Category Archives: Lungs & Breathing

Antibiotics don’t prevent complications of kids’ respiratory infections

Three red and white capsulesBy Milly Dawson
HBNS Contributing Writer
FEB 18, 2014

Antibiotics are often prescribed for young children who have upper respiratory tract infections (URIs) in order to prevent complications, such as ear infections and pneumonia, however, a new evidence review in The Cochrane Library found no evidence to support this practice.  Continue reading

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App lets you determine your neighborhood’s radon risk

Screen Shot 2014-01-21 at 11.28.29From the Washington State Department of Health

Olympia, January 21, 2014 – Washington residents now have a new online map to check and see if their neighborhood has a geological risk for the cancer-causing gas, radon, using a new state app. The new app is offered by the state Department of Health’s Washington Tracking Network.

Some areas of the state, such as Spokane and Clark counties, are well-known for having higher levels of radon, but the new online map shows that there are some areas around the Puget Sound such as Pierce and King counties that might come as a surprise.  Continue reading

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Something odd about your cigarette? FDA wants to hear about it

Consumer Update from the FDA

Cigarette SmokeAre you using a tobacco product that you believe is defective or is causing an unexpected health problem?

Are you using a tobacco product that has a strange taste or smell?

The Food and Drug Administration (FDA) wants to hear from you and has a new online tool you can use to report your problem. Continue reading

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lesson one

Oregon schools use ‘behavioral vaccine’ to reduce smoking

Blackboard with "Lesson one" written on it.

Photo: Krzysztof “Kriss” Szkurlatowski

By Kristian Foden-Vencil
Oregon Public Broadcasting

Behaving well in elementary school could reduce smoking in later life. At least, that’s what Trillium Community Health Plan hopes, and it’s putting money behind the idea.

Danebo Elementary in Eugene, Ore., is one of 50 schools receiving money to teach classes while integrating something called the “Good Behavior Game.”

Teacher Cami Railey sits at a small table, surrounded by four kids. She’s about to teach them the “s” sound and the “a” sound. But first, as she does every day, she goes over the rules.

“You’re going to earn your stars today by sitting in the learning position,” she says. “That means your bottom is on your seat, backs on the back of your seat. Excellent job, just like that.”

For good learning behavior, like sitting quietly, keeping their eyes on the teacher and working hard, kids get a star and some stickers.

Railey says the game keeps the kids plugged in and therefore learning more. That in turn makes them better educated teens and adults who’re less likely to pick up a dangerous habit, like smoking.

The Washington, D.C., nonprofit Coalition for Evidence Based Policy says it works. It did a study that found that by age 13, the game had reduced the number of kids who had started to smoke by 26 percent — and reduced the number of kids who had started to take hard drugs by more than half.

The fact that a teacher is playing the Good Behavior Game isn’t unusual. What is unusual is that Trillium is paying for it. Part of the Affordable Care Act involves the federal government giving money to states to figure out new ways to prevent people from getting sick in the first place.

So Trillium is setting aside nearly $900,000 a year for disease prevention strategies, like this one. Jennifer Webster is the disease prevention coordinator for Trillium Community Health, and she thinks it’s a good investment.

“The Good Behavior Game is more than just a game that you play in the classroom. It’s actually been called a behavioral vaccine,” she says. “This is really what needs to be done. What we really need to focus on is prevention.”

Trillium is paying the poorer schools of Eugene’s Bethel School District to adopt the strategy in 50 classrooms.

Trillium CEO Terry Coplin says changes to Oregon and federal law mean that instead of paying for each Medicaid recipient to get treatment, Trillium gets a fixed amount of money for each of its 56,000 Medicaid recipients. That way Trillium can pay for disease prevention efforts that benefit the whole Medicaid population, not just person by person as they need it.

“I think the return on investment for the Good Behavior Game is going to be somewhere in the neighborhood of 10 to one,” Coplin says.

So, for each dollar spent on playing the game, the health agency expects to save $10 by not having to pay to treat these kids later in life for lung cancer because they took up smoking.

Coplin concedes that some of Trillium’s Medicaid recipients will leave the system each year. But he says prevention still makes medical and financial sense.

“All the incentives are really aligned in the right direction. The healthier that we can make the population, the bigger the financial reward,” he says.

The Oregon Health Authority estimates that each pack of cigarettes smoked costs Oregonians about $13 in medical expenses and productivity losses.

Not all the money Trillium is spending goes for the Good Behavior Game. Some of it is earmarked to pay pregnant smokers cold, hard cash to give up the habit. There’s also a plan to have kids try to buy cigarettes at local stores, then give money to store owners who refuse to sell.

This story is part of a reporting partnership that includes NPROregon Public Broadcasting and Kaiser Health News

Photo courtesy of Krzysztof “Kriss” Szkurlatowski

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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As Washington delays, states move on e-cigarettes

eBy Jake Grovum
Stateline Staff Writer

Money grab, health concerns, or both? Absent guidance from Washington, states are pressing ahead with their own agendas on electronic cigarettes.

Heading into legislative sessions next year, policymakers, industry representatives, health advocates and tax wonks expect electronic cigarettes — or e-cigarettes for short — to be among the top issues at state capitols.

Legislatures are expected to tackle how to classify, regulate and, perhaps most importantly, tax the relatively new products.

The debates in states come as the federal government considers its own answers to similar questions. The Food and Drug Administration is considering classifying e-cigarettes as “tobacco products,” which would extend its reach and potentially subject e-cigarettes to a host of rules and regulations that apply to tobacco cigarettes.

“States are scrambling to figure out how to deal with this,” Ohio Attorney General Mike DeWine said in an interview. “It’s going to be fought out in 50 states; it’s going to be fought out in one jurisdiction after another.”

DeWine was a lead author of an Oct. 23 letter sent by 40 attorneys general to the FDA pushing for federal rules and for e-cigarettes to be treated as “tobacco products” for regulatory purposes.

So far, Washington hasn’t decided how to proceed with e-cigarettes. A proposed rule, expected to be released for public comment in November, was delayed by the government shutdown and is still pending.

That has left a patchwork of rules, regulations and product definitions across the nation, often at the urging of anti-tobacco advocates. “We think it’s really important that states act,” said Danny McGoldrick, vice president of research at the Campaign for Tobacco-Free Kids.

More than half the states, for example, have banned the sale of e-cigarettes to minors, but others have no restrictions. Currently four states — Utah, North Dakota, Arkansas and New Jersey — have lumped the products in with tobacco under indoor smoking bans, even as research about possible ill-effects from second-hand vapor smoke, if there even are any, remains limited.

Some local governments have taken similar steps on their own, enacting rules for e-cigarettes that sometimes go beyond those in place at the state level.

The intensity of the debate illustrates both the lack of good research on e-cigarettes as well as the money at stake. Often, those considering limits don’t even agree on whether applying tobacco regulations is appropriate, given how different the products are. Like tobacco cigarettes, nicotine levels in the “cartridges” that are loaded into the e-cigarette device can vary widely, complicating efforts to agree on a standard approach to regulation and taxation.

E-cigarettes first appeared about a decade ago, and sales have grown exponentially in recent years. The number of American adults who said they have tried them doubled to one in five in just one year (from 2010 to 2011), according to a Centers for Disease Control survey.

Use among middle and high school students also doubled from 2011 to 2012, according to the CDC, with nearly 1.8 million students saying they’ve used them.

E-Cig Revenue

In an era of revenue-hungry state governments — some still dealing with declining revenue from traditional tobacco taxes and recovering from the Great Recession — taxing e-cigarettes seems likely to get the most attention from state lawmakers in 2014. Questions of advertising limits, health claims and ingredient disclosure will likely remain federal issues.

So far, only Minnesota has put in place a specific state tax policy for e-cigarettes, a decision reached in 2012. The products are subject to a 95 percent tax that functions like a sales tax, tacked onto the wholesale cost of the product.

That generally means they are taxed at a higher rate than traditional cigarettes, which are subject to a $1.29-per-pack levy. The state expects to collect $1.16 billion from all tobacco taxes in the 2014-2015 fiscal year.

For now, most other states apply only a sales tax – if they have one – to e-cigarettes. But at least 30 others are considering e-cigarette taxes of some kind next year.

“I will be watching to see if more proposals like Minnesota are replicated in the states,” said Scott Drenkard of the Tax Foundation, an anti-tax research group, “But I hope they are not.”

What this is is a money grab.

As tax experts see it, there’s little rationale aside from simply raising revenue for taxing e-cigarettes as traditional cigarettes. Tobacco, they say, is taxed because it produces negative health consequences that cost the public. For now, there’s little research that shows similar effects from e-cigarettes.

“There is zero, emphasis on zero, justification for taxing e-cigarettes right now,” said David Brunori of the group Tax Analysts, a nonprofit tax analysis group that provides insight to private firms and government agencies. “What this is is a money grab. It’s a way of trying to find revenue to replace lost tobacco taxes.”

According to the nonpartisan Tax Policy Center, state and local tax revenues have somewhat leveled off in recent years as smoking has declined. Collections grew from $7.7 billion in 1997 to $15.8 billion in 2007, but reached just $17.6 billion in 2011, the most recent year available.

Tobacco companies that don’t produce e-cigarettes have often pushed tax parity so their own products are not at a disadvantage. In Minnesota’s case, the state simply said that under its laws, the tax must apply.

But the most popular argument is deterrence—higher taxes might make the product less attractive and less affordable to young people looking for nicotine.

“It has nothing to do with revenue,” Ohio’s DeWine said. “It has everything to do with discouraging use.”

An Alternative to Tobacco

Discouraging use, however, is exactly the opposite goal lawmakers should have, said Ray Story of the Tobacco Vapor Electronic Cigarette Association. It’s an opinion shared by some outside of the industry as well, especially with regard to those already smoking.

“Cigarettes are sold everywhere in the world, and we want to make sure that the e-cigarette is sold as a less-harmful alternative right there next to it,” Story said.

“We should expand the use, not restrict it,” he added, saying that if e-cigarettes can greatly reduce cigarette use the industry “will have made the greatest impact on humanity ever.”

The contrasting approach reflects two key differences in thinking about e-cigarettes: as a new recreational product similar to tobacco cigarettes, or as a potentially less-unhealthy alternative that could even help smokers quit entirely.

E-cigarette producers themselves are divided. Some welcome traditional cigarette-style regulations to a degree, content to play by similar rules as tobacco producers, especially if it saves them from more onerous limits applied to drug manufacturers, for example. Others argue that even thinking about e-cigarettes through the same frame of reference as tobacco is a flawed approach.

Federal officials in Washington will likely be the ones to eventually settle the dispute, and that decision could still be months away. Meanwhile, debates in the states over two key issues within their control – taxes and sales to minors – are likely to rage in 2014.

But the eventual decision from the FDA is sure to affect those debates. “If the FDA says these are essentially tobacco products,” said Brunori of Tax Analysts, “that will give all kinds of cover to state politicians.”

Stateline logo

Stateline is a nonpartisan, nonprofit news service of the Pew Center on the States that provides daily reporting and analysis on trends in state policy.

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When temperatures dip, air quality often does as well

Illustration of the lungs in blueFrom the Washington State Department of Health

You may have noticed spectacular evening skies this winter, yet those sunsets frequently are a sign of air quality problems that occur this time of year. Winter weather patterns can trap air pollution – especially from wood stoves and fireplaces – near the ground, where it can build-up and may threaten people’s health.

The state Department of Health is reminding people air pollution can be harmful to their health. It can be especially harmful for people who have a lung condition like asthma, chronic obstructive pulmonary disorder (COPD), or with heart disease.

Air pollution has fine particles that can cause immediate and long-term health effects when inhaled. It’s a good idea to check local air conditions and limit outdoor activities when air quality conditions are poor.

The amount of air pollution that causes immediate health problems varies from person-to-person. For people who are sensitive to air pollution, even a short outdoor stroll can cause wheezing or shortness of breath.

Others may not have problems until they do more strenuous activities like yard work, running, or shoveling snow. Kids and adults over 65 are among those who should limit their activity during periods of poor air quality.

Air pollution often can’t be seen or smelled, but the state Department of Ecology monitors air conditions and posts them online across the state. More information and statistics on air quality in your community can be found on our website.

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Seattle hookah bars violating laws banning public smoking, King County health officials say

Public Health – Seattle & King County has found that six Seattle hookah bars are violating the state’s law banning public smoking and ordered them to stop allowing smoking on their premises.

Here’s the announcement from Public Health – Seattle & King County

Six Seattle hookah bars receive order for violating public smoking law

Six hookah bars in Seattle are on notice for violating Washington’s Smoking in Public Places law. Public Health – Seattle & King County sent each of the establishments a Notice and Order on Tuesday, October 1, requiring them to stop allowing smoking.

To protect public health, state law requires that all places of employment and public places are smoke-free.

Health inspectors visited the hookah bars multiple times. They found patrons smoking and each of the bars operating as a public place and/or place of employment.

“Our investigation shows that these hookah bars are violating the law, and endangering the health of their workers and patrons. We are forced to take this enforcement action because they haven’t been responsive to our previous warnings,” said Dr. David Fleming, Director and Health Officer for Public Health – Seattle & King County. “Secondhand smoke is a proven killer, and state law works to protect everyone from this health threat.”

Hookah bars have claimed that they are exempt from the indoor smoking law because they are private clubs. However, smoking is prohibited by law if a club has employees and/or the club is open to the public.

The investigation found that these six bars are all open to the public, operating similarly to night clubs that charge a cover for admission.

Each of the establishments received multiple warnings from inspectors, but they have not complied with Washington law. The Notice and Orders require immediate compliance plus payment of fines and fees.

The fine for each violation is $100, in addition to escalating re-inspection fees after the first warning. Subsequent violations will result in additional steps to ensure that state law is followed, including possible court action.

Hookah is a water pipe commonly used to smoke tobacco. Research shows that hookah smoking is at least as harmful as cigarette smoke, even when mixed with sweet fruit and candy flavors.

The establishments have ten days from receipt of the Notice and Order if they wish to appeal or 30 days to pay the fines and re-inspection fees.

Hookah bars receiving a Notice and Order this week include:

 

Lounge Address
Casablanca Shisha Lounge 1221 S Main St

Da Spot Hookah Lounge

1914 Minor Ave
Medina Hookah Lounge 700 S Dearborn St
The Night Owl 4745 University Way NE
Sahara Hookah Lounge 7523 Lake City Way NE
Seattle Hookah Lounge 4701 Roosevelt Way NE

 

Hookah health threat

Tobacco use remains the number one cause of preventable death and disease in King County, costing nearly 2,000 lives and $343 million dollars in health costs and lost wages locally every year.

  • Tobacco is placed inside the bowl at the top of the hookah.

    Tobacco is placed inside the bowl at the top of the hookah.

    Hookah is a water-pipe commonly used to smoke tobacco, often mixed with sweet fruit and candy flavors.

  • Research shows that hookah smoking is not a safe alternative to cigarettes and that hookah smoke is at least as harmful as cigarette smoke.
  • During a typical 45-minute session of hookah use, a person may inhale as much smoke as smoking 100 cigarettes or more.
  • Hookah smoke contains the addictive drug nicotine, along with tar, carcinogens, and heavy metals.
  • Hookah smoking has been associated with lung cancer, oral cancer, heart disease, respiratory illness, periodontal disease, and low birthweight.
  • Sharing a hookah mouthpiece can transmit infectious diseases, including tuberculosis.

Hookah and youth

Hookah use has seen a rise in popularity, especially among youth. According to the 2012 Healthy Youth Survey, hookah use among King County high school seniors is higher than cigarette use (15% and 12%, respectively).

‘We are very concerned about the high hookah use rates among youth,” said Scott Neal, Tobacco Prevention Program Manager for Public Health – Seattle & King County. “Sweet fruit and candy flavors lure youth and help fuel the misperception that hookah smoking is safer than cigarettes.”

Report smoking law violations

To report violations, visit the Tobacco Prevention Program page for an online form; or text the establishment’s name, date of violation, and brief description of the violation to  206-745-2548.

 

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tacuin women

Women’s Health – Week 3: Asthma

From the NIH Office of Research on Women’s Health

tacuin womenAsthma is a chronic (long-term) lung disease that inflames and narrows the bronchioles or airways. People of all ages have asthma, but it most often starts in childhood.

Asthma causes recurring periods of wheezing (a whistling sound when you breathe),  chest tightness,  shortness of breath,  and coughing. The coughing often occurs at night or early in the morning.

Many people with asthma are allergic to airborne allergens. It is believed that allergens (mostly those found indoors),  when inhaled, cause inflammation in the airways in the lungs. Inflamed airways are more sensitive to allergens,  but also extremely sensitive to irritants and to some viral infections.

Allergens,  irritants,  and viral infections can trigger asthma attacks. During an asthma attack,  the muscles surrounding the walls of the airways in the lungs constrict and narrow the airways.

Also, the inside walls of the airways become swollen, making the airways even narrower. The constricting and swelling of the airways prevent air from flowing freely through the lungs.

In a severe asthma attack,  the airways can close so much that not enough oxygen gets to vital organs like the heart and brain. These severe attacks are considered medical emergencies.

If your asthma is not well controlled, then you may miss school, work, and other activities.

asthma_v01

A diagram of the lungs showing the difference between normal airways, or bronchioles, and asthmatic bronchioles.

Symptoms of asthma include:

  • Difficulty breathing.
  • Wheezing.
  • Coughing.
  • Tightness in the chest.

Even when you feel fine,  you still have the disease and it can flare up,  especially when you breathe in allergens or irritants from the environment. These are called triggers.

Some common asthma triggers include:

  • Allergens such as animal dander from the skin,  hair,  or feathers of animals;  dust mites (contained in house dust);  cockroaches;  pollen from trees and grass;  and mold (indoor and outdoor).
  • Airborne irritants including smoke,  strong odors or scents,  and pollution.
  • Cold air,  changes in weather,  and exercise.
  • Workplace chemicals or allergens.
Asthma and pregnancy
Pregnant women who have asthma need to control the disease to ensure their fetus gets enough oxygen. Poor asthma control raises the chance that a baby will be born early,  have a low birth weight,  and be at risk of death. Studies show that it is safer to take asthma medicines while pregnant than to risk having an asthma attack. But you need to carefully review these medicines with your health care provider.

Asthma cannot be cured. With proper treatment,  most people who have asthma can control their asthma and be active all day and sleep well at night. You can control your asthma with these key actions:

  • Work with your health care provider to make a written action plan that describes how you can manage your asthma day-to-day. Be sure to ask questions and discuss any concerns about your asthma treatment. This way,  you and your health care provider can work together on a plan that is best for you.
  • Take your medications as directed. Everyone with asthma needs a quick relief medication for symptoms. Many patients need daily long-term control medication. Most of these patients use inhaled corticosteroids,  but some may need additional medications.
  • Avoid or control allergens or irritants that make your asthma worse. Your health care provider will help you learn which triggers affect you the most and how to avoid or control them.
  • Get regular asthma checkups to monitor your asthma control and see if your treatment should stay the same or be changed. Visits at least every 6 months are recommended because asthma varies from season to season and can change over time (for example,  as a child grows older or if a woman is pregnant).
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Protect babies from whooping cough – CDC infographic

protect-babies-from-whooping-cough

Protect Babies from Whooping Cough (Text Version)

If you’re pregnant get a Tdap shot!

Whooping cough is deadly for babies

[Picture of a nurse holding a baby beside a hospital]
Whooping cough (pertussis) is a respiratory infection that can cause severe coughing or trouble breathing.
About half of infants who get whooping cough are hospitalized!
[picture of arrow saying “1 out of 2” pointing to hospital]
Whooping cough cases across the U.S. have been on the rise since the 1980s.

Pregnant women need to get a Tdap shot

[Picture of a pregnant woman talking to a mother holding a baby]
Pregnant woman: I got my whooping cough vaccine and will encourage everyone caring for my baby to get a shot, too!
Mom: This vaccine helps protect you from whooping cough and passes some protection to your baby.

Create a circle of protection around your baby

4 out of 5 babies who get whooping cough catch it from someone at home*
[Picture of a baby surrounded by his parents, brother and sister, grandparents, and childcare providers]
Everyone needs whooping cough vaccine:

  • Parents
  • Brothers & sisters
  • Childcare providers
  • Grandparents

* When source was identified

Make sure your baby gets all 5 doses of whooping cough vaccine on time

Your baby needs whooping cough vaccine at:

  • 2 months
  • 4 months
  • 6 months
  • 15 thru 18 months
  • 4 thru 6 years

You can get whooping cough vaccines at a doctor’s office, local health department, or pharmacy

[Picture of a nurse and a doctor]
Like it? Tell a friend! It’s important! Pinit! Tweet it! Share it on Facebook!
[Picture of parents with a newborn baby and young daughter]
www.cdc.gov/whoopingcough

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention

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Illustration of the lungs in blue

GOP lawmakers press Sebelius to help child awaiting lung transplant

sebelius100px

Sebelius

By Mary Agnes Carey

A child in desperate need of a lung transplant clinging to life. Long waiting lists of patients who need organs and too few donors to meet the demand.  Rules that govern who gets what life-saving organs – and when.

Department of Health and Human Services Secretary Kathleen Sebelius had to confront all those issues on Tuesday when Republican lawmakers asked her repeatedly why she would not use her authority to make sure a 10-year-old Pennsylvania girl gets a lung transplant that could save her life.

Sarah Murnaghan, who is suffering from end-stage cystic fibrosis, needs a lung transplant or will die in two to three weeks.

Current organ donation rules make her ineligible for an adult lung and there are fewer children’s lungs that come available.  She has been on a waiting list since 2011, according to published reports.

The Organ Procurement and Transplantation Network, whose duties include collecting and managing scientific data about organ donation, says that nearly 1,700 people nationwide are waiting for lung transplants.

Price

Price

Rep. Tom Price, R-Ga., drilled Sebelius about the situation during a Capitol Hill hearing on the HHS budget Tuesday. Murnaghan cannot get the transplant she needs “because of an arbitrary rule that if you’re not 12 years old, you’re not eligible to receive an adult lung,” said Price, who is a physician.  “Madam Secretary, I would urge you this week to let that lung transplant move forward … It simply takes your signature.”

Sebelius said she has spoken with the girl’s mother and “can’t imagine anything more agonizing” than what the family is going through.

Sebelius said about 40 very seriously ill people in Pennsylvania over the age of 12 also are waiting for a lung transplant, as are three other extremely sick children in the same Philadelphia hospital as Murnaghan.

“I would suggest that the rules that are in place and are reviewed on a regular basis are there because the worst of all worlds, in my mind, would be to have some individual picks who lives and who dies,” she said. “I think you’d want a process guided by medical science and medical experts.”

That answer didn’t satisify Rep. Lou Barletta, R-Pa.

“Why do we have such bullcrap around this place and we have the chance to save someone’s life. … Why wouldn’t we do this?” he asked.

While Sebelius has ordered a review of transplant rules to analyze their fairness, “a study will take over a year [and] this young lady will be dead,” Price said at the House Education and the Workforce Committee hearing.

After the hearing, Sebelius told reporters that HHS lawyers “very much disagree that there is any ability for an individual to reach in” and change the current organ rules.

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Should smokers have to pay more for health insurance?

Cigarette thumbBy Martha Bebinger, WBUR

You’ve heard all the campaigns and statistics: Smoking Kills. It’s the leading cause of preventable death in the U.S. And it’s expensive.

The Centers for Disease Control and Prevention says smoking costs the country $193 billion a year in lost productivity and health care spending. Add another $10 billion for secondhand smoking expenses.

That’s why the federal Affordable Care Act permits insurers to charge smokers up to 50 percent more for coverage than non-smokers.

So, says Jon Hurst, president of the Retailers Association of Massachusetts, why not ask smokers to pay more for health insurance?

“If we’re ever going to control costs, we’ve got to make sure that we don’t over-socialize the system,” Hurst says. ”In other words, we don’t make people pay too much for somebody else’s health care costs.”

Fifty percent more for smokers might be too much, continues Hurst, “but let’s not dismiss outright, the ability for employers to try to incent people to get healthier.”

The debate about whether smokers should pay more for health insurance has created unusual alliances. Tobacco companies are working alongside cancer societies and consumer groups to persuade states they should reject higher charges for smokers.

“First of all there is very little evidence that financial incentives or disincentives through premiums change behavior,” says Amy Whitcomb Slemmer, executive director at Health Care for All, a Massachusetts group that advocates for affordable health care access.

Health Care for All and the group’s allies in the public health world routinely support higher taxes for smokers. But Whitcomb Slemmer says higher insurance premiums could lead many smokers to drop their coverage.

“We were concerned that more would pay the penalty to not be insured,” Whitcomb Slemmer continues. “And, specifically, we’d be concerned that they (smokers) wouldn’t have access to what has been demonstrated to be very effective smoking cessation programming.”

In Massachusetts, Vermont, Rhode Island and the District of Columbia, this public health perspective has won the debate, for now. Insurers will not be allowed to add a surcharge for smokers. California is moving in the same direction.

But aides to Massachusetts Gov. Deval Patrick says he’s open to allowing the surcharge in the future — if insurers find accurate ways to determine who smokes and who doesn’t.

The largest insurers in the Bay State are mostly on the sidelines in this controversy. Here’s one reason why: They’ve had the option of hiking premiums for smokers since the state passed its landmark health care act in 2006, and they haven’t done it.

“We try to moderate premiums for the entire market, not seek to target particular populations or individuals because of certain behaviors,” says Eric Linzer, senior vice president at the Massachusetts Association of Health Plans.

The Massachusetts legislature will likely need to amend state law so that a ban on higher charges for smokers takes effect.

And just to make things a little more complicated — it won’t apply to everyone. Large employers, who are self-insured and follow federal insurance rules, will be able to target smokers, if they choose.

This story is part of a partnership that includes WBURNPR and Kaiser Health News. 

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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TIPS-campaign-logo

CDC’s new antismoking campaign: Tips from Former Smokers

This week the US Centers for Disease Control and Prevention (CDC) launches a new ad campaign featuring the stories of former smokers living with smoking-related diseases and disabilities.

“Tips from Former Smokers” ads will run for at least 12 weeks on television, radio, and billboards, online, and in theaters, magazines, and newspapers nationwide.

The education campaign seeks to provide motivation, information, and quit help to those who want it, CDC officials said.

  • The ads feature smoking-related health conditions— including chronic obstructive pulmonary disease or COPD, more severe adult asthma, and complications from diabetes, such as blindness, kidney failure, heart disease, and amputation—and candidly describe the losses from smoking and the gains from quitting
  • Despite the known dangers of tobacco use, nearly one in five adults in the United States still smoke.  Almost 90 percent of smokers started before they were 18, and many of them experience life-changing health effects at a relatively early age. Smoking harms nearly every organ in the body.
  • More than 440,000 Americans each year lose their lives to smoking-related diseases, and for every one death 20 more continue living with one or more serious illnesses from smoking.  Nearly 70 percent of smokers say they want to quit.

For more information on the campaign, including profiles of the former smokers, links to the ads, and free quit help, visit www.cdc.gov/tips.

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Illustration of the lungs in blue

Understanding and preventing lung cancer – from MedlinePlus magazine

From MedlinePlus magazine

What is Lung Cancer

Lung cancer forms in tissues of the lung, usually in the cells lining air passages. The two main types are small cell lung cancer and non-small cell lung cancer. These types are diagnosed based on how the cells look under a microscope.

  • Small cell: The cells of small cell lung cancer look small under a microscope. About 1 of every 8 people with lung cancer has small cell lung cancer.
  • Non-small cell: The cells of non-small cell lung cancer are larger than the cells of small cell lung cancer. Most (about 7 of every 8) people diagnosed with lung cancer have non-small cell lung cancer. It doesn’t grow and spread as fast as small cell lung cancer, and it’s treated differently.

Lung cancer is the leading cause of cancer death in both men and women. Lung cancer is the second most common cancer in the United States, after skin cancer. The number of new cases and deaths from lung cancer is highest in black men.

cancerdiagram_large

Risk Factors

Smoking is the main cause of lung cancer, especially non-small cell lung cancer. Exposure to secondhand smoke and environmental exposures, such as radon and workplace toxins, also increase your risk.

The earlier in life a person starts smoking, the more often a person smokes, and the more years a person smokes, the greater the risk of lung cancer. If a person has stopped smoking, the risk becomes lower as the years pass.

When smoking is combined with other risk factors—such as secondhand smoke, asbestos and arsenic exposure, and air pollution—the risk of lung cancer is increased. A family history of cancer can also be a risk factor for lung cancer.

Dusty Donaldson

Lung cancer survivor Dusty Donaldson helps to spread the word about the importance of screening and early detection.
Photo: Courtesy Dusty Donaldson

In 2005, Dusty Donaldson experienced tenderness and pain in her neck that didn’t go away over several months. When her doctor couldn’t detect any physical cause, and the pain continued, Donaldson decided more had to be done. “The pain was persistent, and so was I.”

Today, she’s thankful for her persistence. Ultrasound and CT scans found something suspicious in her right lung. That turned out to be a five-centimeter cancerous tumor between the upper and middle lobes of her lungs. It was an early-stage cancer and had not spread to other parts of her lungs or her body.

Donaldson, who had quit smoking 26 years before her diagnosis, had not even considered that she might have lung cancer.

“I was really surprised at the time to find out that lung cancer is the number one cause of cancer deaths in men and women. More people die from lung cancer than from all the others combined,” Donaldson says. “Lung cancer death rates are the equivalent of a 747 jumbo jet crashing to the ground every single day.”

Surgeons removed almost two-thirds of her lung and treated her with chemotherapy for three months. Today, she remains cancer free and has made a commitment to help others understand lung cancer and the need for early detection.

Donaldson volunteers with the nonprofit LUNGevity Foundation to help the organization educate the public about lung cancer.

“I’m compelled to find others and share with them information regarding screening,” she says. “Early detection is key to survivorship,” she adds. “There’s not a single soul on this earth who doesn’t need to know about lung cancer. People who don’t know they are at risk, need to know that there are other risk factors—genetics, radon, and other things that can cause lung cancer.”

“If I could tell the world one thing about lung cancer, it’s that anyone can get it and no one deserves it.”
—Dusty Donaldson, 58, High Point, NC.

The 2011 National Cancer Institute’s National Lung Screening Trial showed the importance of detecting lung cancer early. The trial also showed for the first time an effective screening approach for a high-risk population.

“Now thanks to the National Lung Screening Trial, we know screening can be more effective than anything else,” says Donaldson. “People who are at great risk don’t have to consider themselves doomed to lung cancer. They can have early detection, get treated early, and hopefully live a long and healthy life.”

Symptoms

Lung Cancer

Chest x-ray showing lung cancer.

X-ray of the chest. X-rays are used to take pictures of organs and bones of the chest. X-rays pass through the patient onto film.

Possible signs of non-small cell lung cancer include a cough that doesn’t go away and shortness of breath. Check with your doctor or other health professional if you have any of the following problems:

  • Chest discomfort or pain.
  • A cough that doesn’t go away or gets worse over time.
  • Trouble breathing.
  • Wheezing.
  • Blood in sputum (mucus coughed up from the lungs).
  • Hoarseness.
  • Loss of appetite.
  • Weight loss for no known reason.
  • Feeling very tired.
  • Trouble swallowing.
  • Swelling in the face and/or veins in the neck.

Diagnosis

Tests that examine the lungs are used to detect (find), diagnose, and stage non-small cell lung cancer. Tests and procedures to detect, diagnose, and stage non-small cell lung cancer are often done at the same time. Some of the following tests and procedures may be used:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits, including smoking, and past jobs, illnesses, and treatments will also be taken.
  • Laboratory tests: Medical procedures that test samples of tissue, blood, urine, or other substances in the body. These tests help to diagnose disease, plan and check treatment, or monitor the disease over time.
  • Chest X-ray: An X-ray of the organs and bones inside the chest. An X-ray is a type of energy beam that can go through the body, making a picture of areas inside the body.
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the chest, taken from different angles. The pictures are made by a computer linked to an X-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • Lung biopsy. The patient lies on a table that slides through the computed tomography (CT) machine, which takes X-ray pictures of the inside of the body. The X-ray pictures help the doctor see where the abnormal tissue is in the lung. A biopsy needle is inserted through the chest wall and into the area of abnormal lung tissue. A small piece of tissue is removed through the needle and checked under the microscope for signs of cancer.
  • Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope is inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.

Treatments

Certain factors affect prognosis (chance of recovery) and treatment options.

  • The stage of the cancer (the size of the tumor and whether it is in the lung only or has spread to other places in the body).
  • The type of lung cancer.
  • Whether there are symptoms such as coughing or trouble breathing.
  • The patient’s general health.

For patients with advanced non-small cell lung cancer, current treatments do not cure the cancer. The treatment that’s right for you depends mainly on the type and stage of lung cancer. You may receive more than one type of treatment.

Surgery

Surgery may be an option for people with early-stage lung cancer. The surgeon usually removes only the part of the lung that contains cancer. Most people who have surgery for lung cancer will have the lobe of the lung that contains the cancer removed. This is a lobectomy. In some cases, the surgeon will remove the tumor along with less tissue than an entire lobe, or the surgeon will remove the entire lung. The surgeon also removes nearby lymph nodes.

Radiation Therapy

Radiation therapy is an option for people with any stage of lung cancer:

  • People with early lung cancer may choose radiation therapy instead of surgery.
  • After surgery, radiation therapy can be used to destroy any cancer cells that may remain in the chest.
  • In advanced lung cancer, radiation therapy may be used with chemotherapy.

The NCI booklet Radiation Therapy and You (www.cancer.gov/cancertopics/coping/radiation-therapy-and-you) has helpful ideas for coping with radiation therapy side effects.

Chemotherapy

Chemotherapy may be used alone, with radiation therapy, or after surgery.

Chemotherapy uses drugs to kill cancer cells. The drugs for lung cancer are usually given directly into a vein (intravenously) through a thin needle. Newer chemotherapy methods, called targeted treatments, are often given as a pill that is swallowed.

You’ll probably receive chemotherapy in a clinic or at the doctor’s office. People rarely need to stay in the hospital during treatment.

The side effects depend mainly on which drugs are given and how much. Chemotherapy kills fast-growing cancer cells, but the drugs can also harm normal cells that divide rapidly:

  • When drugs lower the levels of healthy blood cells, you’re more likely to get infections, bruise or bleed easily, and feel very weak and tired.
  • Chemotherapy may cause hair loss. If you lose your hair, it will grow back after treatment, but the color and texture may be changed.
  • Chemotherapy can cause a poor appetite, nausea and vomiting, diarrhea, or mouth and lip sores. Your healthcare team can give you medicines and suggest other ways to help with these problems.

The NCI booklet Chemotherapy and You (www.cancer.gov/cancertopics/coping/chemotherapy-and-you) has helpful ideas for coping with chemotherapy side effects.

Targeted Therapy

People with non-small cell lung cancer that has spread may receive a type of treatment called targeted therapy. Several kinds of targeted therapy are used for non-small cell lung cancer. One kind is used only if a lab test on the cancer tissue shows a certain gene change. Targeted therapies can block the growth and spread of lung cancer cells.

Depending on the kind of drug used, targeted therapies for lung cancer are given intravenously or by mouth.

Lung Cancer Research

  • The large-scale National Lung Screening Trial, supported by the National Cancer Institute (NCI), has shown that screening current or former heavy smokers with low-dose helical computed tomography (CT) decreases the risk of dying from lung cancer. That finding was only for heavy smokers.
  • Another recent study showed that low-dose nicotine does not enhance lung cancer development. This suggests that nicotine replacement therapy is safe for former smokers.
  • Results of a 2011 research trial revealed that annual chest X-ray screening of people ages 55 to 74 years does not reduce lung cancer deaths compared with usual care.
  • Researchers have identified genetic regions that predispose Asian women who’ve never smoked to lung cancer. The finding provides evidence that lung cancer between smokers and never-smokers can differ on a fundamental level.

Tests

  • What type of lung cancer do I have?
  • Has the cancer spread from the lung? If so, to where?
  • May I have a copy of test results?

Surgery

  • What kind of surgery do you suggest for me?
  • How will I feel after surgery?
  • If I have pain, how can we control it?
  • How long will I be in the hospital?
  • Will I have any lasting side effects?
  • When can I get back to my normal activities?

Radiation Therapy

  • When will treatment start? When will it end? How often will I have treatments?
  • How will I feel during treatment? Will I be able to drive myself to and from treatment?
  • What can I do to take care of myself before, during, and after treatment?
  • How will we know the treatment is working?
  • What side effects should I expect? What should I tell you about?
  • Are there any lasting effects?

Chemotherapy or Targeted Therapy

  • Which drug or drugs do you suggest for me? What will they do?
  • What are the possible side effects? What can we do about them?
  • When will treatment start? When will it end? How often will I have treatments?
  • How will we know the treatment is working?
  • Will there be lasting side effects?

To Find Out More

  • Be Tobacco Free: www.BeTobaccoFree.gov brings together information on the health effects of tobacco, quitting smoking, and more.
  • The What You Need To Know About Lung Cancer booklet (www.cancer.gov/cancertopics/wyntk/lung) provides information about lung cancer diagnosis, staging, treatment, and comfort care. Information specialists also can answer questions about cancer at 1-800-4-CANCER.
  • The NCI Lung Cancer Home Page provides up-to-date information on lung cancer treatment, prevention, genetics, causes, screening, testing, and related topics. (www.cancer.gov/cancertopics/types/lung)
  • Information on treatment options for non-small cell lung cancer and small cell lung cancer is available from PDQ, NCI’s comprehensive cancer database. (www.cancer.gov/cancertopics/pdq)
  • Clinical trials for non-small cell lung cancer and small cell lung cancer can be found in NCI’s list of clinical trials. (www.cancer.gov/clinicaltrials)

Because most people who get lung cancer were smokers, you may feel that doctors and other people assume that you are or were a smoker (even if you aren’t or weren’t). Whether or not you were a smoker, it’s important for you to protect your body now from smoke. Avoid secondhand smoke from smokers near you.

If you smoke, talk with an expert about quitting. It’s never too late to quit. Quitting can help cancer treatments work better. It may also reduce the chance of getting another cancer.

To get help with quitting smoking…

  • Call NCI’s Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848).
  • Sign up for the free mobile service SmokefreeTXT to get tips and encouragement to quit. To sign up, text the word QUIT to IQUIT (47848) from your mobile phone. Or, go to www.smokefree.gov/smokefreetxt/Signup.aspx.

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Cigarrette

Hutch seeks smokers to test quit-smoking app

Seattle’s Fred Hutchinson Cancer Research Center is seeking smokers to test a quit-smoking iPhone app.

Here’s the announcement from the Hutch:

THERE’S AN APP FOR THAT: ADULT DAILY SMOKERS ARE NEEDED FOR A STUDY OF A QUIT-SMOKING IPHONE APP

Participants in the free Smart Quit study will receive tools to help them quit – and stay quit

Adults who’ve smoked daily for at least the past year who want to quit within the next 30 days are needed for a study of a quit-smoking iPhone app being conducted by Fred Hutchinson Cancer Research Center in collaboration with the University of Washington and 2Morrow Mobile.

Led by Jonathan Bricker, Ph.D., a psychologist based in the Public Health Sciences Division at Fred Hutch, the Smart Quit study will randomly assign participants to one of two iPhone application quit-smoking programs. The goal of the study is to learn which of the two programs is the most useful for people who are quitting smoking.

“This is the first-ever study of any smartphone app for quitting smoking,” said Bricker, an associate member of the Fred Hutch Public Health Sciences Division. “Smartphones are a potentially revolutionary quit-smoking tool because you can carry that support with you anywhere.”

Participants randomly assigned to either program will receive:

  • Interactive tools for dealing more effectively with urges to smoke
  • A step-by-step guide for quitting smoking
  • Personalized plans for quitting and staying quit

Both programs are free. Participants will be asked to complete online questionnaires, including one brief follow-up survey during the next two months. They will receive $25 after completing the two-month follow-up survey. Eligibility criteria include:

  • being age 18 or older
  • having smoked at least five cigarettes daily for at least the past 12 months
  • wanting to quit in the next 30 days
  • being interested in learning skills to quit smoking

Bricker and colleagues gratefully acknowledge that support for this work was provided by the Hartwell Innovation Fund.

For more information about the Smart Quit iPhone study, please visit www.smartquit.org or email smartquit@fhcrc.org.

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What impact have vaccines had on health? – Infographic

Leon Farrant, a graphic design student at Purchase College, used data from the U.S. Centers for Disease Control and Prevention to create a striking infographic showing the impact vaccines have had on health in the U.S.

PrintCreative Commons Licence.

To see more of Farrant’s work go to: To see more of his work go to: www.behance.net/leon_farrant

CDC stats

 

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