U.S. News/HealthDay: Graphic Cigarette Warnings May Target Brain's 'Quit Centers'

By Robert Preidt, HealthDay Reporter

FRIDAY, Feb. 26, 2016 (HealthDay News) — Disturbing images on cigarette pack warning labels activate brain regions crucial in quitting smoking, a new study suggests.

“Regulators can and should use this research to craft more effective warning labels and messages to smokers that both deliver facts about the negative effects of smoking and trigger thoughts and actions that move smokers toward quitting,” said study senior author Raymond Niaura. He is director of science at the Schroeder Institute for Tobacco Research and Policy Studies at the Truth Initiative in Washington, D.C.

“Tobacco is still the leading preventable cause of death in the U.S., and the growing body of research showing the effectiveness of warning labels should energize policymaking,” Niaura said in a news release from Georgetown University Medical Center, in Washington, D.C.

For the study, the researchers conducted brain scans on 19 young adult smokers. During the scans, the smokers were shown non-graphic and graphic pictures used on cigarette pack warning labels. For example, one image included an open mouth with rotten teeth and a tumor on the lower lip. The images were accompanied by the text: “WARNING: Cigarettes cause cancer.”

Seeing the graphic pictures triggered activity in areas of the brain called the amygdala and medial prefrontal region, the study showed. These areas are involved in emotion, decision-making and memory, the researchers said.

“The amygdala responds to emotionally powerful stimuli, especially fear and disgust. And experiences that have a strong emotional impact tend to impact our decision-making,” said study co-lead author Adama Green, a cognitive neuroscientist at the Georgetown University Medical Center and the Truth Initiative.

The study was published online recently in the journal Addictive Behaviors Reports.

“What we found in this study reinforces findings from previous research where scientists have asked participants to report how they think and feel in response to graphic warnings on cigarettes,” said co-lead author Darren Mays, an assistant professor of oncology at Georgetown’s Lombardi Comprehensive Cancer Center.

This study should help researchers understand the biological factors underlying responses to such warnings. And it may help them learn how these warnings can work to motivate a change in behavior, Mays said.

http://health.usnews.com/health-news/articles/2016-02-26/graphic-cigarette-warnings-may-target-brains-quit-centers

Duluth News Tribune: Training targets high tobacco use among addicts, mentally ill

By John Lundy

If someone is dealing with other addictions or mental health issues, it’s not the time to ask them to stop smoking.

Right?

Wrong, says an addictions psychiatrist from New Jersey who’s in Duluth to help lead a two-day training seminar on helping individuals with special challenges overcome tobacco use.

“The newer research suggests that when people address their smoking they actually have better long-term outcomes,” said Jill Williams, who specializes at Rutgers University’s Robert Wood Johnson Medical School in treatment of tobacco and other addictions in mentally ill populations. “When you cue the brain with nicotine, it’s really not different than other drugs.”

Williams is making her third visit to Duluth at the behest of the American Lung Association in Minnesota. After conducting a one-day session in the Twin Cities, she came to the Public Safety Building in Duluth on Thursday to work with about 60 behavioral health professionals from throughout Northeastern Minnesota; the training continues today.

The target is a topic that has “been shuffled to the side,” in the words of Pat McKone, regional senior director for the American Lung Association.

Even as tobacco use overall in the United States continues to decline to unprecedented lows, use by vulnerable groups such as addicts and the mentally ill remains stubbornly high, McKone and Williams said.

For instance, according to Williams:

  • Although the rate of smoking in Minnesota is down to 14 percent, the rate for Minnesotans with addictions or mental illness is between 40 and 60 percent.
  • The No. 1 cause of death in alcoholics is health problems related to tobacco use.
  • Fifty percent of people with mental illness die of tobacco-related causes.

“We always remark to the audience: Imagine if 50 percent of our patients died of suicide, how that would be front page news,” Williams said. “Fifty percent die from tobacco and we don’t do anything about it.”

People with serious mental illnesses die, on average, 25 years earlier than the rest of the population, McKone said. “And it’s not from suicide; it’s not from drug overdose. It’s from heart disease, COPD and cancer.”

Over a couple of years, Williams has offered the training to about a thousand specialists in Minnesota, she said. But they still represent a minority.

“What we hear them say … is that they’re the lone voice at their agency and everyone else is sort of opposed or still believes the myths or the idea that we should let people smoke and not pay attention to it,” Williams said. “So we still have a lot more people to get to.”

One sign of that is that only one in four mental health treatment centers has a smoking-cessation program, she said.

Families of individuals being treated for addiction or mental illness should advocate for treating their loved one’s tobacco addiction along with the other problems, McKone said. She called the reduced life expectancy for people with addictions and mental illness a social injustice.

Williams added: “Everyone has someone in their family with mental illness or addiction, and we can’t just look the other way.”

http://www.duluthnewstribune.com/news/3956324-training-targets-high-tobacco-use-among-addicts-mentally-ill

Today Show: Video: E-cigarette explodes in pocket, man left with second-degree burns

A frightening explosion of an e-cigarette in a Kentucky man’s pocket was caught on camera in a convenience store. The man was hospitalized Tuesday with second-degree burns after the battery in his electronic cigarette exploded in his pants pocket.

To see the video: http://www.today.com/video/video-e-cigarette-explodes-in-pocket-man-left-with-second-degree-burns-631071811975

Medical News Today: E-cigarettes impair immune responses more than tobacco

Written by Yvette Brazier

As evidence emerges that e-cigarettes are not as safe as advertisers claim, a new study shows that flavorings classed as “Generally Recognized as Safe” by the US Food and Drug Administration are best avoided in smoking. The findings are presented at the American Association for the Advancement of Science annual meeting in Washington, DC.

Cigarettes kill more than 480,000 people annually in the US. Since e-cigarettes appeared on the scene, many assume them to be a safer alternative, because smokers are not inhaling known carcinogens.

But as researchers analyze the contents of e-cigarettes, they are finding that some of them could be as risky as tobacco.

Ilona Jaspers, PhD, professor of pediatrics and director of the curriculum in toxicology at the University of North Carolina (UNC) School of Medicine has been researching new and emerging tobacco products, including e-cigarettes.

Having already found that cigarette smoking significantly impairs the immune responses of mucosal cells in the respiratory system, Jaspers’ lab is now looking at how e-cigarette chemicals affect immune responses in smokers’ airways.

E-cigarette flavorings not ‘recognized as safe’ for inhalation

But people do not consume e-cigarette flavorings orally, they inhale them. And the potential for toxic effects of inhalation have not been assessed, in most cases.While the Food and Drug Administration (FDA) may class e-cigarette flavorings “Generally Recognized as Safe,” Jaspers points out that this classification means they are safe for oral consumption.

Jaspers, who is also deputy director of the UNC Center for Environmental Medicine, Asthma and Lung Biology, explains:

“The digestive systems and respiratory systems are very different. Our stomachs are full of acids and enzymes that break down food and deal with chemicals; this environment is very different than our respiratory systems. We simply don’t know what effects, if any, e-cigarettes have on our lungs.”

Researchers studied the effects on smokers of cinnamon-flavored e-liquids and cinnamaldehyde, the chemical that gives cinnamon flavor to an e-cigarette.

Results showed that the cinnamaldehyde e-liquids had a significant negative impact on epithelial cells that could set off a chain of cellular mechanisms potentially leading to impaired immune responses in the lung.

Jaspers elaborates: “The chemicals compromise the immune function of key respiratory immune cells, such as macrophages, natural killer cells and neutrophils.”

Negative effect of e-cigarettes on respiratory immune system

The team also obtained tissue samples from the epithelial layer inside the nasal cavities of smokers, non-smokers and e-cigarette users, to analyze changes in the expressions of nearly 600 genes involved in immune responses.

They then tested nasal lavage fluid, urine and blood samples obtained from participants to detect changes in genetic and proteomic markers of tobacco and nicotine exposure and other markers of inflammation or immune responses.

In conventional cigarette smokers, they observed signs that a number of key immune genes in the nasal mucosa were suppressed.

In e-cigarette users, they found the same genetic changes, as well as suppression of additional immune genes. The findings imply that e-cigarettes have an even broader effect on the respiratory mucosal immune response system than conventional cigarettes.

The next step will involve in-vitro and in-vivo studies into the effects of chemicals on long-term e-cigarette smokers. Research will focus on immune suppression in the respiratory mucosa, with particular focus on cinnamon-flavored e-liquids.

Further evidence that e-cigarette smoking weakens the immune system was published recently in Medical News Today.

http://www.medicalnewstoday.com/articles/306444.php

WDAZ: Devils Lake landlord honored for going tobacco-free

By Kelsie McMahon

DEVILS LAKE, ND (WDAZ-TV) – The secondhand smoke from even one tenant smoking indoors can cause health problems for people in multiple other units.

In North Dakota it is legal to smoke inside an apartment, but one landlord is making a difference in Devils Lake.

Dan Lagein, Lagein Apartments owner: “Probably over a year ago we went smoke free.”

Dan Lagein was honored today for being the first landlord in Devils Lake to make five of his apartment units tobacco-free.

Lagein: “With Liz’s help here we’ve got all the signage and the verbiage for our contracts, so that started all that probably about six months ago.”

Liz Bonney, Lake Region District Health: “Well right now the law reads you can actually smoke inside your apartment within the confines, but not in any common areas and not within 20 feet of the building. What Dan has done is he has taken the state policy, our motto policy I should say, and kicked it up a notch.”

Signs show smoking is prohibited inside the building and within 20 feet of the entrance.

Lagein says there were several requests from tenants to go smoke free.

Lagein: “The smoke that resonates through the whole building, the tenants were just tired of the smoke smell for the small percentage that do it, it affects everybody involved.”

In North Dakota 18%of people smoke, but secondhand smoke can affect everyone.

Bonney: “The larger population needs to be acknowledged and they need to have a place to go and a place to rent that is, you know, protects them and their kids and is tobacco free.”

The hope now is that it will create a domino effect for other property owners.

Bonney: “Now that other property managers and property owners are going to see that he’s taken the step, it’s kind of like the first domino falling and maybe tenants will start speaking up.”

Lagein says while people may still sneak a smoke, the change has made a difference in the smell of the building.

Lagein: “It’s a great day for all of us and especially for the young ones involved or anybody involved that is sensitive to smoke or doesn’t appreciate it, you know, it just gives them their rights too.”

A move by one landlord that could make a difference for housing in the whole community.

Officials say secondhand smoke can cause cancer, heart attacks, and Sudden Infant Death Syndrome.

To read more or watch the video: http://www.wdaz.com/news/north-dakota/3945265-devils-lake-landlord-honored-going-tobacco-free

Duluth Budgeteer News: Bus in Minnesota advertises tobacco… for a purpose

By Duluth Budgeteer News

If you are downtown or near a Duluth Transit Authority Bus route, you might see a colorful bus advertising a soda drink. Or you may see a bus with larger-than-life television news personalities plastered on its side.

And now you might see a DTA bus advertising tobacco. But it’s not pushing everyday use of tobacco for smoking or chewing.

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The colorful bus wrap was inspired by the work of Native American artist Jonathan Thunder. Duluth Budgeteer readers may remember the recent story on Thunder.

The wrap will adorn a Duluth bus for nine months. Each day the bus will be used on a different route.

The wrap was adapted from a mural that Thunder painted at the Lincoln Park Children and Families Collaborative (LPCFC), 2424 W. Fifth St., entitled “Keep Tobacco Sacred” and photographed by Ivy Vainio.

“We did the bus wrap because we want to start conversations about the difference between commercial and sacred tobacco,” said Jodi Broadwell, executive director of LPCFC.

The smoking rates among the American Indian population in Minnesota is 59 percent, compared to 14.4 percent for the general population. Commercial tobacco-related diseases are the top killers within American Indian communities, including the Lincoln Park neighborhood.

“Traditionally, tobacco was viewed as a sacred medicine central to the culture of some American Indian populations, but for generations the commercial tobacco industry has corrupted sacred tobacco practices,” Broadwell said. “They have also marketed directly to American Indian people by exploiting their images in advertisements.”

The LPCFC’s commercial tobacco prevention work is funded in part by the Center for Prevention at Blue Cross and Blue Shield of Minnesota.

LPCFC was founded in 2011 by a group of education, child development, health and social service professionals. The mission of the organization is to strengthen the Lincoln Park Community by connecting families who care about young children. LPCFC offers Anishinaabe Cultural Programming during its Monday Night Family Gatherings, which includes education on sacred tobacco and its traditional uses.

http://www.grandforksherald.com/news/region/3941247-bus-minnesota-advertises-tobacco-purpose

KFYR-TV: ND Gets 'F' Grade for Tobacco Taxes on State of Tobacco Control Report

By: Amanda Skrzypchak, KFYR-TV
When it comes to taxes on tobacco North Dakota gets an F from the American Lung Association.
Released in it’s annual State of Tobacco Control Report Wednesday, North Dakota’s overall grades didn’t change from last year. The report shows the state received A’s for smoke free air, as well as prevention and control program spending. A C for access to cessation and an F for tobacco taxes.
Cigarette taxes are at 44 cents per pack making it one of the lowest in the nation.
The CDC best practices show that increasing the price of tobacco is the most effective way to reduce the amount of kids smoking.
For a complete look at the report and compare our state to others visit stateoftobaccocontrol.org.
http://www.kfyrtv.com/home/headlines/ND-Gets-F-Grade-for-Tobacco-Takes-367523391.html

Bismarck Tribune: Study links chemical in e-cigs to lung cancer

BLAIR EMERSON Bismarck Tribune
A new study found e-cigarettes may not be a safer alternative to smoking tobacco.
Harvard T.H. Chan School of Public Health recently published the results of a study that found popular e-cigarette flavors contain diacetyl, a chemical linked to a severe lung disease.
“This latest study … is yet another reminder that e-cigarettes are not a safe alternative to tobacco use,” said Jeanne Prom, executive director of the North Dakota Center for Tobacco Prevention and Control Policy.
Researchers studied 51 types of flavored e-cigarettes that appeal to youths. Many E-cigarette brands offer fruit and candy flavors, which Prom said are unique and target kids.
The North Dakota 2015 Youth Risk Behavior Survey reports that 22 percent of high school students report using e-cigarettes at least once in the month prior to taking the survey.
“Our own North Dakota high school students have tried these products,” Prom said. “It’s not a safe alternative. … You’re really just swapping out one poison for another.”

Diacetyl is a flavoring chemical linked to a type of lung disease called bronchiolitis obliterans, or “popcorn lung,” which got its name after workers contracted the lung disease while working in microwave popcorn factories.
Currently, e-cigarettes are unregulated, but the U.S. Food and Drug Administration has proposed a rule to regulate e-cigarettes just as the agency regulates cigarettes and other tobacco products.
“It is our hope that the FDA’s final rules are released very soon and can provide some regulatory framework that can lead to these products being more properly regulated and less available to kids,” she said.
http://bismarcktribune.com/news/study-links-chemical-in-e-cigs-to-lung-cancer/article_ff4f45b4-8374-5ae0-9588-32491eb790ad.html

Medical News Today: Graphic warnings on cigarette packets 'help smokers consider health risks'

With 2016 just around the corner, many individuals will be gearing up to take on one of the most challenging New Year’s resolutions: to quit smoking. But a new study suggests this challenge could be made easier if graphic warning labels were put on cigarette packets, after finding such warnings trigger more negative feelings toward smoking than text warnings alone.
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Lead study author Abigail Evans, a postdoctoral researcher at Ohio State University, and colleagues publish their findings in the journal PLOS One.
In 2011, the Food and Drug Administration (FDA) published a final rule that required tobacco companies to include color graphics on cigarette packets that depict the negative health implications of smoking.
In 2012, however, a US federal appeals court overturned the ruling, claiming the images put forward by the FDA were “unconstitutional” and were “unabashed attempts to evoke emotion […] and browbeat consumers into quitting.”
According to Evans and colleagues, their findings suggest the decision to overturn the FDA’s rule based on these grounds was wrong; the team says the graphic images do not “browbeat” consumers, and though they do evoke emotion in smokers, the researchers say these emotions make people think more carefully about the health risks of smoking.
“What the court is missing is that without emotions, we can’t make decisions,” says study coauthor Ellen Peters, professor of psychology at Ohio State. “We require having feelings about information we collect in order to feel motivated to act. These graphic warnings helped people to think more carefully about the risks and to consider them more.”

Feelings produced by graphic images ‘acted as a spotlight’

The team reached their conclusion by assessing 244 adults of an average age of 34 who smoked between 5-40 cigarettes a day.
For 4 weeks, smokers were given their preferred brand of cigarettes in packaging that had been modified; some packets contained warning text only – such as “cigarettes cause fatal lung disease” – some contained warning text plus one of nine graphics depicting the dangers of smoking, while others consisted of warning text, graphics plus additional text detailing the risk of every cigarette smoked.
The warning graphics used were developed by the FDA and contained disturbing images, such as a man smoking through a hole in his throat, depicting a surgical procedure known as a tracheostomy that is a result of some smoking-related cancers.
Each week for the 4-week period, smokers collected their cigarettes from the lab and completed surveys detailing how the new packaging made them feel about smoking.
Compared with participants who received text-only packaging, those who received packaging with graphic warnings were more likely to read or look closely at the information, were more likely to remember the information, and were more likely to report that the packaging made them feel worse about smoking.
“The feelings produced by the graphic images acted as a spotlight,” notes Peters. “Smokers looked more carefully at the packages and, as a result, the health risks fell into the spotlight and led to more consideration of those risks.”
In addition, smokers who received packaging with graphic warnings were also more likely to view the information as more “credible” than those who received text-only packaging, and they were also slightly more likely to say they planned to quit smoking.
“For a health issue like smoking, which causes about a half-million deaths a year in the United States, even small effects can have a large impact in the population,” says Peters. “The effect was small, but it was not unimportant.”
Overall, the researchers say their findings show graphic warnings are more effective than text-only warnings for getting consumers to consider the health risks of smoking. They add: “Policies requiring such labels have the potential to reduce the number of Americans who smoke. The effect induced by graphic warning labels appears to have utility in communicating more and more credible information, useful to promoting risk perceptions and quit intentions among smokers in the US and around the world.”
This research supports another study reported by Medical News Today earlier this year, which found a combination of health warning graphics and text on cigarette packets increased knowledge about the dangers of smoking among young adults, compared with text-only warnings.

Fargo Forum: WF high school rethinking assignment to urge lawmakers to hike tobacco tax

WEST FARGO – Add to North Dakota’s tobacco tax or leave it alone?
That’s a question Sheyenne High School teachers agree would have been better left up to students to decide.

On Friday, senior government class students teamed up with a freshman health class in a collaborative project to write letters to local legislators about the tobacco tax rate in North Dakota. The students thanked lawmakers who voted to increase the tobacco tax in the state during the last session, and encouraged those who didn’t support a higher tax on tobacco to consider doing so in the future.
“For our state, we have very strict laws as far as tobacco in public buildings, but as far as tobacco tax, we are one of the lowest in the nation, and that’s what we are trying to deter,” health teacher Tom Kirchoffner told WDAY-TV.
The original intent was to send the letters to the legislators, but that’s not what happened.
“After this group of teachers did the project, they sat down and they debriefed it. What were the strengths of that project … and what were some of the areas for improvement?,” district spokeswoman Heather Konschak said Tuesday.
That debriefing took place Friday, she said.
“They realized as they chatted about it that one of the areas for improvement would have been that they gave the student group their perspective,” Konschak said. “The students weren’t able to discuss it and come up with their own perspective. And from a government class standpoint, that’s not what you do. You allow kids to discuss and form their own perspective and viewpoint.”
The teachers “decided that because that’s not what happened in the project, that they weren’t going to send the letters,” because it is possible that’s “not an accurate depiction of what the kids would have picked if they had been given the opportunity to do it on their own,” Konschak said.
The decision was “there should have been more open dialogue,” to let the students choose their positions on the issue, Konschak said.
Konschak said one of the teachers got the idea from a conference. The project was in addition to the required curriculum, she said.
Kirchoffner didn’t immediately return a phone message seeking comment Tuesday. He was unavailable because he’s a basketball coach and was traveling to a game, Konschak said.
North Dakota’s tax per pack of cigarettes is 44 cents, which puts it at 48th in the nation. Minnesota’s per pack tax is $2.90, putting it at No. 8 in the U.S., according to the Campaign for Tobacco-Free Kids.
New York has the highest state tax per pack at $4.35, while Missouri has the lowest state tax at 17 cents per pack. The national average is $1.60 per pack, the campaign reports.
Those figures do not include local taxes. The highest state-local tax combination per pack is $6.16 in Chicago, with New York City second at $5.85 per pack, the campaign reports.
http://www.inforum.com/news/3904754-wf-high-school-rethinking-assignment-urge-lawmakers-hike-tobacco-tax