Healthbuzz

Scandal of danger chemical in baby bottles.

Britain’s biggest infant-products retailers are selling baby bottles made with a chemical banned by Canada and three US states and which scientists fear may cause breast cancer, heart disease, obesity, hyperactivity and other disorders, The Independent can disclose.

Childhood obesity linked to heart ills.

Obese children as young as age 3 show signs of an inflammatory response that has been linked to heart disease later in life, researchers said, in a finding that is likely to further stoke concerns about childhood obesity.

Tamara McClintock Greenberg: Can Overweight Women Trust Their Doctors?

Being a doctor these days is hard. But so is being a patient, especially if you happen to be female and overweight. A study last year found that more than 40% of doctors feel “frustrated” by obese patients. But feelings among doctors are not the only problem. Recent studies have found that a woman who is as little as 13 pounds overweight may receive less than optimal medical care. Women who are over 20 pounds on the wrong side of the scale are more prone to inaccurate diagnoses, have more trouble finding a fertility doctor for help with getting pregnant, and are less likely to receive early diagnosis and effective treatment for cancer. The research matches up quite accurately with my clinical experience. Over the years I have known many overweight women who have been misdiagnosed by their physicians. And though I realize that anyone can be misdiagnosed, the striking numbers of overweight women whose doctors have missed serious illness reinforces the belief that doctors think differently about those carrying extra pounds. Of course obesity is a serious problem and one that should be addressed. But weight gain is partially related to self-control, as well as genetic and biological factors. Many physicians, whom we often expect should know better, attribute being overweight solely to dietary habits. This is in spite of data on biological factors that are implicit in weight gain. Psychotropic drugs , which are taken by millions, cause people to put on pounds. Ironically, these medications are often prescribed by the very same doctors that are annoyed with their patients for being heavier than they should be. Additionally, though in need of further study, some have speculated on chemical and environmental factors that impact metabolism via hormone production. There is even speculation that environmental toxins are associated with the development of diabetes in some populations. That being said, some people simply do eat too much. And they can learn to change this behavior. But where are realistic discussions about today’s overwhelming guidelines about what is required of all of us to stay healthy? At last count, recommendations for crucial self-care behaviors for reducing heart disease, cancer and dementia include the following: manage weight, get plenty of exercise, avoid high fat and high cholesterol foods, eat several vegetables and fruits a day, floss at least once a day, get regular teeth cleaning, reduce meat consumption, don’t smoke, avoid sugar and other simple carbohydrates, and take medications strictly as prescribed. And then there are the more confusing recommendations– vitamin D intake (which experts don’t agree on), drinking alcohol (the amounts vary depending on the kind of disease you are trying to avoid) and eating a lot of fish (but not too much, because of mercury). And regarding mercury, how do we manage this potentially dangerous metal? Should we all rush to get our fillings replaced? And in this economy, who can afford it? As if that list weren’t comprehensive enough, for those of us especially worried about both the environment and our health, we are told that we should avoid foods with preservatives, eat organic, and ingest meat that is responsibly raised and without hormones. Though I personally agree with many health recommendations, this dizzying list of behaviors is quite frankly out of reach for most people. Work commitments, time and finances limit many from achieving these ideals. Doctors know this. Many physicians have trouble doing all that is needed to take care of themselves. Presumably, like the rest of us, they are too busy or too confused to follow the guidelines. But still, why do some doctors give up on patients who have trouble controlling their weight, especially if they happen to be women? Since doctors are human, they are subject to the same biases many of us share. And with almost half of medical patients in the U.S. being noncompliant with medical advice, doctors are understandably frustrated. Why this gets taken out on women, however, remains curious. We can look at our fascination with women in the popular media as a guide. Dramatic weight loss post-pregnancy is a major source of hits on websites that profile the famous. And let’s face it, we expect our women role models to be thin, despite how busy they might be trying to raise a family or deal with post-partum hormones and mood. Maybe if things were more balanced on the gender scale for us in society, then doctors would follow. Although medical clinicians are an easy target of our derision, holding them to a higher standard is not working, at least for overweight women who need care. While doctors certainly need to come to terms with their biases, the rest of us need to come to terms with our own. We should stop holding women to higher standards in terms of weight and beauty. Let’s talk about how healthcare guidelines are useful, but more realistic for people who have the time and money to follow them. Read more: Women , Aging , Physicians , Nutrition Guidelines , Obesity , Diet , Healthcare , Women's Health , Doctors , Health Care , Living News

Abdulrahman El-Sayed: Failing the Test: Did Our Discomfort With Numbers Doom Health Reform?

Academic physicians interested in analyzing medical decisions among patients have increasingly turned their attention toward “numeracy,” or facility and ease with numbers, as a predictor of medical decision-making. That literature, unsurprisingly, has shown that patients who are less numerate make poorer decisions about their health. Findings from a study published in the peer-reviewed journal Medical Decision Making in 2001 summarize this phenomenon well: the authors showed that numeracy was an important predictor of how subjects valued their current health. In fact, those with the lowest numeracy scores actually valued worse health over better health! Among the more well-known, disheartening trends in American society are stagnant math and science scores relative to our international counterparts. Increasingly, young Americans are balking at the numerical disciplines, leaving them to more motivated and increasingly better-trained internationals. Every four years, the International Center for Education Statistics produces the “Trends in International Math and Sciences Study” (TIMSS) , which evaluates math and science aptitude among American 4th and 8th graders relative to their peers internationally. The most recent TIMMS report reflects data from 2007. The findings showed that compared to the first study in 1995, scores in science and math have stagnated among US students, as compared to stark improvements in several other countries (including Iran). While the implications of our national falling-out with numbers on the strength of our technical workforce are obvious, the policy implications of this trend may be more insidious. Let’s turn our attention healthcare reform, considering that we’re now mourning “what could have been” after watching the saga of its troubling life, from its infancy as a campaign promise, to its childhood as a mandate following Pres. Obama’s victory, to its chaotic adolescence under the influences of populism in town-hall meetings this past summer, and finally to the fateful near-death accident that’s left it teetering on the edge. A central conundrum many on the left have struggled with, is that the demographic most likely to oppose healthcare reform seems to be the same demographic most likely to benefit from it. If numeracy is a key predictor of the ability to value health among a small sample of Americans, did poor American numeracy doom healthcare reform? After all, the reform package was built around two empiric arguments that would address crucial policy imperatives, the economic imperative to lower healthcare costs, and the moral imperative to improve health coverage. Reform would reel in healthcare costs as a proportion of GDP from the current 16% (estimated to be 37% by 2050 at current rates), and it would expand coverage to between 31 and 36 million Americans, decreasing the proportion of America’s uninsured by up to 78%. Clearly, both of these arguments are quantitatively complex, and therefore, implicitly dependent on the American public’s ability to understand and evaluate percentages, proportions, ratios, and returns. Both ultimately failed. As American math and science skills continue to stagnate, the outlook for appropriate, yet empirically complicated social policy looks bleak. While healthcare reform may be the first on Obama’s ambitious list of policy targets that has suffered as a consequence of poor numeracy among the American populous, it won’t likely be the last. Climate change poses another scientifically and mathematically challenging series of trade-offs that are poorly understood and perceived skeptically by many Americans. Forthcoming climate change legislation may suffer the same troubled and tragically short life as its older brother. With this understanding, even in light of pressing concerns over poor health outcomes and rising healthcare costs, a quickly deteriorating environment, belligerent banks, and a plethora of other urgent policy foci, equitable access to high quality education, especially in the sciences and math, may be the most important policy focus of them all. Frankly, if a group of subjects with poor quantitative skills don’t have the ability to value better health over worse health in a simulation, we can’t expect an increasingly less numerate population to make sound decisions about our national health, our economy, or our shared Earth. In a democracy “for the people, and by the people”, it is crucial that “the people” can understand the theoretical underpinnings, complex trade-offs, and difficult decisions that frame our social policy. Read more: Education , Education Policy , Health Care Reform , Innumeracy , Climate Change , Policy , Health Care , Obama Health Care , Science Education , Healthcare , Politics News

Sahar Sepehri: President Obama, Please Hurry Up

Today President Obama unveiled new healthcare plans, but he will be talking about the details in a couple of days. This proposal supposed to help more than thirty million Americans who need healthcare to survive in the US. Healthcare, one of the President’s major presidential component and his pride has been facing challenges ever since first proposed. One of the major obstacles was losing a senate seat to Scott Brown, Massachusetts’ Republican Senator. Other challenges are how to convince a capitalist mentality, which has been practiced in the US for decades. Such issues and not moving forward faster than expected with the President’s plan has made many, including my family–especially my mother–extremely impatient. My mother suffers from variety of serious medical problems, and she has not had medical insurance in the past a couple of months. Sarcoidosis, heart disease, and two miner strokes are just the important ones. She also has high blood pressure and cholesterol. Not to forget, my mother is on heavy duty medications such as Methotrexate (a kind of chemotherapy medication) and cortisone to control the Sarcoidosis. These medications generate their own complications. She has lost some of her hair. She is constantly tired. Her face has puffed up to a “moon face,” and her back has hunched to a “buffalo hump.” These are medical terms used by her doctors. One of the strokes has made her very forgetful. So, she is practically and officially disabled. A disabled woman without health coverage, can you imagine? She has applied for Medicate, but the process has taken forever. Private insurance is simply not an option because of her medical complications and high price. So we have to wait. My mother is strong emotionally. She has always been a survivor, not knowing any better ever since she was a child. An untreated strep throat back in Iran haunted her up until now at the age of 60. I’m sure she won’t like it knowing I revealed one of her secrets. The strep throat damaged her heart which she had not been aware of until I was born. I am the last child of three. None of us, my sibling and I, could do much to prevent her illnesses from growing. My father passed away five years ago, and my sister lives in England. My brother helps her financially, paying the mortgage and for appliances. They live together. I am more like a moral support. I take her out to shop, talk to her on the phone every day, and watch a movie or two when I go visit her at her place. We are very close. However, not having medical insurance in America makes all of us live with constant anxiety and paranoia. Every time my phone rings, and it is my mother, my heart skips a beat. “I’m fine, don’t worry so much,” she tells me every time I pick up the phone. “You tell me if you don’t have any of your medication or you need to see a doctor right?” It’s my job to remind her all the time; otherwise she won’t say anything, thinking she will be a burden. Recently, we paid more than two thousand dollars for her medication, blood test, a cardiogram, and doctor visits. This is nothing. God forbid, if she needs emergency care, then we have to declare bankruptcy. The question is how many other Americans may have to face this? Today, based on the Bureau of Labor Statistics and the Census Bureau in America, one out of six Americans doesn’t have health insurance. This is a real social catastrophe in the first world power. Last year, I followed President Obama’s healthcare plan very carefully, but to be honest, I never thought this problem would knock on my door. I have always been a supporter of President Obama’s health plan, and I still am if not more so. America as a great power needs to have a stronger healthcare in which everyone will benefit from. It is one of the rarest developed countries, if not the only one, in which its people suffer from unaffordable medical bills. And now, with the rate of unemployment remaining unchanged at 10% percent since last year, people face a swamp of financial debt more than ever. We, as a family, could also fall into that swamp any moment. It could happen to you too. The day my mother calls for medical assistance is getting closer and closer. I feel it. What if she will never get the damn Medicate? Anxiety paralyzes me. I will try, though, to keep a calm face not, and to make anyone else worried. When that day comes, I see myself calling my siblings to ask them to do their best to keep our mother alive. So, before that day arrives, I am asking President Obama to please hurry up. Read more: Sahar Sepehri , Healthcare , Personal Essay , Politics News

Qanta Ahmed, MD: Movement As Medicine: Spinning And The Self-Care Movement

I recently wrote about the paradigm-shifting experience of exercise when I stumbled upon SoulCycle. I read about it when Chelsea Clinton held a Haiti fund-raising event there. I thought two things: wow, Chelsea has time to exercise? And cool, what is this exercise Chelsea does? I had to know and my discoveries are shared on HuffPost. If you haven’t already, run, I tell you, run into your nearest SoulCycle and find out what its all about. A novel and engaging form of spinning, SoulCycle engages body and brain in intense sessions which crest and soar on euphoria, guided imagery, candlelight and the unending surprise of discovering one’s inner strength. Lately, all this cycling has started the cogwheels in my brain spinning. Quite literally, all this movement (internal and external) has got me thinking about motion. Movement is medicine. And my spinning class certainly captures that, whether intentionally or not. A few days after my first class, I thought about the when I see my first patient one morning, an attractive 50-something year old who is planning gastric bypass surgery. She has been referred to me to evaluate for the presence of obstructive sleep apnea syndrome that affects nine out of 10 people going for weight reduction surgery. Finding the obstructive sleep apnea syndrome, and treating it before, during and after surgery significantly improves cardiac and lung complications related to the surgery. It’s important therefore to identify patients before surgery. I enter the room and I am about to tell her all this and much more when I see fat, ripe tears filling her eyes. Before I can even greet my patient, she is crying. I give her time to weep. After a few moments, she begins to speak. “My daughter is getting married in the summer. I have to look good for that. I can’t look like this” and she sweeps her hand in contempt towards her body. She looked at me, and promptly started crying again. “Oh, I used to look like you,” she continued, “and wear exactly the same kind of outfits. I’ll bring you a photo of how I used to look.” She cried some more. I felt vaguely guilty. Something about my appearance that day had triggered a memory of her lost self, a memory she clearly grieved. As we talked, I learned about her direct experience of 9-11 and how terrifying that had been for her. She then described the ‘August Blackout” some years later, when she found herself stranded in Manhattan unable to get home because of train outages and massive, citywide power loss. She described how she spent the night curbside without shelter, in limbo, until power had been restored. Eventually, feeling chronically unsafe, insecure, and vulnerable, she abandoned a job she loved in the City which had been her longstanding passion and moved permanently to the suburbs. Clearly, this was a loss she was still dealing with. She went from a dynamic, brisk lifestyle in the pulsing city to feeling confined and paralyzed, not only literally in the realm of her new work away from New York, but also in the figurative sense. As a result of her fears, her life and world had become much smaller. Unsurprisingly, her fears, her worries had paralyzed her. There was no movement in her life. Food quickly became a self-medication — fear a source of suffocation. The weight gain eventually devoured her old self. Now she was pinning all her hopes on this surgery. Certainly, bariatric surgery, as we term it, can be highly effective for reducing weight and reducing it abruptly. Certified centers of excellence, like the one where I work (at Winthrop University Hospital) combine a high degree of surgical expertise with an extensive medical, psychological and behavioral approach, ensuring the impacts are lasting. Many patients are greatly helped by such programs. We talked about what she had tried in terms of weight loss and the patient recounted many of the mainstream popular approaches of behavioral weight loss that we can all name without thinking. I looked at my patient and wondered what she could accomplish if only she had access to the magic captured in the SoulCycle philosophy. If only her efforts could have been supported with the intangible benefits of visualization, guided imagery and plain old fashioned psychotherapy, perhaps she would have what she needed to move through this difficult part of her life: hope and encouragement, and above all, movement. Movement is medicine. We have known that for a long time. So why then does American medicine espouse movement so poorly? We have created a surgical solution for disease which is fundamentally driven by the lack of movement in our lives, whether literal, or emotional, or oftentimes both. It really gave me pause. I have been treating patients for almost 20 years, talking to patients for 25, yet I know so little about the role of movement in health, and the way to help patients who are paralyzed by fear, difficulty, obstacles, or simply the grisly, arduous experience that is life. I talk to her about strategies for exercise, ways to weave it into a busy, challenging life. The day of her consultation with me, the patient is convinced nothing can help her the way surgery can — she has her heart set on a particular dress for the wedding and must ‘reach goal’ by then. Inside, I know she is correct. With the tools she has at her disposal, only ‘banding’ the stomach — making it abnormally small — will be the single most effective tool of managing her behavior and changing her eating in the short term. She has nothing else available to her. How sad. She had no confidence in other impacts on her behavior or her own ability to influence her own behavior. She had learned to believe she was not in control of her behavior. In her mind, only a surgeon could help. I believe classes like SoulCycle can change that. The words I heard in my first class, ‘you are stronger than you think” keep revolving in my brain like the spokes on spinning wheels. These words which I first heard my instructor Christine D’Ercole say have generated a whirring, whooshing background against which I am building a new landscape. What if Christine was right? What if this was actually true? What if I am literally stronger than I imagine? What if my patient could feel the same? When I think about this possibility, I discover my patient’s doctor is not too different than the patient herself. Like my patient struggling to ready herself for her daughter’s wedding, I also face challenges in the face of which I feel incapable — attainments toward which I am mysteriously barred, beliefs that I have been simply not strong enough to change. What if I removed these self-imposed barriers, and opened the gate to the rolling vista of possibility which lies before all of us through the empowerment of movement? This is one of the many reasons I have been wondering why can I not scribble exercise, including — for those who are healthy enough to safely tolerate it — spinning, on my prescription pad? Why is such exercise uncovered by most plans? It’s not just the 550 – 650 calories an hour one burns in these workouts that brings health. It’s impact is much more profound. Empowered movement, moving in a group, working out in a pack, can demolish the false ideas and confined measures of our own capabilities that we unhealthily hoard. Within the arrested time of a spinning class which successfully engages both mind and body we discover new inner realities. That’s where its powerful medicine lies. In sum, why is ‘modern’ medicine still so one-dimensional, so very not 21st Century? Why do insurance companies refuse coverage for what is fundamentally healing: medicine through movement and instead opt to cover what are largely intensely invasive, organ-specific interventional approaches? The answer is we as physicians haven’t educated ourselves or third-party payors to the contrary. Instead, we remain married to archaic, traditional philosophies even if our medical technology has exceeded the age of Avatar. In our practice, we remain disease-centered at a time when we need to move to being truly patient-centered. Why have we placed no value on being patient-centered in our current system, instead, choosing to accept the inordinate costs of invasive, highly aggressive organ-specific approaches removed from the patient’s actual life and function in society? These questions will remain unanswered until we, as Americans, demand answers. We are living through the tumultuous birth of HealthCare reform and what a pained, bloody process this delivery is emerging to be. I guess it’s a big baby and right now we are stuck in an intractable labor which threatens to turn into a ‘failure to progress.’ While we await the new arrival, here’s a new thought: agreed, as a nation we most certainly need intelligent HealthCare and Health Insurance reform, but what we are in just as much need of is SelfCare Reform. Americans have long abrogated their personal responsibility and, even more profoundly, their belief in being able to care for their own health and well-being . I am not referring to valuable and important screening for a malignancy, or careful measuring and monitoring of hemoglobin AIC, or a blood test for hepatitis or HIV. These are all important components to maintaining health and detecting disease. No. I am speaking to the belief that we have the ability to make ourselves, our families, and ultimately our entire lives healthier. Until we realize our abilities to engage in Self Care, and call for SelfCare Reform , we will remain static, passive, disengaged, as patients and physicians. When we do place a value on SelfCare ourselves, the market will too. Until then, I will not be able to write scripts for SoulCycle or indeed any other health-promoting self-driven patient behavior or intervention. Instead of paying physicians for performance of our procedures, at the present time we can only dream of paying physicians for enhancing our patient’s abilities to perform for themselves. What we need is not disease-centered health care, we need wellness-centered, patient-centered health care, namely SelfCare-centered healthcare . Wellness, nutrition and fitness is already a multi-billion-dollar industry. It’s time we turned these elements into a movement for medicine, and make our nation, our world, our lives healthier, more confident and more within our own control. Its time for SelfCare Reform, and my local SoulCycle on East 83rd may be just the first in many imaginative vehicles to carry us there, to carry us to a new kind of HealthCare – the SelfCare kind. How are you getting there? Read more: Selfcare Reform , Winthrop University Hospital , Chelsea Clinton , Selfcare , 9/11 , Bariatric Surgery , Health Insurance , Obesity , Guided Imagery , Christine D'Ercole , Soulcycle , Obstructive Sleep Apnea , Exercise , Gastric-Bypass , Weight Loss , Healthcare Reform , Spinning , Huffington Post , Medicine , Living News

Quiz time! Aspirin is to breast-cancer recurrence as vitamin E is to …

… maybe heart disease. In light of the finding suggesting that aspirin use might decrease the risk of breast cancer recurrence and related death, it's worth recalling the limitations of such research – and previous extrapolations gone wrong. Here’s a quick recap of Thomas Maugh's (very

FDA escalates warnings about drugs to counter anemia, chemo fatigue

Acting on growing safety concerns, the FDA on Tuesday ordered strict new procedures on the prescribing and dispensing of

Your heart may be full, but is it healthy?

OK, Valentine’s Day is over. Now it’s time to measure the real function of your heart: How well is it ticking?

The American Heart Assn. has defined “ideal cardiovascular health” to help us understand what heart disease is and isn’t.

8 Steps To Truer Food

You may have heard the phrase “out of true.” It means not in correct alignment. During the last 40 years or so, most of us have been eating a diet that is wildly out of true compared to what our bodies need, and equally out of true considering what is best for the health of people and the planet.

Dr. Daniel Seidman: Defragmenting Healthcare: Science, Medicine and Smoking

The lag between what we know about helping smokers and what we do to help them opens a window into the gaping hole between scientific knowledge and clinical practice. Research has developed a way to take the nicotine in the tobacco leaf and turn it into an effective medicine to help smokers. Nicotine replacement therapy (NRT) is very helpful with the physical element of smoking addiction. Clinical researchers have also developed ways to effectively change prevalent behaviors and attitudes bred by chemical dependency on tobacco. This treatment is called cognitive-behavioral therapy (CBT). These scientific advances offer smokers proven pathways to quitting and avoiding relapse. Yet the medical community — doctors, dentist, health professionals — has not yet adopted this comprehensive approach, despite adverse effects of smoking on the health of their patients. Rarely is this most effective treatment (NRT plus CBT) offered to smokers, despite the potential leverage of combining both these scientific advances.. What is the magnitude of the consequences of the smoking addiction on our health care system and why should we be concerned about it? Smoking causes a wide variety of illnesses, including 30 percent of cancers and heart disease, as well as a significant percentage of lung disease. 46 million Americans continue to smoke though 70 percent of them say they want to quit. How does this affect medical care? Let’s look at the issues. Can a doctor or hospital effectively treat asthma or emphysema, heart disease or cancers without treating smoking? Highly unlikely. An astounding 50 percent of periodontal disease is from smoking. How can a dentist treat oral health without addressing the basic cause of tooth loss? How about mental health? According to an article in the Journal of the American Medical Association by Lasser and colleagues (2000) smokers who abuse alcohol and drugs, and those with psychiatric and mood problems consume 44.3 percent of all the cigarettes smoked in the U.S. The two founders of Alcoholics Anonymous, like many alcoholics, did not die from their earlier alcohol intake, but from smoking. What is the state of the science of smoking cessation? In a recent study, an experienced smoking cessation researcher named Sharon Hall at the University of California in San Francisco (UCSF) and her colleagues (2009), tested cognitive-behavioral therapy in smokers over 50. These smokers were first treated with five group sessions and provided with 12 weeks of sustained release bupropion (a smoking cessation medication also known as Wellbutrin or Zyban) and 10 weeks of 2mg and 4mg nicotine gum. The authors report that “extended cognitive behavioral treatments can produce high and stable cigarette abstinence for both men and women”. In fact, the cessation rates reported by Dr. Hall for extended CBT, are 55 percent at 52 weeks, and 55 percent at 104 weeks as well. Dr. Hall reports that “these rates are strikingly higher than those reported in the recent literature.” As a basis for comparison, the “natural” rate of 12 month self-help cessation attempts has historically been about 7 percent or less. For an example, in 2005, among the 19 million American adults who tried to quit, only 4-7 percent reported success. Cessation interventions by physicians and dentists yields 12 month success rates in the range of 10.7-18.7 percent, depending on length of counseling combined with pharmacological prescriptions. In a recent pilot study at Columbia University Medical Center, we evaluated 40 smokers who, in 2008, were offered a similar combination of CBT plus NRT. These patients had at least one DSM-IV psychiatric diagnosis and 75 percent of the sample also had significant medical conditions. On average, patients in the sample had a history of smoking for 30 years, and smoked an average of 15 cigarettes each day. The majority of the sample was unemployed (77.5 percent) and 40 percent had less than an 8th grade education. In anyone’s book, these smokers, would be considered among the most difficult to help. And yet, using the combined treatment approach (NRT with CBT), 60 percent of the sample quit smoking at some point during treatment. Fifty-five percent were still quit at discharge and 47.5 percent reported that they were not smoking at the time of the follow-up phone call. Ninety percent of patients in this sample utilized nicotine replacement therapies. The U.S. Department of Health and Human Services conducted their own study and issued a paper, “Treating Tobacco Use and Dependence 2008 Update” that corroborates that: (1) ” Providing counseling in addition to medication significantly enhances treatment outcomes” (p. 101); and (2) The most effective medication strategy is to combine the nicotine patch “(long-term; > 14 weeks) + ad lib NRT (gum or spray)”. Using the patch combined with another form of NRT, as needed, produced an estimated abstinence rate of 36.5 percent (p. 109) in the HHS analysis. Despite this evidence — which is in the public domain — many popular self-help books with an anti-NRT bias have dominated the scene. In an example of the law of unintended consequences, some of the public health measures designed to get people to quit and to protect non-smokers have gotten smokers instead to train themselves to smoke only at certain times and places. This trend, called “intermittent smoking”, plays into the deepest wish of many smokers which is to have control over their smoking rather than free themselves of the habit completely.. Studies now show a significant group of smokers are using NRT not to quit but to control their smoking. In contrast to the NRT-only and the anti-NRT approaches, the science of helping smokers strongly suggests taking a comprehensive approach to smokers who want assistance to quit. The evidence is that combining medication and counseling therapies is just better than trying these alone. What services does our health care system offer smokers? In our current system, paying for smoking cessation is most often left up to the individual, and it is not a priority in medical practice. In fact, in the current debate about the future of health care in America, screening for smoking, and helping smokers has not received much attention. Indeed, when a senate stimulus bill included 75 million dollars for smoking cessation programs, screening practices were considered “frivolous” spending by many legislators (see New York Times February 2, 2009). The funds were widely derided and quickly cut as “pork.” While it is true that most smokers who have quit have done so on their own, many who have struggled with smoking and who eventually did quit describe it as the hardest thing they have done in their lives. All smokers are not alike, and many need, and the science suggests would greatly benefit from, appropriate professional assistance. Why, despite the advances of science, are we not making the best treatments available to those who smoke? Part of the reason is that smoking has deep economic and cultural roots that date back to the beginnings of our republic; so it just seems “normal” despite the medical problems it causes. Another reason is that nowadays smoking is often regarded more as a moral weakness than as an appropriate focus of serious clinical attention just as alcoholism was viewed in the past as a moral failure not a medical problem. In addition, while the dangers of smoking are widely known by smokers and nonsmokers alike, its true costs to our healthcare system are widely ignored. The Centers for Disease Control estimates that tobacco use costs the United States approximately $193 billion annually. This figure includes about $97 billion from lost productivity, and $96 billion in direct smoking-related health care costs. One out of five adults in the U.S.– an estimated 19.8 percent — continue to smoke. This is down by more than half from 1965, when the smoking rate was 42.4 percent. The impact on the nation’s health of just this one change has been phenomenal, including further reductions in cancer deaths published online last month (December 7, 2009) in the journal Cancer. Clearly, declining tobacco use is an important contributor to the progress that has been made. Those smokers who are also in treatment for serious medical, dental and psychiatric conditions tend to be more addicted to smoking. Many have already been advised by their healthcare professionals to quit, but may require more innovative and targeted clinical services. Further progress on smoking rates will require us, as a nation, to stop viewing tobacco use as a personal weakness and start viewing tobacco cessation treatment as an integral part of the care of all tobacco-related illnesses, and indeed of our healthcare system overall. As we consider health care reform, let’s not forget those one thousand smokers (and the families and friends they leave behind) who die each and every day in the U.S. from disease caused by smoking. Helping smokers quit in a more holistic way is supported by science. It is also likely to be one of the most cost-effective ways to lower the nation’s healthcare costs, and help end the tremendous suffering caused by this most prevalent addiction. Read more: Quit Smoking , Nicotine , Tobacco , Cigarettes , Smoking , Health , Nicotine Replacement Therapy , Cbt , Nbt , Wellness , Cognitive Behavioral Therapy Smoking , Living News

Low I.Q. Predicts Heart Disease

Low intelligence appears to be a powerful risk factor for heart problems, British researchers report, eclipsing factors like obesity and high blood pressure.