

Dr K H Kisku, head of the department of pulmonary medicine said that the World Health Organisation has estimated that there were around 94 million smokers in India.

Among the 94 million smokers in India, 14 million were suffering from Chronic Obstructive Pulmonary Disease (COPD), Dr Kisku said, on the eve of World COPD Day.

Smoking is the prime cause of COPD and the disease has been found to be the fourth leading cause of deaths, he added.

Asserting that COPD was curable, he said that one should quit smoking immediately and undergo treatment for getting better results.

Source: newindpress.com, 14 November 2007
Link: http://tinyurl.com/2wapos