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• Seventy per cent of Bulgarian smokers wanted to quit, survey says  

More than 70 per cent of smokers in Bulgaria wanted to give up smoking, Yulia Medichkova of the Greenwild Foundation was quoted by Bulgarian news agency BTA as saying on November 19 2009.

Medichkova presented the results of a one-year campaign entitled The Culture of Breathing. Over 50 per cent of Bulgarians approved of increased restrictions on smoking that will be introduced by mid-2010. Bulgaria ranks third in the world in terms of number of smokers, after Japan and Greece, Medichkova said.

What was more worrying, according to another survey released by the Health Ministry on November 17 2009, was that every second pregnant woman in Bulgaria smoked during pregnancy.

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Assessment of Exposure to Secondhand Smoke at Outdoor Bars and Family Restaurants in Athens, Georgia, Using Salivary Cotinine  

Nonsmokers outside restaurants and bars in Athens, Georgia, have significantly elevated salivary cotinine levels indicative of secondhand smoke exposure.

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• Secondhand smoke exposure worse for toddlers, obese children 

Toddlers and obese children suffer more than other youth when exposed to secondhand smoke, according to research presented at the American Heart Association's Scientific Sessions 2009.

"Secondhand smoke in children is not just bad for respiratory issues, as has been previously described by other researchers," said John Anthony Bauer, Ph.D., the study's senior co-author and principal investigator at Nationwide Children's Hospital & Research Institute at Ohio State University in Columbus. "Our data support the view that cardiovascular effects of secondhand smoke in children are important, particularly for the very young and those who are obese. We had not investigated the impact of obesity in previous studies."

Bauer and colleagues recruited American boys and girls, including 52 toddlers (ages 2 to 5 years) and 107 adolescents (ages 9 to 18 years). The study included black, white and Hispanic children, including obese toddlers and adolescents.

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• Exposure to secondhand smoke increases risk for Type 2 diabetes 

Chronic secondhand smoke exposure significantly increases the risk for Type 2 diabetes, show results from a study of Greek and Cypriot elderly men and women.

“While active smoking is strongly related to the development of diabetes mellitus, the role of exposure to secondhand smoke in the development of diabetes mellitus is unclear,” write Demosthenes Panagiotakos (Harokopio University, Athens, Greece) and colleagues in the journal Diabetic Medicine.

The researchers recruited 1190 elderly men and women aged 65 years or above from several Greek and Cypriot islands in the Mediterranean during 2005–2007.

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Are Smokers Now at Higher Risk of Bladder Cancer? Are Changes in Cigarettes To Blame? ($$) 

sed on a comparison of two very large cohorts, suggested just the opposite: Far from making the cigarettes safer, the design changes might have made them even more dangerous.

A debate over the consequences of the cigarette changes has continued . . . [Full Text of this Article]

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A Case-Control Study of Smoking and Bladder Cancer Risk: Emergent Patterns Over Time  

Conclusions: Smoking-related risks of bladder cancer appear to have increased in New Hampshire since the mid-1990s. Based on our modeling of pack-years and intensity, smoking fewer cigarettes over a long time appears more harmful than smoking more cigarettes over a shorter time, for equal total pack-years of cigarettes smoked.

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EDITORIAL: Cigarette Smoking and Bladder Cancer: A New Twist in an Old Saga?  

The findings of Baris et al. (7) are provocative and are accompanied by a tenable hypothesis. Recalling the steady accumulation of evidence and the cautious inferences that eventually led to the determination that smoking causes bladder cancer, these intriguing findings offer a testable hypothesis that warrants thorough investigation. An important element of this research will be to more precisely, pinpoint the specific role of cigarette additives will be an important element of this research. This study highlights the need for continued vigilance in monitoring the impact of changing cigarette content and design on disease risk, and demonstrates that the public health implications of the changing cigarette content and design are potentially severe.

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• Nonsmokers Top Smokers in Well-Being Across All Incomes 

Smokers trail nonsmokers in well-being, regardless of income bracket, according to Gallup-Healthways Well-Being Index data collected in 2008 and 2009. In every income group, smokers are less likely than nonsmokers to be "thriving" by at least 12 percentage points. . . .

In the case of emotional health, the connection between smoking and low well-being is especially pronounced for low-income respondents. While the emotional health gap between smokers and nonsmokers is 4 points for the highest income group, the gap for the lowest income group is 10 points.

The differences in the size of the smoking gap across income groups could mean that the emotional consequences of smoking are less pronounced for people in the higher income group. Another possibility is that people in different income groups smoke for different emotional reasons. . . .

Self-reported smoking status is, in fact, strongly linked to depression. . . .

Across all income groups, smokers also fare worse than nonsmokers in physical health as reflected in lower scores on the Physical Health Index. Consistent with medical research connecting smoking to premature mortality, people who are 85 years old or older are unlikely to be smokers.

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Massachusetts' Success in Helping Medicaid Recipients Quit Smoking Shows Why Congress Should Require Cessation Coverage in Health Reform 

Massachusetts today announced extraordinary results from its aggressive efforts to help Medicaid beneficiaries quit smoking by providing easy access to coverage for smoking cessation medication and counseling.

Massachusetts reported that smoking rates among beneficiaries in its MassHealth program plunged by 26 percent in the first two and a half years after the state began providing coverage of smoking cessation in July 2006. Costly medical procedures among those who utilized the cessation benefit also fell dramatically. Among benefit users, there were 38 percent fewer hospitalizations for heart attacks and 17 percent fewer emergency-room visits for asthma symptoms in the first year after using the benefit. There were 17 percent fewer claims for maternal birth complications since the benefit was implemented, state health officials reported.

Massachusetts is leading the way in demonstrating that health insurance coverage for smoking cessation quickly improves health and saves lives, and no doubt reduces health care costs as well.

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• Cigarettes harbor many pathogenic bacteria 

Cigarettes are "widely contaminated" with bacteria, including some known to cause disease in people, concludes a new international study conducted by a University of Maryland environmental health researcher and microbial ecologists at the Ecole Centrale de Lyon in France.

The research team describes the study as the first to show that "cigarettes themselves could be the direct source of exposure to a wide array of potentially pathogenic microbes among smokers and other people exposed to secondhand smoke." Still, the researchers caution that the public health implications are unclear and urge further research.

"We were quite surprised to identify such a wide variety of human bacterial pathogens in these products," says lead researcher Amy R. Sapkota, an assistant professor in the University of Maryland's School of Public Health.

"The commercially-available cigarettes that we tested were chock full of bacteria, as we had hypothesized, but we didn't think we'd find so many that are infectious in humans," explains Sapkota, who holds a joint appointment with the University's Maryland Institute for Applied Environmental Health and the department of epidemiology and biostatistics.

"If these organisms can survive the smoking process -- and we believe they can -- then they could possibly go on to contribute to both infectious and chronic illnesses in both smokers and individuals who are exposed to environmental tobacco smoke," . . .

The study will appear in an upcoming edition of the journal Environmental Health Perspectives. . . .

Sapkota's team took a more holistic approach using DNA microarray analysis to estimate the so-called bacterial metagenome, the totality of bacterial genetic material present in the tested cigarettes.

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The commercially-available cigarettes that we tested were chock full of bacteria, as we had hypothesized, but we didn't think we'd find so many that are infectious in humans. If these organisms can survive the smoking process -- and we believe they can -- then they could possibly go on to contribute to both infectious and chronic illnesses in both smokers and individuals who are exposed to environmental tobacco smoke.
Lead researcher Amy R. Sapkota, an assistant professor in the University of Maryland's School of Public Health, on the study that will appear in an upcoming edition of the journal Environmental Health Perspectives.

• The science behind moving smoking bans outside  

Reflecting on the existing scientific research on second hand smoke exposure outdoors, William Saletan of Slate.com sifts through the most relevant points from two major studies on the subject (the 2006 California Air Resources Board study, and a 2007 study from Stanford). Among the findings: outdoors, second hand smoke levels vary widely and quickly, depend on the individual's distance from a smoker (farther than 6.5 feet or 2 meters, generally reduces exposure to "background" levels), are influenced by how confined the outdoor space is (if there are walls or fences), and the concentration of smokers in a given area. The data, Saletan concludes, point to the need for a measured approach for crafting policy to reduce second hand smoke exposure outdoors. He writes:

"If you want to argue for parkwide smoking bans based on asthma or on an analogy to noise pollution, go ahead and make that case. But let's not cloud that debate by invoking the general harm of secondhand smoke. Studies of secondhand smoke have indeed moved outdoors. Their findings support restrictions on lighting up within a few feet of other people. But they don't warrant more than that."

A new study published in the November issue of the Journal of Occupational and Environmental Hygiene may contribute to the debate. Researchers from the University of Georgia measured second hand smoke exposure among people sitting in the outdoor areas of bars and restaurants where indoor smoking was banned in the city of Athens, Georgia. . . .

generally speaking, hanging out in an outdoor smoking area exposes you to less second hand smoke than being in an indoor, confined space with smokers, and the more space you have between yourself and smokers, the lower levels of exposure you will have. So, this particular study doesn't ring the death knell for outdoor smoking. But, the researchers point out, wielding the official trump card of the public health argument:

Although the increment in cotinine concentrations and, thus, the [second hand smoke] exposure levels were relatively low at the sites of interest, the current view is that there is no level of personal exposure to [second hand smoke] that can be regarded as safe. This study demonstrates the ongoing exposure of nonsmokers to [second hand smoke] outside restaurants and bars, and the limitations of indoor smoking bans alone in protecting the public from exposure to [second hand smoke] outside these establishments.

In other words, the movement to ban smoking in outdoor spaces is here to stay.

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Survey finds many smokers make last minute plans to quit 

Although a majority of smokers want to quit smoking, many delay making a plan to quit until the last minute, according to a recent American Cancer Society online survey of people who say they want to. Twenty-two percent of smokers surveyed planned to quit within 24 hours, while 30 percent said they planned to quit within a week or two. The American Cancer Society stresses the importance of planning ahead to quit smoking as research shows that preparing for quitting by allowing enough time to get nicotine replacement therapy, and planning how to deal with cravings and tempting situations, greatly increases the likelihood of succeeding. The Society encourages smokers to use the annual occasion of the Great American Smokeout® on November 19 as a date to make a plan to quit, or to plan in advance and quit smoking that day.

The survey, conducted via the Great American Smokeout Web site (www.cancer.org/GreatAmericans) also found that 76 percent of smokers surveyed did not know that they could receive free help

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City wants grant to battle smoking 

The American Cancer Society asks smokers to give up the habit for one day today as part of the Great American Smokeout.

A $2 million federal grant could help St. Joseph fight an anti-smoking battle of its own with longer lasting results.

The City Council gave the City of St. Joseph Health Department the green light Monday to apply for the Communities Putting Prevention to Work grant — part of the American Reinvestment & Recovery Act of 2009. If the funding is approved, the health department will work with Heartland Health, the Missouri Department of Health & Senior Services, Buchanan County, the St. Joseph School District, Missouri Western State University, the St. Joseph Youth Alliance and the University of Missouri to implement an anti-smoking marketing campaign, smoking cessation services and other programs.

City Health Director Debra Bradley provided statistics showing the severity of St. Joseph’s smoking problem among young people. According to a study from the health department and Heartland Health, 56 percent of local youths age 18 to 24 smoke, while roughly one in four adults are smokers.

Council member Mike Bozarth was the most vocal opponent of Monday’s resolution. As a smoker and opponent of expanded government regulations, Mr. Bozarth said he didn’t want the council to take part in a program that could restrict citizens’ personal choices.

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BREGEL: Progress slow in choking off smoking rates 

About one in every five residents of Tennessee and Georgia still uses tobacco, studies show, and that's just too many, health advocate say.

Although there has been progress, smoking rates have gone up and down over the past few years in Tennessee, ranging from 27.7 percent in 2002 to 23.1 percent last year, according to the Behavioral Risk Factor Surveillance System surveys that states submit to federal health officials.

The Tennessee smoking rate "is not where it needs to be, and it's certainly not a downward trend, so that's what's sort of disappointing," said Dr. Vince Viscomi, a Chattanooga pulmonologist and president of the Chattanooga and Hamilton County Medical Society.

In Georgia, rates are slowing ticking downward . . .

Culturally, Tennesseans have made "incredible progress" in attitudes toward smoking, said Shelley Courington, executive director of the Campaign for a Healthy and Responsible Tennessee.

"Smoke-free has become the norm here, and who would have thought years ago that that would be possible in Tennessee, in a state where tobacco for years was the No. 1 cash crop?" she said.

Still, low funding has hindered progress, Ms. Courington said. . . .

TENNESSEE QUIT LINE

* 1-800-784-8669

GEORGIA QUIT LINE

* 1-877-270-STOP

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Cigarette Butts Toxic to Fish 

Cigarette butts, one of the most ubiquitous forms of garbage in the world, have been found to be toxic to saltwater and freshwater fish.

WATCH VIDEO: Discovery News' Kasey-Dee Gardner tries out a new genetic test for lung cancer that may make it easier to find out who's at risk.

Even with a small amount of unburnt tobacco clinging to it, a single cigarette butt soaked for a day is enough to turn a liter of water a sickly yellow brown and kill 50 percent of fish swimming in it. Without tobacco, it takes about 4 smoked filters to do the same job.

That's a lot of butts in a small area, and the research team that conducted the laboratory study, led by Elli Slaughter of San Diego State University, is quick to point out that no research has been done yet to test how much poison leaches from butts into ponds, lakes, streams and the ocean. Still, humans are inadvertently carpeting the planet in cigarette butts.

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