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ASH Daily news for 21 June 2010

HEADLINES

  • Study: Smoking associated with 1 in 5 strokes

    Ten risk factors including smoking have been linked to 90pc of strokes, according to an international study involving Irish researchers.

    The study was published in 'The Lancet' medical journal and involved Dr Martin O'Donnell, of NUI Galway, and Canadian researchers.

    Five lifestyle-linked factors -- high blood pressure, smoking, abdominal obesity, diet and physical activity accounted for more than 80pc of the worldwide risk of stroke.

    The findings of the Interstroke study, published in 'The Lancet', followed an examination of data from 6,000 people (3,000 stroke victims and another control group of 3,000 healthy people) in 22 countries worldwide.

    It found the risk factors were all significant for ischaemic stroke (caused by a blood clot blocking a blood vessel in the brain), whereas high blood pressure, smoking, abdominal obesity, diet, and alcohol intake were significant risk factors for intracerebral haemorrhagic stroke (bleeding into the brain tissue).

    The ratio of bad to good blood lipids (apolipoproteins) was an important risk factor for ischemic stroke but not for haemorrhagic stroke.

    Smokers were at double the risk of stroke compared with non-smokers, and smoking was associated with one in five strokes.

    Professor O'Donnell said: "The Interstroke study is the first large standardised case-control study of risk factors for stroke in which countries of low and middle income were included, and where all cases completed a brain scan (usually a CT scan).

    "Our findings showed that five risk factors accounted for more than 80pc of the global risk of all stroke (ischaemic and intracerebral haemorrhagic): hypertension, current smoking, abdominal obesity, diet, and physical activity.

    "With the addition of five other risk factors, including apolipoproteins, the population attributable risk for all stroke rose to 90pc."

    Targeted population-based interventions that reduce blood pressure and smoking, and promote physical activity and a healthy diet, could substantially reduce the global burden of stroke.

    Commenting on the study Professor Des O'Neill, geriatrician at Tallaght Hospital, Dublin, said: "This is a very important study with a global view on stroke. It is a disease predominantly of older people, and most older people now live in low- and middle-income countries. Lessons can be learned in two directions between the developed and low- and middle-income countries."
     

    Source: Independent.ie, 19 June 2010
    Link: http://bit.ly/aIflZB

  • Tobacco smuggling arrest

    A Medway man and four others are being questioned over an alleged smuggling and money laundering scam worth hundreds of thousands of pounds.

    The 41-year-old was arrested after a search of an address in Rochester by HM Revenue and Customs officers.

    The arrest is the latest in an ongoing operation that has already seen four arrests, the seizure of more than three tonnes of hand rolling tobacco and £400,000 in cash earlier this month.

    John Kay, assistant director of criminal investigation for HMRC, said: "The arrests are believed to have significantly disrupted a major smuggling scam. One of our key priorities is to identify the abuse of our tax systems by criminal gangs who smuggle illicit tobacco products into the UK for their own profit."

    Computers and other documents found at the Rochester property were taken away for further examination, together with a quantity of powder believed to be a controlled drug.

    This followed four arrests made earlier in the month and searches at an industrial premises in Surrey .

    All five were arrested on suspicion of smuggling and are currently under investigation by HMRC criminal investigators.

    Source: Kent Online, 19 June 2010
    Link: http://bit.ly/bOmCHU

  • Smoking may contribute to pelvic pain in pregnancy

    A lower risk of pelvic pain could be yet one more reason for women to quit smoking before becoming pregnant, a new study suggests.

    Danish researchers found that among 5,000 women interviewed during and soon after pregnancy, those who smoked during pregnancy were 20 percent more likely to have pregnancy-related pelvic pain than non-smokers.

    A similar risk was seen among women who had given up smoking during the first trimester, according to findings published in the obstetrics journal BJOG.

    Pelvic pain is believed to be a common problem in pregnancy, with recent studies finding that anywhere from 14 percent to 33 percent of women develop it -- most often in the second half of pregnancy.

    The pain can make routine activities, like walking, getting up from a chair or even turning over in bed, difficult. So it is important to reduce the risk of developing the pain, if possible.

    The current findings show an association between smoking and pelvic pain, but do not prove cause-and-effect. Still, there are many reasons for women to quit smoking, particularly if they are planning a pregnancy.

    So a reduction in the risk of pelvic pain can be viewed as a potential added benefit, according to lead researcher Karin Biering, of Herning Regional Hospital in Denmark.

    Smoking during pregnancy is linked to increased risks of miscarriage, low birth weight and other pregnancy complications. So the most important reason for women to quit before pregnancy is for the health of their child, Biering told Reuters Health in an email.

    "The finding of our study just adds another possible consequence of smoking," she said.

    The results are based on data from a subgroup of women included in a national study of more than 100,000 pregnancies between 1996 and 2002. Women in that study were interviewed during pregnancy and six months after giving birth.

    Biering's team compared 2,300 women who reported having pelvic pain during or shortly after pregnancy with nearly 2,700 who did not report the problem. Pelvic pain was defined as pain that was at least significant enough to affect a woman's ability to walk.

    Overall, the study found, smokers -- including those who quit in early pregnancy -- had an elevated risk of pelvic pain, even taking into account a number of other factors, such as age, obesity, the women's self-rated general health and whether they had a physically strenuous job.

    It is not clear why smoking might contribute to pelvic pain during pregnancy. In theory, it may be related to reduced blood flow to the pelvic tissue, according to Biering.

    Even if smoking is a risk factor for pregnancy-related pelvic pain, being a non-smoker is no guarantee that a woman will not develop the problem. Among women with mild pelvic pain in the current study, 73 percent were non-smokers; of those with severe pain -- pain bad enough to interfere with several daily activities -- 69 percent were non- smokers.

    Pelvic pain is a "complex" condition, Biering noted, and there are probably numerous factors involved in pregnant women's risk.

    Source: Reuters Health, 18 Juen 2010
    Link: http://bit.ly/9G9drO

  • Smoking cigarettes is a predictor of rheumatoid arthritis

    Smoking cigarettes is a significant risk factor for developing rheumatoid arthritis (RA) and may have a negative impact on the effectiveness of anti-tumour necrosis factor (anti-TNF) inhibitors in RA patients taking these treatments, according to results of two studies presented at EULAR 2010, the Annual Congress of the European League Against Rheumatism in Rome, Italy. A further study has shown that smoking interferes with the expression of several genes which, when over-expressed can contribute to processes which exacerbate disease activity.

    Results of a Swedish study1 showed that for both men and women, smoking at the time of study initiation was shown to be a predictor for future diagnosis with RA (Odds Ratio (OR) 1.55 95% CI 1.20-2.01). Socio-economic status also had an impact on the risk of developing RA with "Blue-collar workers" (those who do manual labour and earn an hourly wage) having an increased risk compared with white-collar workers (salaried professionals or educated workers).

    Dr Ulf Bergström, lead author of the study said, "The results of our study have confirmed that cigarette smoking and the type of job that people do are predictors of developing RA. Investigating the impact of socio-economic factors on the development of RA could help us to understand disease mechanisms and identify preventative strategies in the future."

    Results of a second Swedish study2 showed that smoking predicted a poor response to anti-TNFs and results of one further study undertaken in Switzerland3 showed that in experimental mice, the presence of smoke in the air induced the expression of the following genes: A 2.3 fold (p=0.02) induction of the expression of vascular endothelial growth factor (VEGF) was seen. VEGF is a growth signal that, when over-expressed, can stimulate the over-production of new blood vessels which can contribute to disease progression. •A 2.7 fold (p=0.03) induction of the heat-shock protein DNAJC6 was seen.

    Dr. Caroline Ospelt, Centre of Experimental Rheumatology, University Hospital Zurich, Switzerland said, "The results of our study show that smoking (or the presence of smoke in the air) has an effect on the expression of the same genes and causes modifications in the same proteins in both mouse models and in human beings. We hypothesise that this is because smoking alters the ability of certain proteins to elicit an immune response in those with a genetic pre-disposition to rheumatic conditions. This could be a contributing factor to the symptoms experienced and an individual's disease progression."

    Source: EurekAlert, 17 June 2010
    Link: http://bit.ly/bHJ2im

  • USA: FDA acts to prevent Philip Morris from evading the new ban on promiting cigarettes as 'Light'

    The U.S. Food and Drug Administration took strong, quick action against Philip Morris USA to prevent the tobacco company from evading the new ban on promoting cigarettes as "light," "mild" or "low-tar" that takes effect on June 22. The ban on these deceptive terms is a key provision of the new federal law giving the FDA authority to regulate tobacco products. It seeks to end a decades-long tobacco industry fraud that has falsely promoted some cigarette brands as less harmful and sought to discourage smokers from quitting.

    According to a letter the FDA sent to Philip Morris today, the company has attached "onserts" to its Marlboro Lights packs that state, "Your Marlboro Lights pack is changing. But your cigarette stays the same. In the future, ask for 'Marlboro in the gold pack.'"

    The FDA letter states, "FDA is concerned that the statements included in the onserts attached to the individual packs of Marlboro Lights may perpetuate the mistaken beliefs associated with your "light" cigarettes when marketed as Marlboro in the gold pack. By stating that only the packaging is changing, but the cigarettes will stay the same, the onsert suggests that Marlboro in the gold pack will have the same characteristics as Marlboro Lights, including any mistaken attributes associated with the "light" cigarettes."

    The FDA is correctly demanding that the company turn over all market research it has conducted or possesses on how consumers react to changes in the Marlboro Lights package, including their perceptions about the new gold packs. This will give the FDA the information it needs to take additional enforcement action if Philip Morris does not pull the onserts. Under the law, tobacco companies may not use any marketing that explicitly or implicitly suggests a cigarette brand is less harmful than others.

    In addition to the onserts, Philip Morris and other tobacco companies are using lighter-colored packaging for light brands and switched to terms such as "gold" and "silver" to replace "light" and "ultra-light" to circumvent the ban.

    We applaud the FDA's action as a crucial first step toward keeping the tobacco industry from continuing the "light" and "low-tar" deception. We call on Philip Morris to go beyond the actions called for by the FDA and immediately stop using these onserts. In fact, all tobacco companies and retailers should cease any activity that communicates to consumers that "light" or "low-tar" brands are still available. Any activity that misleads consumers into believing that certain cigarettes are safer and discourages smokers from quitting is harmful to public health.

    Source: PRNewswire, 17 June 2010
    Link: http://bit.ly/bpHWT4