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Clinical Trials Update: Oct. 28, 2009  

COPD (Chronic Obstructive Pulmonary Disease)

This 10-week study is for people aged 40 to 80 who have been diagnosed with COPD.

The research site is in Phoenix, Ariz.

More information

Please see http://www.clinicalconnection.com/clinical_trials/condition/copd.aspx.

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Congestive Heart Failure (CHF)

This study is for people who have chronic stable heart failure and have an ejection fraction of less than 40 percent. Participants will have an echocardiogram and will be asked to stay overnight. Compensation for time and travel is available up to $2,750 if you qualify.

The research site is in Tustin, Calif.

More information

Please see http://www.clinicalconnection.com/clinical_trials/condition/heart_failure.aspx.

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• Even A Few Cigarettes A Day Reduces Artery Health In Young Adults 

A new study from Canada suggests that even light smoking in otherwise healthy young people damages the arteries, reducing their bodies' ability to deal with physical stress such as exercise, running to catch a bus or climbing stairs.

The study was led by Dr Stella Daskalopoulou, an internal medicine and vascular medicine specialist at McGill University Health Centre (MUHC) in Montreal, Quebec, who presented it at the Canadian Cardiovascular Congress 2009 that is taking place 24 to 29 October in Edmonton, Alberta. The event is co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society.

In fact, Daskalopoulou and colleagues showed that even one cigarette led to serious adverse effects in young adults: it increased the stiffness of the arteries of otherwise healthy 18 to 30 year olds by 25 per cent, she told the conference.

Smoking helps plaque accumulate in the arteries, leading to a higher risk of blood clots, less oxygen in the blood, and higher blood pressure. It also makes the heart work harder and nearly doubles the risk of ischemic stroke . . .

"Young adults aged 20-24 years have the highest smoking rate of all age groups in Canada."

"Our results are significant because they suggest that smoking just a few cigarettes a day impacts the health of the arteries. This was revealed very clearly when these young people were placed under physical stress, such as exercise," she explained. . . .

For the study, Daskalopoulou and colleagues compared the arterial stiffness of young smokers who smoked about five or six cigarettes a day to that of non-smokers. The median age of the participants was 21.

They measured the participants' arterial stiffness in three arteries

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CHURCHWELL: State smoking ban must go further 

As a cardiologist, I've seen firsthand the damage that smoking does to the body. Most patients I have taken care of who have had a heart attack or developed an acute coronary syndrome have a history of smoking or have been in an environment where secondhand smoke is a major issue in their lives. . . .

A study released by the Institute of Medicine earlier this month revealed that smoking bans in public places are effective at reducing the risk of heart attacks associated with exposure to secondhand smoke. . . .

Tennesseans should take this news as a call to action and demand that exemptions to the Non-smoker Protection Act be removed. The societal and financial costs to all of us are too great to continue to ignore. You can get involved and help make Tennessee a healthier place to live and work. CHART, the Campaign for a Healthy and Responsible Tennessee, is building its coalition of supporters to make all Tennessee workplaces smoke-free.

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20 percent of Metro heart attacks due to passive smoke  

Second-hand smoke causes over 20 percent of the number of heart attacks in Metro Manila, officials from the Department of Health (DoH) said on Monday.

One to seven hours of weekly exposure to second-hand smoke increases the number of heart attacks or acute myocardial infarction by 10 percent and a weekly exposure of 21 hours in turn raises the number of heart attacks by 20 percent, said DoH Secretary Francisco Duque III quoting an international study.

The study from the World Lung Foundation and International Union Against Tuberculosis and Lung Disease (The Union) also found that over 50 percent of Filipinos in Manila are exposed to second-hand smoke daily--meaning there is a high likelihood of regular exposure to passive smoking, said Duque.

The health secretary added heart attacks and circulatory systems diseases--the top two killer diseases in 2005 which caused over 130,000 deaths--are caused by exposure to second-hand smoking, a scenario that can be prevented if tobacco control ordinances are implemented and followed nationwide.

Globally, over five million people die from tobacco smoke-related illnesses, with 13,000 to 18,000 of these from the Philippines, said Bloomberg Philanthropies representative Kelly Larson.

The Union representative Bill Bellew said the proper implementation of ordinances on tobacco control in over 10 countries were in place, a reduction of 17 percent to 50 percent in the number of heart attacks was noted.

In line with this, The Union and Bloomberg Philanthropies gave DoH a grant of $745,000 to launch a program to intensify the ban against smoking and the implementation of Tobacco Regulation Act of 2003 through information campaigns and strict implementation of tobacco control ordinances, said Duque.

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Age, Lifestyle Affect Cardiorespiratory Fitness  

Action Points

* Explain to interested patients that cardiorespiratory fitness declines throughout adulthood, but this decline accelerates if they are physically inactive, obese, or smokers.

* Also explain that the decline begins to increase rapidly after age 45.

After age 45, cardiorespiratory fitness declines at an accelerated rate and is independently influenced by body mass index (BMI), physical activity, and smoking, a longitudinal study confirmed. . . .

The analysis revealed that current smoking also was associated with lower cardiorespiratory fitness, with a decline of 0.29 METs in women (95% CI −40 to −0.19) and a decline of 0.41 METs in men (95% CI −0.44 to −0.38).

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Major study validates reason for smoking bans 

A major report confirms what health officials long have believed: Bans on smoking in restaurants, bars and other gathering spots reduce the risk of heart attacks among nonsmokers.

"If you have heart disease, you really need to stay away from secondhand smoke. It's an immediate threat to your life," declared Dr. Neal Benowitz of the University of California-San Francisco, who co-wrote last week's report from the prestigious Institute of Medicine.

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EDITORIAL: Secondhand smoke: We owe it to one another to lessen smoking's effects - it could be a matter of life or death 

Choosing to smoke in public isn't just a personal choice anymore.

A recent study further highlighted the impact of secondhand smoke on others -- particularly those with heart disease.

By adopting and adhering to smoke-free policies, the risk of heart attack can be decreased by 47 percent, according to the U.S. Institute of Medicine.

The study noted that even a brief exposure to cigarette smoke could be enough to trigger a heart attack. . . .

There are numerous resources out there to help in the process, including www.smokefree.gov, the local hospitals and the American Cancer Society.

Smoking continues to be an activity which no longer impacts only the participant. As a community, we owe it to one another to lessen smoking's effects -- especially secondhand smoke.

It could be a matter of life or death.

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EDITORIAL: Secondhand smoke: New study, same message 

The dangers of secondhand smoke have been debated for years.

But all those folks who told you that breathing secondhand smoke was bad for you weren't blowing smoke, after all.

A new study by the Institute of Medicine for the U.S. Centers for Disease Control and Prevention indicates that exposure to indoor smoke, even for a short time, can boost the risk of heart problems for non-smokers. . . .

Some people in the court of public opinion decry smoking bans at restaurants, workplaces and bars as being extreme.

But the latest research indicates that program to reduce the impact of smoking is well worth the effort in public health.

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• Use An E-Cigarette, Reduce Risk of Heart Disease 

E-CigaretteDirect.com recommends that smokers switch to electronic cigarettes to protect themselves and their loved ones from secondhand smoke and heart disease. You don't have to be a smoker for smoke to harm you. Secondhand smoke is known to be even more dangerous than first hand smoke.

The recent study titled Secondhand Smoke Exposure and Cardiovascular Effects assess the relationship among second hand smoke and acute coronary events. The scientists found that smoking regular cigarettes increases the risk of heart disease by 25-30%. The Surgeon General agrees with this conclusion in his 2006 report.

To avoid second hand smoke for others, smokers have a few options: Quit, leave the premises to smoke, or try an electronic cigarette. "The e-cigarette produces ZERO second hand smoke. None. The 'smoke' that is expelled is actually water vapor", states Gina King of E-CigaretteDirect. "People can use this smoking alternative to decrease the risk of smoking for them and their loved ones. This study only proves that regular cigarettes are dangerous for more people than just the smoker".

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• SULLUM: A CDC second-hand smokescreen 

Six years ago, when I asked an epidemiologist about a report that a smoking ban in Helena, Mont., had cut heart attacks by 40 percent within six months, he thought the idea was so ridiculous that no one would take it seriously.

He was wrong. . . .

a closer look at the IOM report, which was commissioned by the US Centers for Disease Control and Prevention, suggests its conclusions are based on a desire to promote smoking bans rather than a dispassionate examination of the evidence. . . .

The largest study of this issue, which used nationwide data instead of looking at cherry-picked communities, concluded that smoking bans in America "are not associated with statistically significant short-term declines in mortality or hospital admissions for myocardial infarction."

It also found that "large short-term increases in myocardial infarction incidence following a workplace ban are as common as the large decreases reported in the published literature."

That study, published by the National Bureau of Economic Research in March, suggests that publication bias -- the tendency to report positive findings and ignore negative ones -- explains the "consistent" results highlighted by the IOM committee. But even though the panelists say they tried to compensate for publication bias by looking for relevant data that did not appear in medical journals, they ignored the NBER paper, along with analyses that found no declines in heart attacks following smoking bans in California, Florida, New York, Oregon, England, Wales and Scotland. . . .

Even while taking refuge in imprecision, the IOM committee tries to make transparently absurd claims seem plausible by intimating that spending a half-hour in a smoky bar just might kill you, even if you were completely healthy when you went in. If so, where are the bodies? The report concedes that "there is no direct evidence that a relatively brief exposure to secondhand smoke can precipitate an acute coronary event."

Siegel, who faults the IOM committee's "sensationalistic" approach, is a longtime backer of smoking bans who nevertheless tries to separate his political advocacy from his scientific analysis.

It's too bad the authors of the IOM report, who immediately used it as an excuse to demand strict smoking regulations throughout the country, did not follow his example.

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Institute of Medicine Report Concludes Smoke-Free Laws Prevent Heart Attacks; It's Time to Make All Workplaces and Public Places Smoke-Free  

A landmark report released today by the Institute of Medicine provides powerful new evidence that elected officials have no excuse for failing to enact comprehensive smoke-free workplace laws. The IOM report concludes smoke-free laws reduce the number of heart attacks and save lives. The report also confirms that there is conclusive scientific evidence that secondhand smoke causes heart disease, including heart attacks, and finds there is compelling evidence that even relatively brief exposure to secondhand smoke can lead to a heart attack.

These powerful conclusions, reached by one of the most prestigious scientific authorities in the United States, send a loud and clear message to elected officials across the U.S. and worldwide: No excuses, no half-measures. It's time to protect everyone's right to breathe clean air by enacting comprehensive smoke-free laws that include all workplaces and public places, including restaurants and bars. There should be no exceptions or loopholes. No one should have to put themselves at risk of a heart attack, lung cancer or the other serious diseases caused by secondhand smoke in order to earn a paycheck or enjoy a night out.

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美医学报告：禁烟可大幅降低心脏病发作风险 

（华盛顿综合讯）美国医学院发表报告指出，在公共场合以及工作场所禁止人们吸烟，大幅度减少烟客和非烟客心脏病发作的次数。

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Smoke-free proving to be heart-healthy  

Cigarette smokers who were bummed about the smoking ban in restaurants, offices and other public places should know that their sacrifice has decreased the cases of heart attack and heart disease.

It's widely known that cigarette smoke is toxic to cigarette smokers, according to cardiologist Dr. Marc Klapholz, but unfiltered secondhand smoke can also cause complications.

A report by the Institute of Medicine, a federally commissioned panel of scientists, found a significant reduction on heart problems after the smoking ban was in place Ð in smokers and non-smokers.

Klapholz said that for non-smokers who shared indoor spaces with those who light up, the secondhand smoke could be more toxic than smoke that directly enters a smoker's lungs.

"A cigarette burns for two minutes, (and) they might be inhaling for 30 seconds or a minute," said Klapholz, director of the Department of Cardiology and professor of medicine at the University of Medicine and Dentistry of New Jersey's medical school. "Most of the smoke goes into the ambient environment."

Klapholz said the IOM report develops a full picture, that cigarettes not only cause problems, "but when you stop it, it prevents things."

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• Adults in Malta smoking less, young people more  

The number of adults in Malta who smoke is appreciably on the decline but young people, particularly girls, are smoking more, a news conference yesterday was told. The news conference was given to promote World Heart Day, being held on Sunday, when radio and television stations will be running an advert to raise awareness regarding the dangers of cardiovascular diseases.

Health parliamentary secretary Joe Cassar said that not enough people in Malta are knowledgeable enough about the dangers their lifestyles can pose.

"Cardiovascular diseases are still the world's largest killers, claiming 17.5 million lives a year, even though the risk factors for heart diseases and strokes are well known.

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EDITORIAL: They call this justice? Smoking ban look sweet. 

Brief opinions about events of the past week: . . .

Merit: One more time for North Carolina's new ban on smoking in bars, restaurants and other public places. It's looking better as time goes by and more scientific evidence comes in.

A study released Thursday by the Institute of Medicine in Washington showed that breathing secondhand smoke, even briefly, can can increase nonsmokers' risk of heart problems.

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