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ASH Daily news for 04 August 2010

HEADLINES

  • Prenatal cigarette exposure increases risk for psychiatric illness into adulthood

    The risk for psychiatric illness is significantly higher in young adults exposed to cigarette smoke in the womb relative to those without prenatal cigarette smoke exposure, even after adjusting for maternal psychiatric illness and other confounding factors, according to a Finnish study reported in the August issue of the Archives of General Psychiatry.

    "This association seemed to be robust because it could be found in a large group of diagnoses and the dose relationship was also strong," first study author Mikael Ekblad, BM, of University of Turku, Finland, and colleagues note in the article.

    Prenatal smoking exposure impairs fetal growth and modulates brain development, which may alter mental development of the offspring, they point out.

    The researchers used population-based, longitudinal registry data to evaluate the effects of prenatal smoking exposure on psychiatric morbidity among 175,869 Finnish young adults born from January 1, 1987, through December 31, 1989, with follow-up lasting 18 to 20 years. They had information on mothers' smoking habits (self-reported) during pregnancy and other relevant background factors, as well as psychiatric history of mothers and offspring.

    Smoking during pregnancy was reported by 26,075 mothers (15.3%). Of these, 8866 (34.0%) smoked more than 10 cigarettes a day. In 5487 children (3.2%), maternal smoking history was unknown.

    The prevalence of any psychiatric diagnosis was 15.0% after excluding the children with unknown maternal smoking history. The prevalence was 13.7% in unexposed children (the reference group), 21.0% in those exposed to fewer than 10 cigarettes a day and 24.7% in those exposed to more than 10 cigarettes a day.

    Prenatal smoke exposure significantly increased the risk for most of the psychiatric diagnoses, with the exception of schizophrenia and anorexia diagnoses, the study authors report. The strongest effects were seen for psychiatric disorders due to psychoactive substance use and behavioral and emotional disorders. The lack of a statistically significant finding for schizophrenia may be due to a fairly low number of cases in the study.

    There were 870 total deaths in the study population (5.7 per 1000), of which 64 (7.4%) were suicides (excluding children with unknown maternal smoking data). After adjusting for confounding factors, young adults exposed to >10 cigarettes a day during gestation had a significantly increased risk for early death compared with unexposed young adults. The mortality rate per 1000 children was 4.7 for unexposed children vs 6.3 and 9.1 for exposure to <10 and >10 cigarettes per day, respectively.

    Commenting on the study for Medscape Medical News, David M. Fergusson, PhD, of the Department of Psychological Medicine, Christchurch School of Medicine & Health Sciences in New Zealand, who was not involved in the study, said, "The results are generally consistent with previous research that has suggested that maternal smoking may be associated with increased risks of at least some mental disorders."

    In their report, Dr. Ekblad's team points to several study strengths, including a large national study population; the ability to control the child's outcome for maternal mental illness, which has not been done previously in similar large epidemiologic studies; and adjustment for a wide range of background factors, such as 5-minute Apgar scores, the child's birth weight, maternal age, and the mother's psychiatric morbidity before the child's birth.

    Limitations of the study include lack of information on alcohol and illicit drug use during pregnancy; self-reported maternal smoking history; potential concern about accuracy of diagnoses; and lack of socioeconomic data, such as parents' educational level and exposure to passive smoke in the home, which can affect risk for psychiatric problems.

    "The study," Dr. Fergusson noted, "adds to previous research by being based on a large population (but) is limited by the use of official record data."

    The control of confounding factors is "limited," he added, "raising the possibility that the findings may reflect the presence of other factors, which are associated with pregnancy smoking. A further limitation is that the mechanisms by which pregnancy smoking may lead to increased risks of a wide range of mental disorders are by no means clear."

    Nonetheless, Dr. Fergusson said this new study further reinforces public health messages regarding the adverse effects of smoking during pregnancy. "It is well known that pregnancy smoking increases the risk of miscarriage, stillbirth, and low-birth-weight infants. The present findings raise the possibility that exposure to pregnancy smoking may have adverse effects on longer-term mental health of offspring," he noted

    Source: Medscape Today, 03 August 2010
    Link: http://bit.ly/aXFPiz

  • Researcher finds that our brain can be taught to control cravings

    Standard therapeutic techniques decrease cravings of cigarette smokers by regulating activity in two separate but related areas of the brain, a new study led by a Yale University researcher shows.

    Smokers who are taught cognitive strategies, such as thinking about the long-term consequences of smoking, show increased activity in the prefrontal cortex, an area of the brain associated with cognitive control and rational thought. They also show decreased activity in areas of the striatum, an area of the brain associated with drug craving and reward-seeking behavior, according to the paper published online Aug. 2 in the Proceedings of the National Academy of Sciences.

    "This shows that smokers can indeed control their cravings, they just need to be told how to do it," said Hedy Kober, assistant professor of psychiatry at the Yale School of Medicine and lead author of the paper.

    Cravings are the triggers that often lead to relapse in a host of addictions, which carry a staggering economic and social cost. Cigarette smoking alone is responsible for over 400,000 deaths per year in the U.S. (more than all illicit drugs and alcohol combined). Some experts predict that substance abusers should show impairments in areas of the prefrontal cortex, which among other functions helps control emotion. But in smokers at least, this does not appear to be the case. This area of the brain showed increased activity - and smokers reported less intense cravings - when using cognitive strategies.

    Cognitive behavioral therapy has been shown to be an effective tool in treating a variety of mental health disorders, including substance use disorders. The new study shows why this approach is effective, Kober said.

    "We do not see any impairment in the prefrontal cortex, which suggests the brain is able, when prompted, to recruit control regions to reduce cravings," Kober said.

    Kober and colleagues are investigating whether they can replicate the findings in subjects who use other types of drugs.

    The senior author of the paper is Kevin Ochsner of Columbia University. Researchers from Princeton University, the University of Michigan, and the New York State Psychiatric Institute also contributed to the paper. The work was funded by the National Institute of Drug Abuse.

    Source: Medical News Today, 03 August 2010
    Link: http://bit.ly/aoPraP

  • Staffordshire: Quit smoking for Ramadan

    Muslim smokers have been urged to kick the habit during Ramadan.

    The Co-operative Pharmacy is offering a tailored quit service in areas with a high proportion of Muslim customers during the fast.

    A total of 82 pharmacies are looking to help residents manage their medicine consumption over Ramadan.

    And they are also saying it will be an ideal time to quit smoking as many will already be abstaining during the fast.

    The Muslim Council of Great Britain supports the initiative and urges patients not to alter medication during the Ramadan.

    Mandeep Mudhar, Co-operative Pharmacy's head of NHS development, said: "Last year we were able to help a significant number of Muslim people intending to fast during Ramadan."

    Source: thisisstaffordshire, 03 August 2010
    Link: http://bit.ly/cJ6F46

  • Australia: Big tobacco bankrolls anti-Labor ad campaign

    The big tobacco companies are fighting back against the Government's plans to introduce plain cigarette packaging by funding small retailers in a massive advertising campaign timed to coincide with the final weeks of the election campaign.

    The Alliance of Australian Retailers (AAR) has taken out full-page advertisements in tomorrow's papers criticising the plan, which they argue will hurt small business and lead to job losses.

    The Daily Telegraph is reporting that the $5 million campaign has been devised by former Liberal Party strategists and Howard government advisers.

    But this morning Opposition Leader Tony Abbott said the Liberal Party had "absolutely nothing to do with any sort of pro-smoking campaign."

    "As far as I am concerned, if we are returned on August 21 we will certainly consider going ahead with the Government's plain packages for cigarettes," he said.

    And the firm Crosby Textor has issued a statement saying reports that it is connected to the campaign are wrong.

    The newly-formed AAR has 19,000 members representing corner stores, petrol stations, and newsagents.

    It opposes the Labor Government's policy to force retailers to sell all cigarettes in plain packets, devoid of colour, special fonts and branding, by 2012.

    AAR spokeswoman Sheryle Moon says small businesses depend on cigarette sales.

    "Plain packaging is not a proven policy," she said. "There's no credible evidence that this policy will stop people smoking, that it will stop kids, young people, taking up cigarette smoking.

    "It will just make it more difficult for retailers to do their business."

    Ms Moon says the retailers are taking out full-page advertisements in the daily newspapers to express their discontent.

    "I've got to put [the cigarette packets] away on a shelf," she said. "[Plain packaging makes] it difficult to do that - I can't identify necessarily which product is which product because it is harder to see them, they're not identified, they all look very similar.

    "If I'm serving customers it's difficult for me to find the right product for the customer. All those increase my transaction times and make it more difficult for me to run my business efficiently."

    The ABC's Lateline program last night revealed that the big tobacco companies are helping fund the campaign.

    "We're quite open about our funding arrangements so the three cigarette manufacturers are providing financial support to the alliance," Ms Moon said.

    "That's not what the issue is; the issue is not about the funding.

    "The issue is about making sure we have policy that is evidence based."

    Health Minister Nicola Roxon says Opposition Leader Tony Abbott must explain any Liberal Party involvement in the campaign.

    "This is an unprecedented intervention by big tobacco into an election campaign and I think Mr Abbott needs to come clean on whether he's made any commitments to his friends in big tobacco to convince them to take this unprecedented step," she said.

    Mike Daube from the Australian Council on Smoking and Health says the advertising campaign is an outrageous effort by the global tobacco industry to influence the Australian election.

    "This is a lethal industry using its financial muscle to keep people smoking," he said.

    "What this really tells us is just how effective they fear plain packaging will be. The real reason they're running this big campaign is they're worried that if it happens in Australia it's going to happen elsewhere."

    Professor Simon Chapman, from the school of public health at the University of Sydney, says Australia would be the first country to introduce plain packaging.

    "The international tobacco industries are scared stiff about this," he said.

    "They've had international conferences about it, they've had cover stories on their trade magazines, they've bunkered down they've worked out that they really have to try and get on top of this issue in Australia."

    "Because it will domino all around the world."

    Professor Chapman says it is an absurd argument that small retailers will lose money because someone gives up smoking.

    "Ex-smokers don't stop spending their money, they don't take their money that they would have otherwise spent on cigarettes home and put it in a jam jar under their bed, they go to the shop and they buy other things with it," he said.

    Source: ABC News, 04 August 2010
    Link: http://bit.ly/dDkzfh

  • BAT Kenya to start producing semi-processed tobacco

    British American Tobacco Kenya Ltd., East Africa’s biggest cigarette maker, will start producing and exporting semi-processed tobacco this month, Managing Director Gary Fagan said.

    Output of semi-processed tobacco is expected to grow by as much as 70 percent next year, Fagan told reporters in the capital, Nairobi, today.

    The company has invested 350 million shillings ($4.37 million) in machinery for the new venture that is expected to have a three-year payback period.

    Sales are forecast to grow 6 percent in the second half of the financial year, he said.

    “Barring unforeseen eventualities we are optimistic that second-half performance will also be good,” he said.

    The company’s sales in the first half to June grew 6 percent to 10.9 billion shillings as market share expanded by 1.2 percent, he said.

    British American Tobacco Kenya shares climbed 2 shillings, or 0.8 percent, to 250 shillings as of 9:43 a.m. in Nairobi. A close at this price would be the highest since Jan. 12, 2007.

    Source: Bloomberg Businessweek, 03 August 2010
    Link: http://bit.ly/a9U4fE