Category Archives: Asthma

States target asthma care as number of patients grow

Washington is one of the few states that has made the Asthma and Allergy Foundation of America honor roll of states that have adopted comprehensive public policies supporting people with asthma, food allergies, anaphylaxis risk and related allergic diseases in schools.

Illustration of the lungs in blueBy Michael Ollove
Stateline Staff Writer

April 16, 2014 

In a valley wedged between the Mississippi and Missouri rivers, St. Louis often finds itself beset by a stationary air mass that only a severe storm of some kind can dislodge.

St. Louis is also an industrial city with high humidity, so it’s no wonder it usually makes the list of worst places for asthmatics to live.

But the state has also pioneered advances in addressing asthma treatment and costs. Two years ago, the Missouri legislature became the first to allow schools to stock quick-relief asthma medications for emergencies.  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.”

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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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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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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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Quit Smoking Tips from HealthFinder.gov

Cigarette thumb

Quitting smoking is one of the most important things you can do for your health. The sooner you quit, the sooner your body can begin to heal. You will feel better and have more energy to be active with your family and friends.

Take Action!

Follow these steps to quit:

  1. Call 1-800-QUIT-NOW (1-800-784-8669) for free support and to set up your quit plan.
  2. Talk with your doctor about medicines to help you quit.
  3. Set a quit date within the next 2 weeks.
  4. Make small changes, like:
    • Throw away ashtrays in your home, car, and office so you aren’t tempted to smoke.
    • Make your home and car smoke-free.
    • If you have friends who smoke, ask them not to smoke around you.
  5. Plan for how you will handle challenges like cravings.

Here are some more tips to help you quit.

Write down your reasons to quit.

Make a list of all the reasons you want to quit. For example, your reasons to quit might be to set a healthy example for your kids and to save money. Keep the list with you to remind yourself why quitting is worth it.

Change your routine.

Changing your routine can help you break the smoking habit.

  • Try taking a different route to work.
  • For the first few weeks, avoid activities and places you connect with smoking.
  • Do things and go places where smoking isn’t allowed.
  • Make getting active and eating healthy part of your quit plan. Go for walks and try different foods.

Quitting may be hard, so prepare yourself. 

Remember, the urge to smoke will come and go. Here are some ways to manage cravings:

  • Do something else with your hands, like washing them, taking a shower, or washing the dishes. Try doing crossword or other puzzles.
  • Have healthy snacks ready, like carrots, nuts, apples, or sugar-free gum.
  • Distract yourself with a new activity.
  • If you used to smoke while driving, try something new. Take public transportation or ride with a friend.
  • Take several deep breaths to help you relax.

Take this withdrawal quiz every day to see your progress.

Break the connection between eating and smoking. 
Many people like to smoke when they finish a meal. Here are some ways to break the connection:

  • Get up from the table as soon as you are done eating.
  • Brush your teeth and think about the fresh, clean feeling in your mouth.
  • Try going for a walk after meals.

Deal with stress.

Manage stress by creating peaceful times in your daily schedule. Try relaxation methods like deep breathing or lighting candles.

Check out these tips on dealing with stress as you quit.

Stick with it.

When you stop smoking, you may feel:

  • Irritable
  • Anxious
  • Hungry

You may even have trouble sleeping.

Don’t give up! It takes time to overcome addiction. Check out these tips on staying quit.

Learn from the past. 

Many people try to quit more than once before they succeed. Most people who start smoking again do so within the first 3 months after quitting. If you’ve tried to quit before, think about what worked for you and what didn’t.

Drinking alcohol, depression, and being around other smokers can make it harder to quit. If you are finding it hard to stay quit, talk with your doctor about what medicines might help you. Remember, quitting will make you healthier.

If you’ve tried to quit before, check out this booklet about how to commit to quitting again [PDF - 797 KB].

If you want help, talk with your doctor.

A doctor or nurse may be able to help you quit smoking. The doctor can help you choose the strategies that are likely to work best for you. She can also tell you about medicines to help make quitting easier.

Get more information about the different types of medicines that can help you quit.

What about cost?

You can get free help with quitting by calling 1-800-QUIT-NOW (1-800-784-8669) or by visiting smokefree.gov.

Also, some services to help people quit smoking are covered under the Affordable Care Act, the health care reform law passed in 2010. Depending on your insurance plan, you may be able to get these services at no cost to you.

Check with your insurance provider to find out what’s included in your plan. For information about other services covered by the Affordable Care Act, visit HealthCare.gov.

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Air quality improves but burn ban remains in effect

Photo: Sanja Gjenero

Photo: Sanja Gjenero

Air quality in King, Pierce, and Snohomish counties has improved but the the Puget Sound Clean Air Agency says a “stage 1″ burn ban remains in effect,

“Air pollution levels throughout the region have dropped, likely due to clouds and warmer temperatures,” said Dr. Phil Swartzendruber, agency forecaster. “The drop in pollution could also be due to the help of our communities following the burn ban.”

Earlier in the week, the agency had imposed the stricter stage 2 ban, but the improving air quality led officials to lower the ban to stage 1.

During a Stage 1 burn ban:

  • No burning is allowed in fireplaces or uncertified wood stoves.
  • Residents should rely instead on their home’s other, cleaner source of heat (such as their furnace or electric baseboard heaters) for a few days until air quality improves, the public health risk diminishes and the ban is cancelled.
  • No outdoor fires are allowed. This includes recreational fires such as bonfires, campfires and the use of fire pits and chimneys..
  • Burn ban violations are subject to a $1,000 penalty.

It is OK to use natural gas, propane, pellet and EPA-certified wood stoves or inserts during a Stage 1 burn ban.

The Washington State Department of Health recommends that people who are sensitive to air pollution limit time spent outdoors, especially when exercising.

Air pollution can trigger asthma attacks, cause difficulty breathing, and make lung and heart problems worse. Air pollution is especially harmful to people with lung and heart problems, people with diabetes, children, and older adults (over age 65).

For more information:

Photo courtesy of Sanja Gjenero

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Flu outbreak spreads to Washington state — what parents can do

This article first appeared on Seattle Children’s blog On the Pulse.

child wincing while be given a shot injection

Flu cases in Washington state are already at higher-than-average levels, and experts say we have yet to hit the flu season’s peak.In the last few weeks, health officials have reported a spike in influenza activity.

Seattle Children’s is seeing an increase in emergency department visits for flu symptoms.In the past week, 62 infants, kids and teens tested positive for flu, which is three times more than the number of cases seen in the first week of December.

Across the United States, 47 states are reporting widespread influenza activity, and at least 18 children have died from the flu this season, according to the Centers for Disease Control and Prevention.

In Washington state, at least six people have died, including a 12-year-old boy.

It’s not too late to get vaccinated against the flu, a contagious virus that infects the nose, throat and lungs, and can cause fever, cough, sore throat, muscle aches, fatigue, vomiting and diarrhea.

Yearly flu vaccines prevent 70 to 90 percent of the flu in children and adults, as Doug Opel, MD, MPH, general pediatrician at Seattle Children’s, explained in a recent blog post. This year’s flu vaccine contains the most common flu viruses currently circulating.

Getting the flu vaccine is especially important for children with cancer, lung or heart disease, and diabetes, but the flu can be serious even in children who are otherwise healthy. All caregivers and family members over the age of six months should receive a flu shot each year.

Use the HealthMap Vaccine Finder to search for locations offering the flu vaccine.

5 tips to prevent the spread of flu

Tony Woodward, MD, MBA, medical director of the division of emergency medicine at Seattle Children’s, encourages parents to follow some simple steps to help keep the flu from spreading:

  1. Wash hands – yours and your kids’ – frequently with soap and water. Adults and older children can use alcohol-based hand sanitizers for disinfecting between hand washes.
  2. If your child is sick, keep them home from school or day care for at least one day after they no longer have a fever. If you’re sick, stay home from work.
  3. Use tissue or the crook of your elbow to cover your mouth when coughing or sneezing. Throw used tissues away in a covered trash bin.
  4. Remind kids to avoid touching their eyes, nose or mouth, and to keep their hands away from their face.
  5. Avoid sharing personal items like spoons and towels, and clean shared spaces often.

Where to go for help

In most cases, children do not need emergency care for flu symptoms, unless they are under 2 years old, at high risk because of underlying or ongoing medical issues, or experiencing difficulty breathing or other life-threatening symptoms.

For a stable child with a fever and flu symptoms, Woodward recommends that parents contact their doctor before coming to the emergency department or urgent care clinic.

On evenings and weekends, parents in the Puget Sound region can take kids to one of Seattle Children’s urgent care clinics in Bellevue, Mill Creek and Seattle, which are open from 5 to 10:30 p.m. on weekdays and from 11 a.m. to 8:30 p.m. on weekends and holidays.

For tips on when to visit urgent care and when to go to the emergency department, parents can review this checklist or watch a video.

Related posts:

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Make good on your resolution to quit smoking

Cigarette thumbBy Carolyn M. Clancy, M.D.

For people who smoke cigarettes, the New Year is a popular time to try to quit.

And it’s no wonder why.

Tobacco use kills about 443,000 people in the United States each year or about 1 in 5 deaths annually. It is the Number One cause of preventable deaths, according to the Centers for Disease Control and Prevention.

Quitting smoking is one of the best things you can do for your health and for the health of your loved ones. Within just 12 hours of your last cigarette, the carbon monoxide levels in your blood return to normal.

Within 1 year of quitting, the excess risk of heart disease is half that of a person who continues to smoke, according to the U.S. Surgeon General.

Quitting smoking helps protect the health of people around you, especially babies and children. Secondhand smoke has more than 50 chemicals that are known to cause cancer in adults.

It can also cause lung disease and heart disease in people who have never smoked. Parents who quit smoking provide a great role model to their children and teens.

Within 1 year of quitting, the excess risk of heart disease is half that of a person who continues to smoke.

And contrary to what some people say, smokeless tobacco isn’t a safe option.  It includes chewing tobacco, dip, and snuff.  It causes cancer of the esophagus, mouth, and pancreas.

Like many New Year’s resolutions, deciding to change a behavior isn’t as easy as actually doing it. In fact, many smokers or tobacco users try to quit several times before they succeed.

How can you follow through on your plan to stop smoking for good in 2013?

A great place to start is BeTobaccoFree.gov. The new, comprehensive Web site gives one-stop access to the latest information from the Federal government on tobacco-related information, including evidence-based methods on how to quit.

The Web site includes interactive features, mobile apps, and tools and resources designed specifically for parents, educators, and teens.

For example, people who are getting ready to quit smoking now will find resources and tools to help them.

You can START the process by—

  • S = Setting a quit date. Pick a date within the next 2 weeks. That gives you enough time to get ready, but not so much time that you lose your determination.
  • T = Telling others about your plan to quit. Quitting is easier to do with support from others. Tell family, friends, and co-workers how they can help you.
  • A = Anticipating the challenges you will face. Most people who return to smoking do it within the first 3 months. Be prepared for situations when you will be tempted to smoke and plan for how you will deal with them.
  • R = Removing cigarettes from your home, car, and work. Getting rid of things that remind you of smoking will help you get ready to quit. Clean your car, get rid of lighters and ashtrays, and have your teeth cleaned to get rid of smoking stains.
  • T = Talking to your doctor about getting help to quit. Some people need help to manage the withdrawal from nicotine. Ask your health care provider if a medicine might help you. You can buy some of these medicines on your own, like the nicotine patch or nicotine gum. Others require a prescription.

Another section of the Web site called SmokefreeTeen helps teenagers recognize the pressures they face and how they typically handle them, including whether to start or stop smoking.

Using interactive quizzes, SmokefreeTeen looks at important topics such as depression, stress, and relationships. Answers can help teens understand their behavior style and the role that smoking, or trying to quit, may plan in it.

Another feature for teens is a mobile service called SmokefreeTXT. The service sends text messages with advice and tips on how to stop smoking for good.

Quitting smoking is one of the best New Year’s resolutions you can make to protect your health. The BeTobaccoFree Web site can help you turn your wish into reality.

I’m Dr. Carolyn Clancy, and that’s my advice on how to navigate the health care system.

Resources

Centers for Disease Control and Prevention 
Fact Sheet: Fast Fact—Smoking and Tobacco Use
http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/

U.S. 2010 Surgeon General’s Report—Smoking and Tobacco Use
http://www.cdc.gov/tobacco/data_statistics/sgr/2010/index.htm

BeTobaccoFree.gov
http://betobaccofree.hhs.gov/index.html

Quit Now: BeTobaccoFree.gov
http://betobaccofree.hhs.gov/quit-now/index.html

Smokeless Tobacco and Your Health
http://betobaccofree.hhs.gov/health-effects/smokeless-health/index.html

SmokefreeTeen
http://teen.smokefree.gov/about.aspx

SmokefreeTeen: SmokefreeTXT
http://teen.smokefree.gov/smokefreeTXT.aspx

Current as of January 2013


Internet Citation:

Make Good on Your Resolution To Quit Smoking. Navigating the Health Care System: Advice Columns from Dr. Carolyn Clancy, January 8, 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/consumer/cc/cc010813.htm

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Tobacco sales to minors jump

Cigarette thumbAbout 16 percent of tobacco retailers in Washington state illegally sold tobacco to minors this year, up from 11 percent in 2011 and 10 percent in 2010, hitting the highest level in more than a decade, according to a new report.

Under law, if the rate of retailers selling tobacco to minors exceeds 20 percent, the state could lose nearly $14 million dollars in federal funding for drug, alcohol, and tobacco prevention and treatment.

The new report is the result of federal legislation that requires states to enact and enforce laws that prohibit the sale of tobacco products to minors and to conduct annual random, unannounced inspections of retailers to assure their compliance with the law.

These compliance checks are conducted by local health agencies and the state Liquor Control Board. The checks include having teens, working with law enforcement, visit randomly selected retailers to try to buy cigarettes and other tobacco products.

Clerks who sell tobacco to minors can be fined up to $100 and retail owners can be fined up to $1,500. After multiple violations, a retailers license to sell tobacco is permanently revoked.

The data on retailer compliance is compiled annually by U.S Substance Abuse and Mental Health Services Administration and published in a document called the Synar Report, named after  Congressman Mike Synar of Oklahoma, who sponsored an amendment that mandated states to enforce laws restricting tobacco sales to minors.

Youth smoking rate in Washington state is currently about 13 percent, about half what it was in 2000, according to the Washington State Department of Health.

But in recent years, however, the decline in youth smoking rates has leveled off, state health officials said, and “the use of alternative tobacco products like chew, cigars, and hookahs is a growing concern.”

The state estimates that about 70,000 youths in Washington state currently smoke, with about 50 taking up the habit each day.

Efforts to educate youth about the dangers of smoking and retailers of their obligations under the law have been hampered by state and local government budget woes, health officials said.

“Meanwhile, the tobacco industry continues to invest huge amounts of money to attract new smokers. In 2010, the industry spent about $80 million on marketing activities in Washington alone,” they said.

Overall, about 7,900 people die every year in Washington from tobacco-related diseases.

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QuitPal Thumbnail

Trying to quit? There’s an app for that!

The National Cancer Institute (NCI) has created a free smartphone app to help you quit smoking.

The app, NCI QuitPal, was developed by the using the latest evidence-based smoking cessation methods and behavior change theory, the NCI says.

NCI QuitPal’s features:

  • Set a quit date, financial goals, and reminders
  • Track daily smoking habits with an easy-to-use calendar
  • See graphs tracking money saved and number of packs not smoked
  • Receive health milestones and craving tips to stay motivated
  • Connect with social networks to give milestone updates
  • Create a video diary, and watch personalized video messages from loved ones
  • Access NCI’s Cancer Information Service by toll-free phone line or live chat

The NCI QuitPal is available for free at iTunes.

 

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