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CHEST: No Sex Difference Found in COPD Treatment  

Action Points

* Explain to interested patients that this analysis fails to support suggestions that women may respond differently to COPD treatment.

* Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered preliminary until published in a peer-reviewed journal.

SAN DIEGO -- Men and women with chronic obstructive pulmonary disorder (COPD) derive comparable benefits from treatment with tiotropium (Spiriva), researchers found.

A secondary analysis of a large clinical trial found improvements of similar magnitude in lung function, exacerbations, and health-related quality of life in both genders, according to Donald Tashkin, MD, of the University of California Los Angeles.

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• Hazard in plain sight? 'Crossover products' may help hook kids on smoking, drugs 

Redford recently spoke about the products at a Marblehead Board of Health meeting, unloading for the board a bag of such products that she's collected throughout the year. Her presentation left most board members in disbelief.

"Are we the only ones who don't know about this stuff?" asked a bewildered Helaine Hazlett, the board's chairman.

Take a walk into the 7-11 store in Marblehead, and here is what you will find: "grinders" (small metal contraptions that are used to grind up tobacco or drugs), pipes, hookah pipes for smoking specially made flavored tobacco, flavored chewing tobacco, boxes of blunt wraps (tobacco-based rolling papers), cigarettes that are packaged like Chanel perfume boxes, and smokeless-tobacco gum that comes in a candy-mint-like container. The list goes on.

None of these products are illegal to sell, although in most states, including Massachusetts, to buy any tobacco-related product a person must be 18 or older. In fact, as a local tobacco-control officer, Redford's job is to conduct "compliance checks," . . .

Cigarette companies spent approximately $13 billion on advertising and promotional expenses in 2005 for those tobacco-specific products, nearly double what was spent in 1998, according to statistics from the Centers for Disease Control and Prevention.

Of that money, Redford says advertisers are more often targeting women and teens.

In 2008, tobacco company Philip Morris USA unrolled its sleek "purse pack" cigarette packaging containing ultra-slim cigarettes; the packaging is made to look as if it is a cosmetics case.

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Smoking mums have 'problem kids' 

Smoking during pregnancy significantly increases the risk of having a child with behavioural problems, according to UK and US researchers.

Writing in the Journal of Epidemiology and Community Health, they say the problems can be evident in children as young as three years old.

They believe smoking in pregnancy may damage the developing structure of the baby's brain.

One expert said it was another strong reason for mothers to give up smoking.

The researchers from the universities of York, Hull and Illinois looked at more than 14,000 mother and child pairs who were taking part in the Millennium Cohort Study.

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• Smoking while pregnant linked to behavioural problems in children  

Smoking during pregnancy significantly increases the risk of having a child with behavioural problems, according to research published today. Disturbances can manifest themselves in children as young as three years old, the study in the Journal of Epidemiology and Community Health claims.

The findings are based on more than 14,000 mother-and-child pairs drawn from the millennium cohort study, a population-based study of children born between 2000 and 2001 whose families are receiving child benefit.

The research was carried out by Professor Kate Pickett, at the department of health sciences at Hull York medical school, University of York.

Mothers, who were categorised as light or heavy smokers, depending on how many cigarettes they smoked every day during pregnancy, were asked to score their children's behaviour.

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Top athlete joins fight to stop girls smoking 

TRIATHLETE Helen Jenkins has urged the Welsh Assembly Government to do more to prevent teenage girls from smoking.

Helen, the 2008 world triathlon champion, who lives in Bridgend, has become a patron of the anti-smoking charity Ash Wales.

One of her first jobs as a non-smoking role model has been to meet teenage girls from Cardiff and Caerphilly during a visit to the Senedd.

And the 25-year-old has called for the Assembly Government to take more action as it emerged that almost one in four teenage girls in Wales smokes.

Helen said: "To learn that nearly one in four 15-year-old girls are regularly smoking is staggering.

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• State's smoking rate still high  

Smoking by women is one of the gravest preventive health concerns in Kentucky. While numerous smoking cessation and public health programs have been initiated to address the problem, Kentucky women continue to smoke in numbers that lead the nation and they are not quitting or even trying to quit, according to health experts at the University of Kentucky.

The median state prevalence of current smoking was 22.4 percent, but Kentucky prevalence is 34.7 percent (the next highest was West Virginia at 34 percent), while the median percent of daily smokers who quit is 39.8 percent - in Kentucky, it's only 28.9 percent, according to data from the Center for the Advancement of Women's Health at the University of Kentucky in Lexington.

Further, the median percent of daily smokers who made a quit attempt was 58 percent, but in Kentucky it was only 43.4 percent.

"So we are not quitting in Kentucky," said Dr. Leslie Crofford, the center's director. "We're not even trying to quit."

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Mums-to-be cut ciggies  

The number of mothers who admit smoking during pregnancy has fallen by nearly 12%, according to a study at the Coombe hospital, Dublin.

The proportion dropped from just over 23% to just under 21%, less than the smoking rate in the general population, which was 27% last year, but still higher than in other countries. In Massachusetts, America, for example, only 7% of pregnant women admit to smoking.

"When you compare the rates of smoking in pregnant women who attended the Coombe before and after the [smoking in public] ban, it's a significant reduction," said Luke Clancy, director-general of the Tobacco Free Research Institute (TFI).

"We are not saying the ban necessarily caused it, but we hope it influenced them . . .

The survey was published in BJOG, an international journal of obstetrics and gynaecology.

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Reliability of self reported smoking status by pregnant women for estimating smoking prevalence: a retrospective, cross sectional study (FULL TEXT) 

In conclusion, reliance on self reporting to measure smoking during pregnancy significantly underestimates the number of pregnant smokers in Scotland, with more than 2400 unrecognised pregnant smokers a year who will not be offered smoking cessation services. Reliance on self reporting resulted in twice as many undetected smokers in the most deprived areas compared with the least deprived areas. Overall, these figures call for more accurate methods of identifying pregnant smokers, especially when such data are used to inform policy and provide patient care.

What is already known on this topic

Self reported smoking during pregnancy is known to be an inaccurate method of identifying smokers Self reported smoking in Scotland is used to generate smoking prevalence and, largely, to target smoking cessation services

What this study adds

Reliance on self reported smoking during pregnancy underestimates the true smoking prevalence in Scotland by 17% Each year in Scotland twice as many pregnant smokers from more deprived areas go undetected compared with pregnant smokers in the least deprived areas Reliance on self reporting results in a failure to detect over 2400 pregnant smokers each year in Scotland who are therefore not offered smoking cessation services

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Reliability of self reported smoking status by pregnant women for estimating smoking prevalence: a retrospective, cross sectional study 

Objective To determine what impact reliance on self reported smoking status during pregnancy has on both the accuracy of smoking prevalence figures and access to smoking cessation services for pregnant women in Scotland. . . .

Conclusion Reliance on self reporting to identify pregnant smokers significantly underestimates the number of pregnant smokers in Scotland and results in a failure to detect over 2400 smokers each year who are therefore not offered smoking cessation services.

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• Around One In Five Pregnant Smokers Go Undetected Each Year 

Self-reported smoking during pregnancy underestimates the true number of pregnant smokers in Scotland by 17%, and results in a failure to detect 2400 pregnant smokers each year, finds new research published on bmj.com today.

This results in thousands of smokers not being identified or offered smoking cessation services, say the authors.

It is well known that self reported smoking during pregnancy is an inaccurate way to identify smokers. Yet it is still used widely by antenatal clinics to determine the smoking status of pregnant women and to refer them to smoking cessation services. The Scottish Government also relies on self-reported smoking figures to set targets and measure the success of smoking cessation services. . . .

The authors estimate that the true smoking prevalence for pregnant women in Scotland, after adjusting for area deprivation, maternal age and self-reported smoking is 28%, higher than the 23% based on self report data.

They conclude by calling for more accurate methods of identifying pregnant smokers, so that accurate data is used to inform policy and provide appropriate

Source British Medical Journal

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• Mothers' smoking causes newborn discomfort 

French researchers say they have tied maternal smoking to an increased risk of discomfort in newborns.

The study, published in Biological Psychiatry, suggests significantly more discomfort among newborns of smoking mothers may be related to having less monoamine oxidase A an enzyme, which degrades chemicals involved in brain message-sending.

Monoamine oxidase A activity was reduced both in the pregnant smokers and in their newborns when the researchers tested for blood biomarkers of monoamine oxidase A activity in smoking and non-smoking pregnant women and in the cord blood of their newborns.

Smoke exposure-induced low monoamine oxidase A activity in the womb may affect fetus brain neurotransmission and create potential vulnerabilities to behavioral disorders later in life,

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11.5% rise in female deaths from lung cancer  

More women in Scotland are dying from lung cancer, while rates of the disease among men have fallen, new statistics have shown.

Death rates from the disease rose by 11.5% for women over the past 10 years, compared with a drop of 21% for men. A total of 4000 people now die from the condition every year.

The rise in female mortality, outlined in the figures published by ISD Scotland, bucks the overall trend for cancer deaths, which dropped by 7% in the decade to 2008.

But the new statistics reveal the extent of the health divide in Scotland, where people living in the most deprived areas are 75% more likely to die from cancer than those in the richest areas. They are also 40% more likely to be diagnosed with any form of the disease, with rates of lung and cervical cancer particularly high among poorer sections of society.

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• More Scottish women die of lung cancer 

Soaring numbers of Scottish women are dying of lung cancer despite survival rates among men improving significantly, new figures show.

The increase also bucks the trend for death rates from other types of cancer north of the Border, all of which are going down.

Lung cancer deaths in men plummeted by 21 per cent in the 10 years to 2008, but increased by more than 11 per cent among women. . . .

However, the figures also reinforced major health differences across Scotland, with those living in the poorest areas 40 per cent more likely to have cancer than those in the wealthiest neighbourhoods.

Death rates in the most deprived communities are 75 per cent higher than those in the richest areas.

Dr Richard Simpson, Scottish Labour health spokesman, said: "I welcome the general improvement in cancer survival rates, but I am both disappointed and deeply concerned that more women are dying of lung cancer.

"This mainly reflects the increase in smoking among women over the past 20 years."

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Reduced Monoamine Oxidase A Activity in Pregnant Smokers and in Their Newborns 

Background

Tobacco smoking is associated with reduced monoamine oxidase A (MAOA) activity. Smoking-associated low MAOA activities in pregnancy and in newborns may have negative perinatal and postnatal consequences. We aimed to compare, in everyday clinical conditions, biomarkers of MAOA activity in smoking (SPW) and lifetime nonsmoking pregnant women (NSPW) and in cord blood and to assess the newborns' behavior during the first 48 hours of life. . . .

Conclusions

Smoking is associated with MAOA inhibition in pregnant women and in their newborns at birth. Further studies are needed to estimate the behavioral significance of these findings.

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• Is Smoking Tougher on Women?  

Women may be more vulnerable than men to the carcinogens and other noxious substances in cigarette smoke, a growing body of research suggests.

In one study of nearly 700 people with lung cancer, Swiss experts found that women tended to be younger when they received the diagnosis, even though they smoked less than the men who developed lung cancer.

In another study, researchers from Harvard University and the University of Bergen in Norway evaluated more than 950 men and women with chronic obstructive pulmonary disease (COPD), known to be linked to smoking. The result: The women with COPD were younger when they got the diagnosis and had smoked less than the men with the respiratory ailment.

"Maybe women are more susceptible to the lung-damaging effects of smoking," said Dr. Inga-Cecilie Soerheim, a visiting research fellow at Harvard and a researcher at the University of Bergen, who led the COPD study. She presented the findings in May at the American Thoracic Society's annual conference.

In fact, several other studies in the past 20 years have suggested that female smokers may be more susceptible to lung cancer than male smokers.

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