College Freshmen See Rx Drug Misuse More Risky Than Alcohol, Pot

Freshman college students think the occasional use of prescription drugs for non-medicinal purposes poses a greater risk to their health than smoking pot or knocking back five drinks every weekend, a new study indicates. Read more

Tough Laws, Higher Prices Mean Fewer Kids Smoke

(HealthDay News) -- American adolescents who live in states that comply with tobacco sales laws are less likely to pick up a smoking habit than are those who live where the laws are not vigorously enforced, a new study has found.

And raising the price of a pack of cigarettes might have an equal, if not greater, effect, the study also showed.

"Efforts to prevent the sale of tobacco to children pay off," said study author Dr. Joseph R. DiFranza, a professor of family medicine and community health at the University of Massachusetts Medical School. "It's very effective at reducing the number of kids who smoke."

Since 1992, states have been required to prohibit the sale and distribution of tobacco to minors. But in 1996, the U.S. Substance Abuse and Mental Health Services Administration issued a regulation that, in essence, put some teeth into the legislation that requires states to pass and enforce so-called no-sale laws.

Though there has been some debate about the effectiveness of the congressional mandate, a growing body of evidence demonstrates that enforcing existing laws reduces the number of adolescent smokers.

DiFranza and his colleagues analyzed data from a 2003 survey of 16,244 adolescents, nearly all 15 to 17 years old, to obtain information on smoking habits. In addition, they looked at state-collected data on merchants' compliance with anti-tobacco laws. Then they correlated the data, taking into account such factors as cigarette prices, restaurant smoking policies, anti-smoking campaigns and demographic information that included age, gender, race, ethnicity and parents' education level.

The researchers found that, as merchants more diligently enforced the ban on tobacco sales to minors and as the price of cigarettes rose, the likelihood of teens smoking dropped.

Improved compliance with the laws from 1997 to 2003 was credited with about a 21 percent decline in the likelihood of a teen smoking. Price increases for a pack of cigarettes during that time reduced the odds by about 47 percent, the study found.

The results appear online April 17 in the journal BMC Public Health.

"Cigarette smoking is a major contributor to many of the chronic diseases that we see in society today -- cardiovascular disease, cancer, dementia and other forms of cognitive decline and low birth weight," said Dr. Ted Schettler, science director at the Science & Environmental Health Network in Ames, Iowa. "And adolescent smoking increases the risk of lifelong smoking."

According to the American Lung Association, about 90 percent of smokers started before age 21, and an estimated 4.5 million U.S. adolescents smoke.

"Up until now, it's been controversial about whether all the effort put into enforcing the law has been worthwhile or not," DiFranza said. "Some people had made halfhearted efforts to obey the law, and those have not worked at reducing either the number of stores that sell tobacco to kids or the number of kids that smoke."

The finding from DiFranza's study mirrors that from a study published this month on the effect of laws targeting the sale of alcohol to minors.

In that study, states that had enacted more punitive laws -- including use-and-lose laws that allow the suspension of a driver's license for any underage alcohol violation and zero-tolerance laws that make it illegal for young people to drive with any amount of alcohol in their system -- had fewer drinking-related fatalities among teens than did states that did not have such laws. The results were published in the April 7 issue of Alcoholism: Clinical and Experimental Research.

"In the past, we've had success in reducing the number of teens who smoke by enforcing these laws in communities, but this is the first study to show that it works at the national level," DiFranza said. "It's important to show that this strategy works across the whole geography of the United States, in rural and urban areas."

Schettler said that it's important to note "that many of these strategies go well beyond just advising people not to smoke and really get into more systemic public health interventions and trying to create, at the societal level, barriers to smoking."

More information
The U.S. Centers for Disease Control and Prevention has more on teen smoking.

Database Helps Assess Your Breast Cancer Risk

(HealthDay News) -- If you want to learn more about the key risk factors for breast cancer, such as obesity, pollutants or smoking, a database can guide you to the available evidence that confirms or quells an association.

"Breast cancer is multifactorial. It would be rare for there to be a single environmental chemical that alone would be sufficient to cause an increase in breast cancer," said Dr. Robert Schneider, co-director of breast cancer research at New York University School of Medicine in New York City.

"In many cases, an increased risk of breast cancer is quite small, and we don't yet know how each factor affects the risk of breast cancer," he said, explaining that it's similar to a puzzle. "We need to know how all of the pieces fit together, and this database begins to help us start assessing some of that."

The database, a joint project of Susan G. Komen for the Cure and the Environmental Factors and Breast Cancer Science Review project led by the Silent Spring Institute, includes information on 216 chemicals, diet, smoking, physical activity and weight that may play a role in the development of breast cancer.

Fewer than 100 chemical compounds have been identified as human carcinogens by the International Agency of Research on Cancer. However, that doesn't mean that all other chemicals are safe, just that they haven't been tested. And, an estimated 80,000 chemicals have been registered for commercial use in the United States, according to the database study, which was published in a recent issue of the journal Cancer.

Although many factors have been associated with breast cancer, Schneider said his top three would include the chemical bisphenol A, radiation exposure from CT scans and delayed first pregnancy.

Bisphenol A (BPA) is an estrogenic chemical found in many products made of polycarbonate plastic (clear, hard plastic), such as baby bottles, reusable water bottles, food storage containers, food cans and water supply pipes, according to the National Institute of Environmental Health Sciences. Although no human studies have confirmed an association with breast cancer, a study done in mice suggests there may be a link. However, the U.S Food and Drug Administration recently said the agency felt there were "adequate margins of safety" for the chemical in the amounts commonly consumed.

"We don't know what constitutes an unacceptable level," said Schneider who would prefer to err on the side of caution and limit BPA exposure, especially in infants and young girls.

Schneider said another concerning risk factor is the amount of radiation people are exposed to for routine health problems, particularly from CT scans.

Although the last risk factor from Schneider's top three -- delayed first pregnancy -- isn't one people are likely to change, he said it's important to be aware of it. "In a modern society, it's exceedingly difficult to have a pregnancy before 20 when it would be quite protective," said Schneider.

Dr. Jay Brooks is chair of hematology/oncology at Ochsner Health System in Baton Rouge, La. He said, "When you look at environmental and chemical risk factors, you have to remember that we live in a sea of chemicals, and those chemicals have made our lives so much nicer, and it's hard to know exactly what each one does to an individual's risk.

"I advise my patients to try to control the things you have good control over. Weight is a huge issue in breast cancer, as is the use of combined estrogen/progesterone after menopause," he added.

Brooks said extra weight is a risk factor that many women underestimate, but being overweight clearly increases risk. And, he said, estrogen therapy alone used to ease menopausal symptoms doesn't seem to increase risk the way the estrogen/progesterone combination does.

More information
To learn more about breast cancer risk factors, check the searchable database from the Silent Spring Institute.

Should Smoking Around Kids Be Illegal?

By Scott Mowbray

When I was a kid, a few years after the surgeon general released the original report linking smoking to vast health risks, my Dad—a doctor!—still smoked a pipe and the occasional cigar. I remember him lighting a stogie during a long drive in the family VW. I remember throwing up. It was an effective counterattack. But it’s not practical in all circumstances.

The most recent news about secondhand smoke (SHS) exposure is good; the Centers for Disease Control and Prevention reported that “detectable serum cotinine” levels are down across the board in nonsmoking Americans. Serum cotinine is a marker in the blood that signals a nonsmoker’s exposure to secondhand smoke, and if levels go down, disease risk also probably declines with it. The CDC speculated that workplace and public-place smoking bans were the likely cause. Read More

Health Tip: Keep Cholesterol Under Control

(HealthDay News) -- Too much dietary cholesterol can lead to high cholesterol levels in the blood, which can be a risk factor for heart disease.

The Cleveland Clinic offers these suggestions to help lower your cholesterol:

• Avoid high-fat or fried foods.
• When you do eat foods with fat, look for foods with unsaturated, not saturated, fat.
• Reduce the amount of red meat that you eat, and eat more fish and poultry.
• Get enough soluble fiber by eating plenty of fruits, beans, peas and oats.
• Don't eat more than three egg yolks per week.
• Get plenty of exercise, maintain a healthy body weight, and stop smoking.

Health Tip: Can't Sleep?

(HealthDay News) -- If you have trouble falling or staying asleep, it's important to understand the reasons for your insomnia.

Here's a list of possible reasons for your sleepless nights, courtesy of the U.S. National Library of Medicine:

• Discomfort or illness.
• Depression.
• Stress or anxiety.
• Drinking caffeine or alcohol, smoking, or taking certain medications or illicit drugs.
• An inappropriate sleep environment, including one that's too bright or too noisy.
• Related activities that affect your sleep, such as taking naps or going to bed too early.

No Smoking Anywhere: Tough New Law in Kenya

By Theresa Tamkins

Kenya has enacted a tough new smoking rule, which bans smoking on the street and in parks, markets, bars, private homes, and private cars. That’s right: If you’re not lighting up in one of the country’s designated smoking zones, you’re not smoking at all—unless you want to risk imprisonment (up to three years) or a fine of up to $43,000, according to the BBC.
Being an ex-smoker, I tend to give the nicotine-addicted more sympathy than scorn and rarely complain about secondhand fumes. But even I thought, Hmm, wouldn’t that be nice? Read More

Training Student Leaders Cuts Peers' Smoking Rates

(HealthDay News) -- Training influential students to spread anti-smoking messages in their everyday conversations with peers helps reduce smoking rates, according to a U.K. study.

The study included almost 11,000 students, ages 12 to 13, at 59 schools in western England and Wales. At 30 of the schools, certain students were selected to receive training about the risks of smoking, the economic benefits of not smoking, communication skills, group work, negotiation, conflict resolution, sensitivity to others, personal values, and building confidence and self-esteem. The students at the other 29 schools acted as a control group.

For 10 weeks after their ASSIST (A Stop Smoking in Schools Trial) training, the peer support students talked with other students in their age groups about the benefits of not smoking.

Overall, students in those schools were 25 percent less likely to take up regular smoking than students in the control group schools immediately after ASSIST intervention, 23 percent less likely to start regular smoking after one year, and 15 percent less likely after two years.

Among high-risk students (occasional, experimental or ex-smokers at the start of the study) in schools with ASSIST intervention, the risk of regular smoking was reduced by 21 percent immediately after the program, 25 percent after one year, and 15 percent after two years.

Overall, students in the intervention schools were 22 percent less likely to be smokers than those in the control group schools. Based on their findings, the University of Bristol and Cardiff University researchers calculated that widespread implementation of ASSIST could reduce smoking prevalence by 3 percent among students ages 14 to 15. On a U.K.-wide basis, that translates into 43,000 fewer 14- to 15-year-old students who become regular smokers.

The findings were published in this week's edition of The Lancet.

"Our study has shown that the ASSIST training program was effective in achievement of a sustained reduction in uptake of regular smoking in adolescents for two years after its delivery. Furthermore, it was well received by both students and staff," the authors wrote. "Confidence in the robustness of this finding is enhanced by the very high response rates achieved (over 90 percent), the retention of all schools for the duration of the trial, the diversity of the schools involved, and the concurrence of self-reported smoking data with saliva testing."

More information
The U.S. Centers for Disease Control and Prevention has more about youth and tobacco.