Tuesday, January 19, 2010

Smoking Cessation Part 2: Public Health's Response

Now that I've discussed smoking cessation options and the cost-effectiveness of smoking cessation, it's time to bring public health into the story (of course). This post will focus on what public health does to encourage smoking cessation on a population-wide level.

Naturally, public health encourages individuals to stop smoking. CDC's website offers how to quit, the benefits of quitting, etc. But there are several big-picture strategies that public health has employed to encourage the population to stop smoking.
  1. Smoking cessation education campaigns - This method includes public service announcements, ad campaigns, etc. Smoke-Free Illinois has this ad campaign. Tobacco Free California has some great materials and website, including clever e-cards that you can send smoker friends. And check out this video from Iowa's Just Eliminate Lies video that works to eliminate tobacco companies' effects on youth.

  2. Smoking bans - Many states have enacted smoking bans to restrict smoking in public places. According to the American Lung Association, 26 states and D.C. have enacted laws banning smoking to some degree. And these bans seem to work; air pollution in restaurants and bars have decreased, and some areas have reported decreased heart attacks and other health effects, although these findings are somewhat debatable. A recent IOM report states that "smoking bans can have a substantial impact on public health."

  3. Scare tactics - Ah, the scare tactic. Yes, this fits in with #1, but it is a particular type of ad campaign. This type is sometimes employed by public health departments and other times by private non-profit organizations. The Truth campaign is probably the most well-known of these campaigns. However, this tactic may not work. A recent article stated that this public shaming technique may not be effective: "People are made to feel really, really bad about their smoking and are treated quite badly, but feel quite helpless in quitting," said Kirsten Bell, a medical anthropologist.

  4. Cigarette taxes - Taxes, the American way, right? Well, it's true in the case of cigarette taxes. Taxes on cigarettes range from $0.07 (South Carolina) to $3.46 (Rhode Island). And according to the Campaign for Tobacco Free Kids, these taxes work: For every 10 percent increase in the price of cigarettes, youth smoking decreases by 7 percent and overall smoking decreases by 4 percent. Click here for related scientific studies. And the federal tax increased in 2009 from $0.39 per pack to $1.01 per pack.
So there are a few ways public health tries to curb smoking. These along with individual smoking cessation tactics are aimed at improving the public's health overall, a noble cause.

Infectious diseases threaten the Haitian population

Now that the initial relief effort has started in Haiti, the threat of infectious disease looms. Read more here:


Plastics & chemicals: Part 2

This article states that the FDA is rethinking its stance on BPAs. Take a look and reference this posting about plastics & chemicals that I posted about a month ago.

Thursday, January 14, 2010

Smoking Cessation: Effectiveness and Cost Effectiveness

Smoking is a gigantic problem in the U.S. According to CDC, smoking is the single most preventable cause of disease, disability, and death in the U.S. Over 40 million adults smoke in this country, and 126 million adults and children are exposed to secondhand smoke. Although trends have indicated that tobacco use is on the decline, it is still a huge issue.

And it's pervasive in our society. I mean, even movies like Avatar feature characters who smoke! The WHO encourages media to limit or eliminate smokers highlighted in TV shows and movies.

If you smoke, stop! It's hard, no doubt. It takes the average smoker several times for quitting to actually stick. And here are some options to do so:
  1. Quitting cold turkey - Quitting all of a sudden and sustaining it undoubtedly requires a great deal of will and determination. Enlist your friends, family, and coworkers to help you quit.
  2. Nicotine fading - This method involves reducing your tobacco intake slowly until you eventually quit. This option is inexpensive, easy, and reduces the potential for withdrawal.
  3. Nicotine replacement therapies (NRTs) - These therapies include nicotine gum and nicotine skin patches, and they are recommended with reservations as part of a "comprehensive smoking cessation program."
  4. Finally, there are prescription medications such as Zyban that help people stop smoking.
  5. Support groups and counseling can also help greatly when combined with other methods.
Insurance companies are covering smoking cessation aids more and more, recognizing the cost effectiveness of helping their patients quit. The benefits and cost effectiveness are overwhelming. One article states, "The results of existing economic evaluations consistently indicate that smoking cessation interventions are relatively cost-effective in terms of cost per life-year saved." An article in JAMA also suggests smoking cessation is cost-effective. Based on a study of various interventions, the study found that smoking cessation is a particularly cost-effective intervention, compared with other preventive health interventions. "The more intensive the intervention, the lower the cost per QALY [quality-adjusted life year] saved, which suggests that greater spending on interventions yields more net benefit."

And that smoking cessation is cost-effective just makes common sense! "If you’re paying about 10 bucks a day for a pack of cigarettes in New York City, that adds up to about $6,000 over two years," said Thomas Glynn, of the American Cancer Society. "You could check yourself into the in-patient program at Mayo Clinic for that," he says in this recent New York Times article.

Of course, the tobacco industry is ridiculously powerful. This webpage (albeit a little extreme) showcases tobacco companies and their truths. Another site also highlights the pervasiveness of tobacco companies. Tobacco companies claim to aid in smoking cessation, but from their business's perspective, why should they? If smokers across the country quit, they buy fewer cigarettes, and their profits decrease, equaling no more company. It's in their financial interest to keep smokers smoking!

The bottom line: Tobacco use is a problem in the U.S. Quitting benefits your health and it is cost effective to do so. Resolve to quit today!

Here are more resources:

Update to Google Flu

Google Flu updated recently to now include 121 cities across the country. Interesting.

Food Safety iPhone Apps

This article in Food Safety News talks about iPhone apps for food safety. Hm, I guess every market can find an iPhone niche!

  • Food Watch New York City: This app uses data from the NYC Department of Health & Mental Hygiene to give inspection ratings for restaurants nearby, as determined by the phone's GPS.
  • Locavore: This one keeps you apprised of local food available near you. It also locates farmers' markets, tells you when fruits & vegetables are coming into season, and links to Wikipedia and Epicurious sites.
  • Still Tasty: This app tells you the shelf life of your produce, products, and groceries. It tells you the expiration date of your foods, including an alert function. Finally, it tells you how long you can keep various types of foods in the fridge or freezer.
  • Good Guide: Good Guide helps you find safe, healthy, sustainable products by scanning the barcode. You can find product ratings, and the health/environmental/social performance of various brands.
Happy shopping and eating!

Thursday, January 7, 2010

Vaccines and herd immunity

Vaccines - ah, that long-controversial topic. Well, vaccines have resurfaced in the news this week. Some news about vaccines that might be of interest to you:
  • A recent study from CDC shows that more U.S. kids are immunized and that disparities among socioeconomic groups are decreasing. "While these disparities persisted through the study period, they did get smaller, and racial and urban/suburban/rural disparities were no longer statistically significant by 2008." Of course, "additional work is needed to make sure that the underserved groups of children are vaccinated and protected against vaccine preventable diseases," says the author of the study.
  • The American Academy of Pediatrics has released its 2010 immunization schedule for children. Changes include the addition of a recommendation to get the influenza A (H1N1) vaccine and revaccination for meningococcal disease.
  • This article in USA Today explains the concept of herd immunity and its importance. It includes the standard USA Today human interest components (too much for my tastes), but it is a good snapshot of immunizations and their importance among the community. Nationally, 1.48% of children have exemptions from school immunization requirements, but this number is much higher in certain parts of the U.S. A recent study found that children who are unvaccinated are 9 times more likely to contract chicken pox and 23 times more likely to contract whooping cough.
    The article states, "before vaccines became available, hundreds of thousands of Americans — including thousands of children — routinely came down with dreaded infectious diseases each year. Although vaccines have nearly eliminated many of these diseases, doctors say outbreaks in unvaccinated communities put everyone at risk."