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Tobacco Quit Line Expands Services for Pregnant Women Who Smoke 

Quitting smoking is one of the best things a woman can do to protect her own health and the health of her baby. In time for Mother's Day on May 11, the state Department of Health has added new services to its free Tobacco Quit Line to provide pregnant women with more help when they're ready to quit using tobacco.

The new tools include quit materials and extra follow-up calls specifically to help pregnant women increase their chances of quitting and remaining tobacco-free after the baby is born. Quit coaches have received additional training to better understand the challenges pregnant women face when trying to quit smoking. In Washington, more than 8,700 babies are born each year to women who smoke during their pregnancy.

"Quitting smoking is a Mother's Day gift that a pregnant woman can give to herself and her baby," said Secretary of Health Mary Selecky. "Babies with moms who smoke are more likely to die from Sudden Infant Death Syndrome and have health problems like ear infections and pneumonia. These new resources will make a real difference in the health of pregnant women and their babies."

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Anesthesiologists Help Patients Extinguish Smoking Habits 

In response to the continuing tobacco epidemic, the American Society of Anesthesiologists formed a Smoking Cessation Initiative Task Force in 2006. ASA Member David O. Warner, M.D., an anesthesiologist at the Mayo Clinic, heads the nine –person smoking task force on behalf of ASA.

Dr. Warner explains how the ASA initiative differs from the numerous other “Stop Smoking” programs available today. “The focus of the ASA initiative is not only on the long-term benefits of not smoking, but also on the benefits of not smoking as long as possible before and after surgery. Smokers require special consideration when undergoing anesthesia for a surgical procedure, because smoking complicates anesthesia management and increases the risks of complications.”

As a component of the Smoking Cessation Initiative, ASA is advocating the Ask –Advise – Refer program. This offers physicians practical advice on how to engage their patients in a conversation about their smoking habits and refer them to helpful expert resources, like the national tobacco quit-line, 1-800-Quit- Now.

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It's never too late to quit: Women who give up smoking can reverse health hazards, study says 

According to the latest figures from the federal Centers for Disease Control and Prevention, 20.8 percent of adults in the United States smoke, accounting for about 438,000 deaths each year. In Wisconsin, 21 percent of adults smoke, according to the latest statistics from the Wisconsin Department of Health and Family Services.

Fiore said that a third of all smokers try to quit each year, and that 70 percent of Wisconsin smokers say they've tried to stop at least once.

Shirley Reimer started smoking a half-pack of cigarettes daily when she 18 years old because it seemed cool and helped her relax. She was unaware she had a genetic lung disease called sarcoidosis that would be worsened by her habit.

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Study: Quitting smoking pays off in 5 years 

Good news for women who smoke: If you quit now, in five years you will have significantly reduced your chance of dying from a heart attack. And in 20 years, you'll have almost the same health risks as a woman who has never smoked.

A Harvard study, which appeared in Wednesday's Journal of the American Medical Association, confirms what doctors have long said but provides a clearer window into what those health benefits are and how quickly they accrue.

In Indiana, which has the sixth-highest smoking rate for women in the nation, anti-smoking advocates hailed the results as an incentive for more women to quit the habit.

"This study is very encouraging," said Karla Sneegas, executive director of the Indiana Tobacco Prevention and Cessation Agency. "It's encouraging to say if you quit, there are wonderful health implications that are positive. It really can make a difference in your life."

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Fla. Anti-Smoking Campaign to Start Offering Free Nicotine Patches, Gum, Lozenges 

Florida's revamped anti-smoking campaign is starting to move into high-gear.

Lawmakers had gutted the program's budget in recent years, but in 2006 voters forced the program back into relevancy.

They approved a constitutional amendment to require the Legislature to put 15 percent of the state's tobacco settlement dollars into the program each year.

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POLITO: Does updated tobacco treatment "Guideline" reflect sham science? 

It appears that pharmaceutical influence continues to own official U.S. smoking cessation policy. According to an advance agenda, the newest U.S. policy pronouncement will be unveiled Wednesday, May 7, at 9 a.m. in room 3C at AMA headquarters located at 515 North State Street, Chicago. The revision panel's controversial chairman, Dr. Michael C. Fiore, whose significant financial ties to the pharmaceutical quit smoking product industry made front-page ethics news in the Wall Street Journal on February 7, 2007, is scheduled to summarize "findings and recommendations" from the 2008 update of the U.S. Guideline for Treating Tobacco Use and Dependence.

According to an advance summary, as in 2000, Dr. Fiore will reveal that it is the Guideline's recommendation that, with few exceptions, "clinicians should encourage" pharmaceutical quitting product "use by all patients attempting to quit smoking." While this cessation quitting method monopoly will generate billions in pharmaceutical industry profits, does it serve public health?

Sadly, what should and could have been a national resource and treasure in helping teach physicians what is not taught in most medical schools, how to effectively counsel patient's to quit smoking, is instead little more than a glorified pharmaceutical quitting product guide and sales advertisement. . . .

An advance copy of Wednesday's recommendations indicates that recommendations 3, 6 and 7 will combine to continue to effectively destroy the legitimacy and prevent government backing of any and all non-pharmacology quitting programs, programs relying upon education, counseling, skills development, motivation and/or support.

While the May 2008 Guideline strongly encourages "counseling" it refuses to allow it unless accompanied by "medication." This is not a question of scientific study evidence. It is a question of policy, policy gone astray. . . .

Wednesday is a golden opportunity for health journalists to at last ask the tough questions. But will they? With roughly 40% of U.S. smokers making a serious quitting attempt during 2008, with the latest cure - Chantix - asking smokers to assume risk of death, with decline in the U.S. smoking rate having ground to a halt, those addicted to smoking nicotine deserve answers. But will they get them? Below are a few questions deserving of answers:

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• New federal quit-smoking advice recommends Chantix despite safety concerns 

The federal government's new advice to doctors for helping smokers quit recommends the drug Chantix, which has recently been linked with depression and suicidal behavior. The new guidelines mention the psychiatric risks but also say the popular Pfizer Inc. drug is the most effective at helping people get off cigarettes.

The guidelines mention other options, too, and highly recommend combining counseling and medication. But doctors are encouraged to talk to all smokers who want to quit about trying medication.

Consumer advocates cautioned that the safety picture on Chantix is incomplete because it's a relatively new drug, on the market just since 2006.

"It is somewhat better than other therapies; on the other hand, it appears to have more risk," said Dr. Sidney Wolfe of the watchdog group Public Citizen. "That part of the risk-benefit equation is missing, and it's changing rapidly."

Another issue with the quit-smoking guidelines, released this week by the U.S. Public Health Service, is the lead author's past connections with Pfizer. Dr. Michael Fiore, an expert on smoking and health issues, was a consultant to the maker of Chantix. But he said he cut those ties in 2005. . . .

"People are quitting smoking to save their lives," Polito said. If Chantix's risks outweigh its benefits, "then it's insane for people to risk their lives" by using it, he said. . . .

The guideline authors analyzed 83 studies and found that Chantix helped 33 percent stay off tobacco for six months after quitting, compared with a nearly 14 percent abstinence rate for dummy pills. . . .

Medications have not been shown to be effective in certain groups, the guidelines say. Those groups include pregnant women, smokeless tobacco users, light smokers and adolescents.

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Higher Cigarette Tax Expected to Force New Yorkers to Quit Smoking  

The higher state tax on cigarettes in New York will likely prompt thousands of New Yorkers to stop smoking. WRVO's Chris Ulanowski spoke with the Director of The Center for A Tobacco Free New York about the impact.

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• Smoking How much will it end up costing you? 

Smokers aren't the only ones who feel the costs of smoking.

"Tobacco use and secondhand smoke exposure cost the state of Louisiana $3 billion per year in health care costs and lost productivity," says Carrie Broussard of the Louisiana Campaign for Tobacco-Free Living.

TFL estimated in 2005 that of the $1.47 billion in health care costs directly caused by smoking in Louisiana, $663 million was covered by the taxpayer-funded state Medicaid program. Louisiana residents' total state and federal tax burden used to address problems caused by smoking averaged out to $626 per household. And those numbers aren't including health-care costs caused by secondhand smoke, cigar and pipe smoking or chewing tobacco.

You probably don't even want to think about the non-health-related costs: not just lost productivity, but property losses in fires caused by smoking (over $500 million -- not to mention more than 1000 deaths -- across the country each year) and cleaning and maintenance costs made necessary by tobacco smoke and cigarette litter (around $4 billion nationwide just for commercial establishments). . . .

Occasional smokers are often college students -- a 2007 report by the American College Health Association found that while only 10 percent of students smoke regularly, 30 perent smoke intermittently. And with tobacco companies facing increasing criticism for aiming advertisements at children, they've started targeting the 18-to-24-year-old demographic -- partly by advertising aggressively in environments where college-age intermittent smokers are most likely to indulge, such as bars and nightclubs.

"Intermittent smokers usually believe that they can stop smoking at any time and often think that they will quit after college," says David, but they're usually wrong. . . .

Today, in her work as development director with the Acadiana Arts Council, Moss makes it a priority to work to promote smoke-free venues where Acadiana residents can go to hear musical performances without worrying about secondhand smoke exposure.

Interested in joining the fight? Consider getting involved with the American Cancer Society's Cancer Action Network (acscan.org) or the Louisiana Campaign for Tobacco-Free Living (tobaccofreeliving.org)

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戒烟大赛6月1日举办 戒半年可赢万元 

上海市健康教育所日前发布信息称，今年全市戒烟大赛将于6月1日起正式举办。凡本市范围内年满18周岁，正在吸烟或者使用其他烟草制品，并且“烟龄”超过一年的烟民，只要成功戒烟半年以上就有机会赢得万元大奖。

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Helping Smokers Quit (PDF) 

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• Treating Tobacco Use and Dependence: 2008 Update (PDF) 

Treating Tobacco Use and Dependence: 2008 Update, a Public Health Service- sponsored Clinical Practice Guideline, is a product of the Tobacco Use and Dependence Guideline Panel (“the Panel”), consortium representatives, consultants, and staff. These 37 individuals were charged with the responsibility of identifying effective, experimentally validated tobacco dependence treatments and practices. The updated Guideline was sponsored by a consortium of eight Federal Government and nonprofit organizations: the Agency for Healthcare Research and Quality (AHRQ); Centers for Disease Control and Prevention (CDC); National Cancer Institute (NCI); National Heart, Lung, and Blood Institute (NHLBI); National Institute on Drug Abuse (NIDA); American Legacy Foundation; Robert Wood Johnson Foundation (RWJF); and University of Wisconsin School of Medicine and Public Health’s Center for Tobacco Research and Intervention (UW-CTRI). This Guideline is an updated version of the 2000 Treating Tobacco Use and Dependence: Clinical Practice Guideline that was sponsored by the U.S. Public Health Service, U. S. Department of Health and Human Services. An impetus for this Guideline update was the expanding literature on tobacco dependence and its treatment. The original 1996 Guideline was based on some 3,000 articles on tobacco treatment published between 1975 and 1994. The 2000 Guideline entailed the collection and screening of an additional 3,000 articles published between 1995 and 1999. The 2008 Guideline update screened an additional 2,700 articles; thus, the present Guideline update reflects the distillation of a literature base of more than 8,700 research articles. Of course, this body of research was further reviewed to identify a much smaller group of articles that served as the basis for focused Guideline data analyses and review. This Guideline contains strategies and recommendations designed to assist clinicians; tobacco dependence treatment specialists; and health care administrators, insurers, and purchasers in delivering and supporting effective treatments for tobacco use and dependence. . . .

This Guideline concludes that tobacco use presents a rare confluence of circumstances: (1) a highly significant health threat;4 (2) a disinclination among clinicians to intervene consistently;5 and (3) the presence of effective interventions. This last point is buttressed by evidence that tobacco dependence interventions, if delivered in a timely and effective manner, significantly reduce the smoker’s risk of suffering from smoking-related disease.6-13 Indeed, it is difficult to identify any other condition that presents such a mix of lethality, prevalence, and neglect, despite effective and readily available interventions. Although tobacco use still is an enormous threat, the story of tobacco control efforts during the last half century is one of remarkable progress and promise. In 1965, current smokers outnumbered former smokers three to one.14 During the past 40 years, the rate of quitting has so outstripped the rate of initiation that, today, there are more former smokers than current smokers.15 Moreover, 40 years ago smoking was viewed as a habit rather than a chronic disease. No scientifically validated treatments were available for the treatment of tobacco use and dependence, and it had little place in health care delivery. Today, numerous effective treatments exist, and tobacco use assessment and intervention are considered to be requisite duties of clinicians and health care delivery entities. Finally, every state now has a telephone quitline, increasing access to effective treatment.

The scant dozen years following the publication of the first Guideline have ushered in similarly impressive changes. . . .

The overarching goal of these recommendations is that clinicians strongly recommend the use of effective tobacco dependence counseling and medication treatments to their patients who use tobacco, and that health care systems, insurers, and purchasers assist clinicians in making such effective treatments available. 1. Tobacco dependence is a chronic disease that often requires repeated intervention and multiple attempts to quit. Effective treatments exist, however, that can significantly increase rates of long-term abstinence.

2. It is essential that clinicians and health care delivery systems consistently identify and document tobacco use status and treat every tobacco user seen in a health care setting. 3. Tobacco dependence treatments are effective across a broad range of populations. Clinicians should encourage every patient willing to make a quit attempt to use the counseling treatments and medications recommended in this Guideline. 4. Brief tobacco dependence treatment is effective. Clinicians should offer every patient who uses tobacco at least the brief treatments shown to be effective in this Guideline. 5. Individual, group, and telephone counseling are effective, and their effectiveness increases with treatment intensity. Two components of counseling are especially effective, and clinicians should use these when counseling patients making a quit attempt: • Practical counseling (problemsolving/skills training) • Social support delivered as part of treatment 6. Numerous effective medications are available for tobacco dependence, and clinicians should encourage their use by all patients attempting to quit smoking—except when medically contraindicated or with specific populations for which there is insufficient evidence of effectiveness (i.e., pregnant women, smokeless tobacco users, light smokers, and adolescents). • Seven first-line medications (5 nicotine and 2 non-nicotine) reliably increase long-term smoking abstinence rates:

– Bupropion SR – Nicotine gum – Nicotine inhaler – Nicotine lozenge – Nicotine nasal spray – Nicotine patch – Varenicline

8 • Clinicians also should consider the use of certain combinations of medications identified as effective in this Guideline. 7. Counseling and medication are effective when used by themselves for treating tobacco dependence. The combination of counseling and medication, however, is more effective than either alone. Thus, clinicians should encourage all individuals making a quit attempt to use both counseling and medication. 8. Telephone quitline counseling is effective with diverse populations and has broad reach. Therefore, clinicians and health care delivery systems should both ensure patient access to quitlines and promote quitline use. 9. If a tobacco user currently is unwilling to make a quit attempt, clinicians should use the motivational treatments shown in this Guideline to be effective in increasing future quit attempts. 10. Tobacco dependence treatments are both clinically effective and highly cost-effective relative to interventions for other clinical disorders. Providing coverage for these treatments increases quit rates. Insurers and purchasers should ensure that all insurance plans include the counseling and medication identified as effective in this Guideline as covered benefits.

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Women Who Quit Smoking Lower Heart Risks Quickly  

New research shows that women who quit smoking have a 21 percent lower risk of dying from coronary heart disease within five years of extinguishing their last cigarette.

The risks of dying from other conditions also decline after quitting, although the time frame varies depending on the disease.

"The harms of smoking are reversible and can decline to the level of nonsmokers," said study author Stacey Kenfield, whose report is in the May 7 issue of the Journal of the American Medical Association. "For some conditions like chronic obstructive pulmonary disease, it can take more than 20 years, but there is a rapid reduction for others."

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New Guidelines Show Smokers Have More Tools to Quit Than Ever, But Elected Officials Must Do More to Help  

The guidelines for smoking cessation released today by the U.S. Public Health Service provide an important reminder to the nation's 45 million smokers that they have more scientifically proven tools available to help them quit smoking and protect their health than ever before, including safe and effective medications, counseling and telephone quitlines. Combining counseling and medication is especially effective in helping smokers quit. These findings are based on a thorough review of the evidence and have critical implications for policymakers as well as medical providers.

Unfortunately, while most smokers want to quit, and millions try each year, most do not avail themselves of the evidence-based treatments that improve success rates. While the guidelines address actions clinicians can take, policy makers at all levels, as well as employers, also need to take action to prevent kids from smoking in the first place, encourage smokers to quit, enhance awareness of the treatments available and provide affordable access to these live-saving interventions. As the guidelines emphasize, providing insurance coverage for these evidence-based treatments increases both the rates that smokers use these treatments and the rates that smokers quit.

Federal government: Congress and the Administration should implement the National Action Plan for Tobacco Cessation

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New Smoking Cessation Guideline Confirms That Now is the Time to Quit Smoking 

Today the U.S. Department of Health and Human Services published an update to its 1996 Public Health Service Clinical Practice Guideline, Treating Tobacco Use and Dependence, which contains revised and improved recommendations to providers and clinicians so that they can better assist smokers in quitting. The guideline also confirms that there has never been a better time for smokers to quit than right now.

With the release of these new guidelines, smokers can receive improved strategies from physicians and other health care providers to help successfully quit smoking. The guidelines definitively state that combining FDA-approved pharmacotherapies and counseling is the most effective way for smokers to end addiction to tobacco products. The Public Health Service also finds that cessation treatments are cost-effective and that providing these treatments through healthcare systems will increase the number of people who seek treatment for smoking, attempt to quit and successfully quit.

"These new guidelines underscore how important it is for smokers to receive assistance quitting," said Bernadette Toomey, President and CEO, of the American Lung Association. "The American Lung Association stands ready to help smokers quit through our different smoking cessation programs and resources."

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