Heart patients are twice as likely to quit smoking with intensive in-hospital support

A new study in CMAJ (Canadian Medical Association Journal) shows that patients admitted to a hospital with coronary artery disease are twice as likely to quit smoking after receiving intensive smoking cessation support than those receiving minimal support. 

The researchers, through a randomised clinical trial, compared intensive intervention with minimal intervention. They found that patients admitted for open heart surgery, such as coronary artery bypass grafts, had considerably higher long-term abstinence rates after one year, compared with those admitted for heart attacks, such as acute myocardial infarctions.

Other elements were instrumental in reaching successful long-term smoking cessation, including absence of a previous heart attack, postsecondary education and some type of smoking restrictions at home.

The study used an intervention that turned out to be in the highest rates of one-year confirmed smoking termination in prior tests in the US.

Education of periods of forty five to sixty minutes were used in this Canadian study, as well as counselling sessions in hospital followed by seven telephone counselling sessions with a nurse at precise intervals over two months. The patients found help in these calls in order to solve problems by developing cognitive, behavioural and social support strategies. They used those schemes when they found themselves in high-risk situations in order to go on with their smokefree status.

Dr. Patricia Smith, of Northern Ontario School of Medicine and Dr. Ellen Burgess, of the University of Calgary write: "The rates of confirmed long-term abstinence rates observed in this trial are among the highest rates reported in cardiac populations and are among the highest reported absolute differences between minimal and intensive interventions."

Source: Medical News Today, 22 June 2009
Link: http://tinyurl.com/pjg5eb

Scotland: Protect children from the allure of smoking, say doctors

BMA Scotland has warned that children who smoke face years of tobacco addiction that can lead to life-threatening diseases and premature death. 

The association also called on MSPs to support the proposals contained in the Tobacco and Primary Medical services (Scotland) Bill to reduce children’s exposure to tobacco products.

Findings in the Scottish Schools Adolescent Lifestyle and Substance Use Survey (SALSUS) published today show that, although it is illegal to sell cigarettes to children under the age of 18, 42% of 13-year-old regular smokers and 57% of 15-year-old regular smokers reported buying cigarettes from a shop.

To achieve a smokefree Scotland by 2035, BMA Scotland wants to see a robust approach to tobacco control to reduce the number of teens who smoke.

Dr Peter Terry, Chairman of the BMA in Scotland, said: "It is essential that cigarettes are made less accessible to children. Banning point of sale displays and getting rid of tobacco vending machines will go some way to doing this.

“Smoking causes lung cancer, heart disease and respiratory problems. It ages skin, makes your breath smell and stains fingers yellow. Every day doctors witness the death and despair caused by smoking.

“We need to break the tobacco trap. Young smokers will become tomorrow’s parents who smoke and they will continue the cycle of smoking-related ill-health.”

Source: Nursing in Practice, 23 June 2009
Link: http://tinyurl.com/lxmm32

TV chef Antony Worrall Thompson joins campaign for limited pub smoking

Celebrity chef Antony Worrall Thompson joined a campaign to amend the current smoking ban to bolster the pub and club industry.

The TV chef joined MPs from the three main political parties in calling for the comprehensive ban to be relaxed to help establishments losing revenue, laying off staff or facing closure.

One of the changes the group hopes will be considered is the adoption of the Spanish model - where venues with limited floor space can choose to be smoking or non-smoking, but venues larger than 100 square metres can have a designated, fully-partitioned, smoking room.

They are also proposing that smoking of tobacco be allowed in venues that can secure a licence by ensuring an agreed level of ventilation and air quality in all areas.

It is also hoped the Government could allow some discretion for local authorities in determining the nature and extent of smoking regulations.

Greg Knight, Conservative MP for East Yorkshire, David Clelland, Labour MP for Tyne Bridge and John Hemming, Liberal Democrat MP for Birmingham Yardley have all pledged their support to the campaign.

Source: Independent, 23 June 2009 
Link: http://tinyurl.com/mpbn8d

Smoking linked to brain damage

New research which suggests a direct link between smoking and brain damage will be published in the July issue of the Journal of Neurochemistry. Researchers, led by Debapriya Ghosh and Dr Anirban Basu from the Indian National Brain Research Center (NBRC), have found that a compound in tobacco provokes white blood cells in the central nervous system to attack healthy cells, leading to severe neurological damage.

The research centres on a compound known as NNK, which is common in tobacco. NNK is a procarinogen, a chemical substance which becomes carcinogenic when it is altered by the metabolic process of the body.Unlike alcohol or drug abuse NNK does not appear to harm brain cells directly, however, the research team believe it may cause neuroinflamation, a condition which leads to disorders such as Multiple Sclerosis.

Ghosh said, "Considering the extreme economical and disease burden of neuroinflammation related disorders, it is extremely important from a medical, social and economic point of view to discover if NNK in tobacco causes neuroinflammation."

To prove if such a link exists the team conducted two types of tests, one outside of a living host in glass and one in laboratory mice. The team used blot analysis techniques which showed that the introduction of NNK resulted in a clear increase in proinflammatory signaling proteins, proinflammatory effector proteins and other stress related proteins. Increased levels of proinflammatory cytokines, which act as molecular messengers between cells, were also detected.

This shows that NNK provokes an exaggerated response from the brain's immune cells, known as microglia. Microglia cells act as 'destroyers' for the brain by attacking damaged or unhealthy cells. However, when provoked by NNK these cells start to attack healthy brain cells rather than the unhealthy cells they are supposed to attack.

"Our findings prove that tobacco compound NNK can activate microglia significantly which subsequently harms the nerve cells," said Basu.
While other harmful side effects of smoking, such as lung disease, usually derive from tar or smoke this research suggests damage is not confined only to smoking. NNK is present in all forms of tobacco and therefore it can also enter the body through chewing.

The study also suggests that secondhand smoking may lead to the same neuroinflamation conditions. Concentrations of NNK in tobacco can vary from 20-310 nanograms in cigarettes. However, NNK is also present in the smoke itself, meaning that smoke-filled air indoors may contain up to 26 nanograms of NNK. This means that both direct and second-hand smoking can lead to substantial measures of NNK intake.

"This research sheds light on the processes that lead to nerve cell damage in those who smoke cigarettes or consume tobacco products on regular basis," said Ghosh.

Source: Science Daily, 23 June 2009
Link: http://tinyurl.com/n2ycnt

Scotland: Smoking, drugs and alcohol survey

A survey published today about smoking, drinking and drug use by 13 and 15 year olds underlines the need for the tough action the government is taking in these areas.

The figures show a decline in smoking by girls and a decline in the number of young people who had drunk alcohol in the last week. However, it also shows that too many young people continue to smoke, drink and take drugs.

Health Secretary Nicola Sturgeon said, "We know that too many people continue to smoke and drink too much alcohol and this survey shows that young people are no exception. That's why the government has taken swift action to help tackle these issues.

"The continued decrease in the number of teenagers who are smoking is welcome news, as is the significant rise in the number of young people who have never smoked. However, the fact that teenagers are still smoking shows the need for action.

"We have raised the age for tobacco sales to 18 and introduced proposals to remove cigarettes from open display in shops. I believe these measures will help to further reduce smoking amongst young people.

The Scottish Schools Adolescent Lifestyle and Substance Use Survey was published today and provides headline statistics on the prevalence of Smoking, alcohol and drugs misuse among 13 and 15 year olds.

Source: Wiredgov, 23 June 2009
Link: http://tinyurl.com/mlrzht