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Smoking not 'lesser evil' in mental health treatment settings

By: Maiken Scott, Newsworks
Picture an AA meeting, and a gigantic coffee urn and a cloud of smoke come to mind.
In fact, the two men who started AA, Dr. Bob and Bill W. both died from tobacco-related illnesses.
Public health experts say smoking is still pervasive among people living with addiction and mental illness, and it’s often not seen as a priority in treatment settings.
For example, smoking rates in Philadelphia have dropped significantly over 10 years, but haven’t budged among people with mental illnesses and substance-abuse issues.
Smoking is often seen as a “lesser evil” in mental health and addiction treatment settings, explained Ryan Coffman, tobacco policy manager for Philadelphia’s Department of Public Health. It’s not a priority, and some providers assume it helps their clients cope.
Research shows the opposite to be true, says Coffman. “Individuals living with mental illness and substance-abuse disorders who smoke have more severe symptoms, poorer well-being and functioning, they have more hospitalizations, and are at a greater risk for suicide,” he said.
Research also shows that people who quit smoking along with quitting other drugs have better recovery outcomes.
Philadelphia is increasing efforts to train mental health providers on tobacco-cessation programs, and to provide them with the most up-to-date resources available to their clients, Coffman said.
But for these efforts to really take root, a major cultural shift will have to occur, said University of Pennsylvania psychiatrist Robert Schnoll, who studies tobacco cessation.
“Research indicates that upwards of 25 percent of mental health care facilities still permit smoking on the grounds and on the premises,” he explained. “There’s pervasive use of cigarettes, or cigarette breaks, as a reward for pro-social behavior, so that’s certainly one of the issues we need to address going forward.”
Some providers think their clients don’t care about tobacco cessation, he said, or don’t understand the benefits. Some also simply don’t see it as their responsibility.
Research also indicates that smoking rates are high among people who work in mental health treatment settings, Schnoll said.
http://www.newsworks.org/index.php/homepage-feature/item/75483-smoking-not-lesser-evil-in-mental-health-treatment-settings?linktype=hp_impact

Smoking while using oxygen blamed for fire at Fargo's Sanford Medical Center

FARGO (KFGO-AM) — Investigators say a patient who was smoking while using oxygen caused a fire that injured both the patient and a staff member at Sanford Medical Center in downtown Fargo last week.
Fire chief Steve Dirksen says the combination of pure oxygen and open flame is extremely volatile.  He says it was quick response by hospital employees that prevented a much more serious situation.
The exact nature of the injuries has not been disclosed because of the patient confidentiality law.
Hospital employees who responded to a smoke alarm early Thursday in the room rescued the patient, had the fire out when firefighters arrived and evacuated patients in nearby rooms.
Damage to the room was minor.
http://kfgo.com/news/articles/2014/nov/17/smoking-while-using-oxygen-blamed-for-fire-at-fargos-sanford-medical-center/

Sanford fire caused by smoking around oxygen

By Forum staff reports
FARGO – Fargo fire investigators say the fire that injured two people and caused the evacuation of several patients at Fargo’s downtown Sanford Medical Center on Thursday was caused by someone smoking while using oxygen.

Sanford officials said the fire originated in a patient room early Thursday morning and was extinguished by staff members before it spread.

The patient in that room and one staff member were hurt in the fire.

Ten patients had to be evacuated to other parts of the hospital.

Fargo Fire Marshal Ryan Erickson said he was not sure whether officials would recommend criminal charges against the person who was smoking around the oxygen.

He reminded people to never smoke near an oxygen source, even when it’s turned off.

http://www.inforum.com/content/sanford-fire-caused-smoking-around-oxygen

Fewer high school students smoking

Posted by: Colleen Stoxen
In the steepest decline ever found in Minnesota, the percent of high school students who smoked cigarettes in the past 30 days dropped from 18.1 percent in 2011 to 10.6 percent in 2014.
The 2014 Minnesota Youth Tobacco Survey also found fewer young people used used chewing tobacco and cigars between 2011 and 2014.
Efforts to curb cigarette smoking appear to be helping. They include a 2013 tobacco tax, bans on indoor smoking, and tighter restrictions on youth access to tobacco products.
For the first time, the survey also asked about e-cigarette use and found that 12.9 percent of high school students used or tried an electronic cigarette in the past 30 days. The survey found that 28 percent of high school students reported ever having tried an e-cigarette.
“These new findings indicate that our statewide efforts to reduce and prevent conventional tobacco use among Minnesota children are working,” said Minnesota Department of Health Commissioner Dr. Ed Ehlinger. “At the same time, we are seeing a wild-west approach toward e-cigarettes, which allows tobacco companies unlimited marketing access to young men and women. This has led to increasing numbers of Minnesota high school and middle school students using e-cigarettes.”
An estimated 85,900 Minnesota public school students in grades 6-12 have tried e-cigarettes, and 38,400 reported using them in the past 30 days. Nicotine is known to harm adolescent brain development. Nearly one-fourth of high school students who have tried an e-cigarette have never tried another tobacco product.
Read more from the Minnesota Department of Health.
http://www.startribune.com/lifestyle/blogs/282152861.html

Tobacco tax increase a success: Fewer Minnesota kids smoking

MINNEAPOLIS, Nov. 10, 2014 /PRNewswire/ — The Raise it for Health coalition praised the results of a study today released by the Minnesota Department of Health (MDH), showing a dramatic drop in the number ofMinnesota kids smoking cigarettes. Specifically, the smoking rate among Minnesota students grades six through 12 decreased from 18.1 percent in 2011 to 10.6 percent in 2014, the steepest decline ever recorded by this survey. The study also showed fewer Minnesota kids using other tobacco products, including cigars, cigarillos and smokeless tobacco.
The Minnesota Legislature raised the tax on cigarettes and other tobacco products significantly in 2013. The proposal had strong support from Governor Dayton, elected officials on both sides of the aisle and a majority of Minnesotans from all corners of the state.
“The dramatic drop in the number of Minnesota kids smoking is one clear indication that the tobacco tax is working,” said Molly Moilanen, Director of Public Affairs at ClearWay Minnesota, and co-chair of the Raise it for Health coalition. “The tobacco industry spends nearly 165 million dollars each year marketing their dangerous products in our state. Raising the price of tobacco is the best tool we have to prevent youth smoking and give our kids a fighting chance against Big Tobacco.”
In addition to keeping more kids from smoking, the $1.60 per-pack increase will:

  • Help more than 36,600 addicted adults stop smoking.
  • Prevent 25,700 Minnesotans from dying prematurely from smoking-related deaths.
  • Save $1.65 billion in long-term health care costs.

“Thank you, Governor Dayton and members of the Minnesota Legislature, for taking this bold and important step,” said Janelle Waldock, Director of the Center for Prevention at Blue Cross and Blue Shield of Minnesota, and co-chair of the Raise it for Health coalition. “These results reinforce what we know: increasing the tax on tobacco products was a victory for the health of Minnesota’s kids.”
The Minnesota Department of Health has conducted the Minnesota Youth Tobacco Survey (MYTS) in 2000, 2002, 2005, 2008, 2011 and 2014. The survey includes questions on the use of various tobacco products, characteristics of smokers, exposure to secondhand smoke, media awareness and other topics. Public schools and classrooms across the state were selected at random and invited to participate.
For more information on the MYTS, please visit www.health.state.mn.us.
Raise it for Health is a coalition of Minnesota’s leading health and nonprofit organizations with a common goal of reducing tobacco use in the state. Partners include: AARP Minnesota, Allina Health, American Cancer Society Cancer Action Network, American Heart Association, American Lung Association in Minnesota, Association for Minnesota Counties, Association for Nonsmokers – MN, Blue Cross and Blue Shield ofMinnesota, CentraCare Health System, Children’s Hospitals and Clinics of Minnesota, ClearWay Minnesota(SM), Courage Center, Four Corners Partnership, HealthEast Care System, HealthPartners, LAAMPP Institute, Local Public Health Association, Mayo Clinic, Medica, Metro-MN Oncology Nursing Society, Minnesota Academy of Family Physicians, Minnesota Cancer Alliance, Minnesota Chapter of the American Academy of Pediatrics, Minnesota Comprehensive Health Association, Minnesota Council of Health Plans, Minnesota Medical Association, Minnesota Public Health Association, Park Nicollet Health Services, PartnerSHIP 4 Health, School Nurse Organization of Minnesota, Service Employees International Union Healthcare Minnesota, Southwest Community Health Improvement Program and Twin Cities Medical Society.
SOURCE Raise it for Health
http://www.prnewswire.com/news-releases/tobacco-tax-increase-a-success-fewer-minnesota-kids-smoking-282162591.html

Cigars Loaded With Harmful Toxins, Study Shows

(HealthDay News) — Some cigar smokers may believe they face less health risk than if they were smoking cigarettes, but a new study casts doubt on that notion.
Researchers say that cigar smokers are exposed to high levels of cancer-causing agents and other toxic substances, which suggests that the habit is as risky as smoking cigarettes.
None of this came as much surprise to lung experts.
“In spite of the fact that cigar smokers don’t inhale, more attention needs to be paid to the damages of secondhand smoke, and to acknowledge that no smoking is safe,” said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City.
“It is well known that secondhand smoking causes asthma, as well as a possible increase in the risk for lung cancer. The cloud around a cigar smoker’s respiratory system is tantamount to this phenomenon,” Horovitz said.
Cigar use in the United States more than doubled from 2000 to 2011, according to the U.S. Centers for Disease Control and Prevention.
The findings are reported Nov. 7 in the journal Cancer Epidemiology, Biomarkers & Prevention.
In the new study, researchers analyzed the presence of five chemical signals of tobacco exposure in tests conducted on more than 25,500 Americans.
Two of the biomarkers — cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) — are specific to tobacco. The other biomarkers — lead, cadmium and arsenic — are not tobacco-specific and can come from other sources.
The study found that cigar smokers — whether or not they also smoked cigarettes — carried higher levels of cotinine, NNAL, cadmium and lead than people who did not use tobacco. Cigar smokers with a history of cigarette use had much higher levels of cotinine and NNAL than cigar smokers who did not smoke cigarettes.
Also, levels of NNAL in daily cigar smokers were similar to those of daily cigarette smokers, according to the study.
“Cigar smoking exposes users to similar types of harmful and cancer-causing agents as cigarette smoking,” lead author Dr. Jiping Chen, an epidemiologist at the U.S. Food and Drug Administration’s Office of Science, Center for Tobacco Products, said in a journal news release.
“Once differences are accounted for in frequency of use, the levels of NNAL, a strong carcinogen, are comparable in cigar and cigarette smokers,” Chen said.
Another expert in respiratory health agreed that cigars are probably no better than cigarettes when it comes to health.
“This is especially significant because, although youth cigarette smoking has decreased, high school students in the U.S. are twice as likely as adults to smoke cigars,” noted Patrician Folan, director of the Center for Tobacco Control at North Shore-LIJ Health System in Great Neck, NY.
“Frequently, cigars are cheaper and are available in a wide variety of flavors that appeal to adolescents and young adults,” she said. “This combination of factors makes cigar smoking more attractive to young people, who may have the perception that cigar smoking is less harmful, especially due to flavors like chocolate, grape, strawberry and peach.”
More information
The American Cancer Society has more about cigar smoking.

SOURCES: Len Horovitz, M.D., pulmonary specialist, Lenox Hill Hospital, New York City; Patricia Folan, RN, director, Center for Tobacco Control, North Shore-LIJ Health System, Great Neck, N.Y.;Cancer Epidemiology, Biomarkers & Prevention, news release, Nov. 7, 2014

http://consumer.healthday.com/cancer-information-5/smoking-cessation-news-628/cigars-loaded-with-harmful-toxins-study-shows-693504.html

Letter: Raise state cigarette tax, protect ND kids

By Nicholas Thies, Fargo

I have a friend who started smoking in ninth grade, roughly seven years ago, and he is still addicted to this day. The tobacco companies are aware of these trends and spend millions of dollars on new products and deceptive marketing with the goal of turning children into lifelong customers, as is the case with my friend. I have talked with him, and he has told me how raising the tobacco tax would greatly encourage him to quit smoking.

One of the best ways to prevent kids from ever starting the deadly addiction is to increase the price of tobacco products so they can’t afford to purchase them. States have been successfully using this tactic over the past decade by increasing local tobacco taxes. It can also help detract adult smokers from continuing the habit. Many of my aunts and uncles have been smoking for decades, and I always wished for something that would make them quit.

I’m suggesting we raise North Dakota’s cigarette tax significantly. Of the surrounding states, North Dakota’s tobacco tax is incredibly cheaper.

This one simple act can keep nearly 7,900 North Dakota kids from ever becoming adult smokers. And, more importantly, it means that more than 4,700 caused deaths would be prevented.

North Dakota, this is a win-win idea. You can decrease long-term health care costs and protect our children. I urge you to write your legislator and ask them to consider increasing North Dakota’s tax on all tobacco products.

It’s the right choice for our kids.

http://www.inforum.com/content/letter-raise-state-cigarette-tax-protect-nd%E2%80%88kids

Fewer Fargo High School students smoking, binge drinking

By Helmut Schmidt | Fargo Forum
FARGO – The percentage of Fargo High School students taking up cigarette smoking is dropping fast, and fewer students are binge drinking.

But other risks are coming to the fore, including what appears to be higher rates of depression and thoughts of suicide. Students also report a high rate of texting, emailing and talking on cellphones as they drive.

One out of five Fargo high school students polled were bullied electronically, while nearly one in 10 students said they were physically hurt by someone they were dating.

Statistics from the 2013 Youth Risk Behavior Survey paint a stark picture of the challenges faced by youths today, said Ron Schneider, a counselor at Fargo’s Woodrow Wilson High School.

Presenting the survey results and trend data to the School Board Tuesday, Schneider said it’s vital for family, teachers and school officials to make connections with young people.

“The more connections, the more relationships, the less likely they get involved with negative behavior,” Schneider said.

Among the findings:

  • Depression is a problem that’s either on the rise, or it has become more acceptable to talk about, Schneider said. “My guess is it’s a little of both,” he said. In 2013, 26.9 percent of Fargo students polled in grades 9-12 felt sad or hopeless almost every day for two or more weeks straight, up from 22.7 percent in 2009, the survey showed.
  • Of those surveyed, 16.8 percent had seriously considered suicide in the previous year, 12.4 percent had made a plan about how they would attempt suicide and 11.6 percent had attempted suicide one or more times in that year.
  • About two out of three young drivers are so hooked on their cellphones they can’t put them down when driving. Among Fargo students surveyed, 57.3 percent said they had texted or emailed while driving in 2013. Meanwhile, 67 percent of Fargo students said they had talked on a cellphone while driving in 2013.
  • In Fargo, 8.6 percent of students surveyed in 2013 reported being hurt by someone they dated, with that rising to 9.7 percent statewide.
  • Also, 10.1 percent of Fargo high school students in 2013 said they had been physically forced to have sexual intercourse, compared with 7.7 percent of those polled statewide.
  • About 20.1 percent of Fargo students said they had been electronically bullied, compared with 17.1 percent statewide.
  • Nearly a third of Fargo students, 28.7 percent, said they had an alcoholic drink in the last 30 days. It was 35.3 percent statewide.

Drug use

Schneider said it appears that the use of other chemicals has stabilized.

  • In 2013, 19.6 percent of Fargo students had tried marijuana in the last 30 days, compared with 15.9 percent statewide.
  • About 10.7 percent of Fargo students said they had sniffed glue, huffed from aerosol cans, or inhaled paints or spray to get high, while 5.6 percent said they had used methamphetamines.
  • In 2013, 20.5 percent of Fargo students said they had illegally used prescription drugs such as OxyContin, Percocet, Vicodin, codeine, Adderall, Ritalin or Xanax.
  • About 13.5 percent of Fargo high school students used over-the-counter drugs to get high in 2013, while 10.8 percent said they had used synthetic drugs such as K2, Spice or bath salts.
  • About 12.5 percent of students polled in 2013 said they had attended school drunk or high in the last 30 days.

Some positives

  • Regular smokers, Fargo teens who had smoked a cigarette on 20 of the last 30 days before the 2013 poll, dropped significantly, from 11.1 percent in 2009 to 3.9 percent in 2013.
  • About 21 percent of Fargo students reported smoking cigarettes, cigars or using chewing tobacco, snuff or dip in the last 30 days in the 2013 poll.
  • Binge drinking declined, as 17.7 percent of Fargo students in 2013 said they had five or more drinks in a couple of hours, compared with 23.9 percent in 2009. Statewide, 21.9 percent reported binge drinking in 2013, compared with 30.7 percent in 2009.

Sexually active

Many young people reported that they were sexually active. Of the students surveyed in 2013:

  • 39.7 percent of Fargo high school students reported that they had sexual intercourse, compared with 44.9 percent statewide.
  • 12.4 percent of Fargo students said they had sex with four or more partners during their lives.
  • 51.7 percent of Fargo students said they had used a condom during their last sexual experience, compared with 56.3 percent statewide.

http://www.inforum.com/content/fewer-fargo-high-school-students-smoking-binge-drinking

Q: Is hookah or water pipe smoking a safe alternative to cigarettes?

By Sanjay Gupta, MD

A: Absolutely not. In fact, as Daniel Neides, MD, medical director of the Wellness Institute at Cleveland Clinic points out, hookah smoking “may actually be worse than smoking.”

Hookahs are water pipes in which charcoal is used to heat up flavored tobacco. An ancient form of smoking that originated in the Middle East and India, it has become increasingly popular among American adolescents and young adults. Roughly 1 out of 5 U.S. high school seniors had smoked a hookah in the past year, according to recent data.

The hookah’s gaining popularity is largely due to the misconception that it’s not harmful. That’s not the case. “First, the tobacco used in hookah contains the same cancer-causing agents found in cigarettes,” Dr. Neides says. “Secondly, there is charcoal that is used to heat the tobacco, which gives off carbon monoxide and heavy metals as a by-product when it is heated.”

A hookah session usually lasts longer than time spent smoking cigarettes, with hookah smokers puffing more frequently and inhaling more deeply. A 2010 study reported the amount of smoke inhaled during a hookah session can be nearly 200 times the amount inhaled when smoking a cigarette. Earlier this year, researchers at the University of California, San Francisco, found that hookah smoking raised nicotine urine levels as much as 73 times.

Neides adds that because water pipes are usually smoked in specialty hookah shops or bars and shared among friends, users are exposed to greater levels of secondhand smoke and are at a higher risk of contracting viruses or infections.

The bottom line, Neides says, is that “hookah smoke should be considered the same as cigarettes and cigars – a very unhealthy habit that leads to chronic disease and death.”

http://www.everydayhealth.com/columns/paging-dr-gupta/is-hookah-or-water-pipe-smoking-a-safe-alternative-to-cigarettes/

The Health Claims Of E-Cigarettes Are Going Up In Smoke

Jasper Hamill, Contributor | Forbes

The sales pitch of electronic cigarette manufacturers seemed too good to be true. Could nicotine addicts around the world really get their fix whilst dodging the health risks of puffing away on cancer sticks?

Sadly for smokers and “vapers”, the answer is far from clear. Over the past week, new evidence has emerged which suggests that E-Cigarettes can be dangerous too – in some cases carrying higher amounts of certain toxins than the blazing tobacco of old.

Researchers at the University of South California have found that although E-Cigarettes are less harmful than ordinary smokes, the vapour emitted by the gadgets contains the toxic element chromium, which is not found in traditional cigarettes, as well as levels of nickel four times higher than in real tobacco. The electronic replacements also contain lead, zinc and other toxic metals, although in lower levels than cigarettes.

English: Two electronic cigarette models. Self...

Two electronic cigarette models. (Photo credit: Wikipedia)

“Our results demonstrate that overall electronic cigarettes seem to be less harmful than regular cigarettes, but their elevated content of toxic metals such as nickel and chromium do raise concerns,” said Constantinos Sioutas, professor at the USC Viterbi School of Engineering.

There is a bit of good news for reforming smokers, as E-Cigarettes contain virtually no detectable polycyclic aromatic hydrocarbons, which are known to cause cancer. The researchers also said the metal particles were likely to come from the cartridge of the E-Cigarette devices, opening up the possibility that a change in the production process could eliminate the dangerous chemicals.

But this isn’t the only bit of bad news for vape inhalers. In the UK, the BBC reported that E-Cigarette liquid sold in the north east of England was found to contain a chemical called diacetyl, which is used to add butterscotch flavor to liquid tobacco.

Whilst this substance is harmless to eat, it is extremely dangerous to inhale. The chemical is known to cause a serious condition called popcorn lung, orbronchiolitis obliterans, an irreversible disease which scars the lung and makes it impossible to breathe properly. This illness has struck workers in popcorn factories, who are known to breathe in vast quantities of diacetyl, as well as ordinary people who eat a lot of popcorn.

Commenting on the report, Dr Graham Burns, a respiratory expert at Newcastle’s Royal Victoria Infirmary, said the illness is often “serious enough to warrant lung transplantation”.

VP, the firm which manufactured the cigarettes, immediately withdrew the liquid from sale, and Lynne White, head of retail distribution, admitted there were concerns about inhaling the liquid on a long-term basis.

“We are very sorry it has happened, we are investigating how it has happened,” she added.

“Because of the small amount the vaper would actually consume it was deemed in the short term there would be no health concerns.

“Long-term yes there could well be, however we decided it was a withdrawal rather than a recall of the product and that was based on Ecita’s (Electronic Cigarette Industry Trade Association) guidelines.”

But for many health-conscious people, the damage is likely to have been done. Once upon a time, the world didn’t know about the many terrible effects of cigarettes. It was only after a concerted campaign by scientists, doctors and activists that the risks began to be publicized and governments began to act on them. The long term implications of switching to E-Cigarettes have not yet been tested, so anyone using the devices has to ask themselves if they are willing to take the risk of becoming a guinea pig.

Marlboro Cigarettes

Marlboro Cigarettes (Photo credit: Wikipedia)

The World Health Organisation has issued a report advising that use of E-Cigarettes should be banned indoors and and all advertising stopped until the emerging industry produces “convincing supporting scientific evidence and obtains regulatory approval”.
Backing this call, the British Medical Association board of science deputy chair Ram Moorth said “tighter controls are needed to ensure their use does not undermine current tobacco control measures and reinforces the normalcy of smoking behaviour”.

‘There is a need for research to understand the health impacts of E-Cigarettes on both the user and bystanders, and it is vital that the sale of e-cigarettes is appropriately regulated to ensure they are not sold to minors, and are not aggressively marketed to young people as tobacco was in the past,” he continued.

“Any health claims must be substantiated by robust independent scientific evidence to ensure that the consumer is fully informed regarding potential benefits and risks of E-Cigarettes.”
Are you willing to take the chance and keep on vaping?
For more news and comment, follow me on Twitter @jasperhamill
http://www.forbes.com/sites/jasperhamill/2014/08/31/the-health-claims-of-e-cigarettes-are-going-up-in-smoke/