Cheap Cigarettes in Europe Associated With Increased Infant Mortality

MedicalResearch.com Interview with:

Filippos Filippidis MD MPH PhD Lecturer in Public Health School of Public Health Imperial College London London

Dr. Filippidis

Filippos Filippidis MD MPH PhD
Lecturer in Public Health
School of Public Health
Imperial College London
London

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Smoking kills millions of people every year. It is well established that increasing tobacco prices is the most effective way to reduce tobacco consumption and hence mitigate the devastating effects of tobacco on health. Taxation on tobacco products is high in the European Union, which makes cigarettes less affordable. However, transnational tobacco companies are known to manipulate prices, ensuring that cheap or ‘budget’ cigarettes are still available. This is particularly important for younger smokers and those of low socioeconomic status who are more sensitive in price increases.

Smoking during pregnancy, as well as exposure of pregnant women and babies to cigarette smoke increase infant mortality. There is also evidence that increasing tobacco prices is associated with lower infant mortality. However, researchers typically use average or premium cigarette prices. We analysed 54 million births from 23 European Union countries to see if the differential between average priced and budget cigarettes (i.e. the availability of cigarettes much cheaper than average priced ones) is associated with infant mortality.

We found that increasing average cigarette prices by 1 Euro per pack was associated with 0.23 fewer deaths per 1,000 live births in the same year and an additional 0.16 fewer deaths per 1,000 live births in the following year. A 10% increase in the price differential between budget and average priced cigarettes was associated with 0.07 more deaths per 1,000 live births the following year. This means that 3,195 infant deaths could potentially have been avoided in these 23 countries if there was no price difference between cigarette products over the 10-year study period.

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Holes in Cigarette Filters Linked To Increase in Lung Adenocarcinomas

MedicalResearch.com Interview with:
Peter G. Shields, M.D.
Deputy Director, Comprehensive Cancer Center
James Cancer Hospital
Professor, College of Medicine
Julius F. Stone Chair in Cancer Research
The Ohio State University Columbus, OH

MedicalResearch.com: What do we know about the health effects of cigarette filters? 
Response:  The issue is that the design of the filters makes a cigarette even more dangerous, which can be regulated by the FDA. The issue is not about having a filter, but how they are made. And now we are changing the dialogue to the design of virtually all cigarettes. The holes on the filter are likely one reason the cigarettes of today are more dangerous.

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“Heat-Not-Burn” Cigarettes Release Heart Attack and Cancer-Causing Chemicals

MedicalResearch.com Interview with:

Reto-Auer.jpg

Prof. Reto Auer

Reto Auer, MD, MAS
Institute of Primary Health Care (BIHAM), University of Bern, Bern,
Department of Ambulatory Care and Community Medicine
University of Lausanne, Lausanne, Switzerland

MedicalResearch.com: What is the background for this study?

Response: When the tobacco industry began to promote new “heat-not-burn” (HNB) tobacco cigarettes as a “safer” alternative to traditional cigarettes, we wanted to find out if their claims were true. Philip Morris International (PMI) created an HBN called IQOS® (I-Quit-Ordinary-Smoking). IQOS® uses tobacco sticks soaked in propylene glycol, which are inserted into a holder and heated to a maximum of 350°C. PMI claims that because its HNBs don’t combust, they emit far fewer harmful chemicals than conventional cigarettes. We decided to test their claims.

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Patients Who Quit Smoking Had Fewer Adverse Events After Knee Replacement

MedicalResearch.com Interview with:
Amy Wasterlain, MD

Fourth-year orthopaedic surgery resident
NYU Langone Medical Center who led the study with Dr. Richard Iorio 

MedicalResearch.com: What is the background for this study?

Response:  We looked at smoking habits and outcomes for 539 smokers undergoing primary total hip or knee arthroplasty, 73 of whom participated in a pre-operative smoking cessation program. Patients who participated in program were 4.3 times more likely to quit than smokers who tried to quit on their own. Program participants also reduced their tobacco intake dramatically (10.6 fewer cigarettes/day) compared to smokers who didn’t participate (2.3 fewer cigarettes/day), even if they weren’t able to quit completely. Patients who completed the program before undergoing total knee arthroplasty had about 24% fewer adverse events (readmission, venous thromboembolism, stroke, urinary tract infection, pneumonia, and surgical site infection) than smokers who didn’t participate in the program.

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Prenatal Tobacco Smoke Raises Risk of Atopic Dermatitis in Offspring

MedicalResearch.com Interview with:

Dr. Saskia Trump PhD Helmholtz-Centre for Environmental Research – UFZ Department of Environmental Immunology Leipzig, Germany

Dr. Saskia Trump

Dr. Saskia Trump PhD
Helmholtz-Centre for Environmental Research – UFZ
Department of Environmental Immunology
Leipzig, Germany

MedicalResearch.com: What is the background for this study?

Response: Environmental chemicals have long been discussed to contribute to the exacerbation or even the development of allergic diseases. In our study we were particularly interested in the effect of tobacco smoke exposure, which is the main source for indoor benzene exposure, on regulatory T cell (Treg) function and its relation to the development of childhood atopic dermatitis (AD). Tregs play a critical in controlling T effector cell activity by avoiding overexpression. A deficiency in this T cell subset increases the risk for allergic inflammation.

We have previously described that exposure to tobacco smoke during pregnancy can decrease the number of regulatory T cells (Treg) in the cord blood and predispose the child to the development of AD (1). In this subsequent study we were interested in the underlying mechanism involved.

Benzene itself is not considered to be toxic, however its metabolization leads to the formation of highly reactive molecules. In humans for example the metabolite 1,4-benzochinone (1,4-BQ) can be found in the blood as a consequence of benzene exposure.

To further assess the effect of benzene on Treg and the development of AD we combined in vitro studies, evaluating the impact of 1,4-BQ on human expanded Treg, with data from our prospective mother-child cohort LINA. The LINA study, recruited in Leipzig, Germany, is a longitudinal evaluation of mother-child pairs with respect to lifestyle and environmental factors that might contribute to disease development in the child. Based on this deeply phenotyped cohort we were able to translate our in vitro findings to the in vivo scenario.

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CVS Pharmacy’s Discontinuance of Tobacco Sales Led To Big Drop In Cigarette Purchases

MedicalResearch.com Interview with:

Jennifer M. Polinski PhD Senior Director, Enterprise Evaluation and Population Health Analytics, CVS Health CVS Caremark Corporation Harvard School of Public Health

Dr. Jennifer Polinski

Jennifer M. Polinski PhD
Senior Director, Enterprise Evaluation and Population Health Analytics, CVS Health
CVS Caremark Corporation
Harvard School of Public Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Nearly three years ago, we removed tobacco products from all CVS Pharmacy locations to help our customers on their path to better health. While there is a growing body of evidence that suggests that restricting access to tobacco helps reduce its use, we wanted to understand if our decision to remove tobacco had a nationwide impact on our customers’ purchasing behavior and presumed smoking habits.

In fact, our research findings, published in the American Journal of Public Health, show that CVS Health’s decision to remove tobacco from all CVS Pharmacy stores reduced the number of cigarette purchases across all other retail settings, including gas stations, convenience stores, and other outlets. In addition, customers who exclusively purchased cigarettes at CVS Pharmacy were 38 percent more likely to stop buying cigarettes, and those who purchased three or more packs of cigarettes per month at a CVS Pharmacy were more than twice as likely to stop buying cigarettes altogether.

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Memory Retrieval and Extinction Reduces Craving For Cigarettes

MedicalResearch.com Interview with:

Michael E. Saladin, Ph.D. Professor, Department of Health Sciences and Research College of Health Professions Medical University of South Carolina Charleston, SC

Dr. Michael Saladin

Michael E. Saladin, Ph.D.
Professor, Department of Health Sciences and Research
College of Health Professions
Medical University of South Carolina
Charleston, SC

MedicalResearch.com: What is the background for this study?

Response: To the extent that learning and memory processes govern all aspects of behavior, they also govern dysregulated or maladaptive behaviors such as addiction and anxiety states. In the former case, stimuli associated with drug administration can acquire the ability to control drug-related motivational states (urges and craving) as well as drug seeking behavior. To illustrate the point, the simple act of observing a person light up a cigarette will cause the typical smoker to desire a cigarette and engage in smoking. A nonsmoker, by contrast, would not be similarly affected because they have no history where stimuli associated with smoking (e.g., sight of a lighter, cigarettes, plumes of smoke) are reliably paired with, or followed by, the rewarding effects of nicotine.

The research we conducted recently was based on neuroscience research showing that retrieved drug-associated memories (prompted with drug-paired cues) can be updated with information that decreases drug craving and/or administration. One such study showed that heroin craving in heroin addicts can be decreased by retrieving memories for heroin use via a brief heroin cue presentation (video of people using heroin) and then, a short time later, presenting an extensive variety of heroin cues (video, pictures and heroin use paraphernalia) over a 1-hour period. The logic of this intervention was that once the heroin memories were prompted into a labile state by the brief video presentation, the extensive heroin cue exposure would serve to update the content of the original memories with new information (i.e., cues are not followed by heroin reward) that is inconsistent with the original cue-drug contingency (i.e., cues are followed with heroin reward). Remarkably, just two sessions of this type of training, which we call retrieval-extinction training, resulted in significant reductions in heroin craving that persisted for six months. This study was done with heroin addicts who were inpatients so there was no way to assess the effects of this treatment on actual heroin use.

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Teen Vaping is a Risk Factor for Future Smoking

MedicalResearch.com Interview with:

Professor Richard Miech Institute for Social Research University of Michigan

Prof. Richard Miech

Professor Richard Miech
Institute for Social Research
University of Michigan

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The main finding of this study is that teen vaping predicts future smoking.  We surveyed a nationally-representative sample of 12th graders in 2014 and then re-surveyed them a year later.  We found:

  • Among teens who had never smoked at baseline, those who vaped were more than four times more likely to have smoked a year later than those who didn’t vape
  • Among teens who were former smokers at baseline, those who vaped were more than twice as likely to have smoked a year later than those who didn’t vape
  • Among teens who were current smokers at baseline, smoking levels a the one-year followup were the same for vapers and non-vapers.

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Can Propranolol Reduce Nicotine Cravings?

MedicalResearch.com Interview with:

Lin Lu, M.D. Ph.D. Director/Professor, Institute of Mental Health and Peking University Sixth Hospital Director/Professor, National Institute on Drug Dependence, Peking University Beijing China

Dr. Lin Lu

Lin Lu, M.D. Ph.D.
Director/Professor, Institute of Mental Health and Peking University Sixth Hospital
Director/Professor, National Institute on Drug Dependence, Peking University
Beijing China

MedicalResearch.com: What is the background for this study?

Response: Nicotine addiction is the leading preventable cause of mortality, and causes over 6 million deaths each year. One fundamental mechanism that maintain smoking relapse in smokers is the persistence of memories of both nicotine reward and nicotine-associated conditioned stimulus (CS, e.g. ashtray,cigarette lighters, etc.).Preclinical studies suggest that the drug reward memories can be reactivated by nicotine-associated CS undergo an unstable stage, named memory reconsolidation, and that pharmacological or behavioral manipulations that interfere with reconsolidation inhibit subsequent drug relapse.

However, most of the translational studies targeting reconsolidation stages of the drug reward memory have not been successful.One important reason is that when participants were exposed to nicotine-associated CS to induce memory reconsolidation, the pharmacological or behavioral manipulations only interfere with the reconsolidation of memories selectively associated with the reactivated CS, without affecting other CSs.

However, in real life, smoking is associated with multiple CSs that vary across individuals. Thus, a key question is how to interfere with reconsolidation of multiple nicotine-associated memories . In the present study, we introduce a novel memory reconsolidation interference procedure in which we reactivated multiple nicotine reward memories in rats and human smokers by acute exposure to nicotine (the UCS) and then interfered with memory reconsolidation using the noradrenergic blocker propranolol, an FDA-approved drug.

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E-Cigs Linked To Adverse Cardiac Effects

MedicalResearch.com Interview with:

Holly R. Middlekauff, MD Professor UCLA Division of Cardiology David Geffen School of Medicine UCLA

Dr. Holly Middlekauff

Holly R. Middlekauff, MD
Professor
UCLA Division of Cardiology
David Geffen School of Medicine
UCLA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: E-cigarettes are the fastest rising tobacco product in the US today, but almost nothing is known about their cardiovascular effects. Rather than wait decades for epidemiological data in e-cigarette users to become available, we reasoned that investigations into the known mechanisms by which tobacco cigarettes increase heart disease would provide insights into the health risks of e-cigarettes.

We focused on 2 critical mechanisms:
1) cardiac adrenaline activity, and
2) oxidative stress, measured in chronic e-cigarrete users compared to matched, healthy controls.

The major findings were that, compared to healthy controls, e-cig users had increased cardiac adrenaline activity (measured by a technique called “heart rate variability”). Furthermore, compared to healthy controls, the e-cig users had increased susceptibility to oxidative stress.

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Cigarette Smoking Remains A Huge Public Health Problem

MedicalResearch.com Interview with:
Andrew Hyland, PhD

Chair of the Department of Health Behavior at Roswell Park Cancer Institute and
Karin Kasza, MA
Senior Research Specialist in the Department of Health Behavior
Roswell Park Cancer Institute

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The PATH Study is unique because it is a large, nationally representative study of more than 45,000 youth and adults who are interviewed at multiple points over time and asked about their use of a wide array of tobacco products. The data reported in this study are from the baseline wave, and we find that while cigarettes are by far the most commonly used product for both youth and adults, we see a lot of use of non-cigarette products. E-cigarettes trailed only cigarettes in popularity for youth and water pipe smoking was high among 18-24 year olds. However, we see different patterns of use for different products with cigarettes being used much more frequently that other products like e-cigarettes. Another surprising finding was that about 4 in 10 youth and adult tobacco users were currently using two or more tobacco products.

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Young Smokers Have Drastic Increase in Heart Attack Risk

MedicalResearch.com Interview with:

Dr. Kevin Campbell MD FACC Wake Heart and Vascular Assistant Professor of Medicine,  UNC School of Medicine Cardiology and Cardiac Electrophysiology in Raleigh, Smithfield and Wilson North Carolina.

Dr. Kevin Campbell

Dr. Kevin Campbell MD FACC
Wake Heart and Vascular
Assistant Professor of Medicine,  UNC School of Medicine
Cardiology and Cardiac Electrophysiology in Raleigh, Smithfield and Wilson
North Carolina 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In this study, data was analyzed from nearly 1800 patients who had ST elevation MI.  Findings were published in Heart.  They found that younger  smokers (age under the age of 50)  had an 8-fold increased risk of acute STEMI , when compared to ex- and never smokers.

In addition, researchers found that current smokers of all ages were 3.26 times more likely to have STEMI than ex- and never-smokers—suggesting that if you stop smoking, you can reduce your risk for heart attack.

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Smoking Deaths Disproportionately Affect Poor and Black Americans

MedicalResearch.com Interview with:
Jane Henley MSPH

Epidemiologist
Division of Cancer Prevention and Control

MedicalResearch.com: What is the background for this study? 

Response: The Surgeon General concluded that cigarette smoking causes at least 12 types of cancer: oral cavity and pharynx, esophagus, stomach, colon and rectum, liver, pancreas, larynx, lung, bronchus and trachea, bladder, kidney and renal pelvis, cervix, and acute myeloid leukemia. Other tobacco products — cigars, chewing tobacco and snuff — and secondhand smoke are also linked to some of these cancers.

MedicalResearch.com: What are the main findings?

Response: We examined rates and trends of new cases and deaths from these cancers using U.S. registry and mortality data from 2004 to 2013. We broke the data down by characteristics that might display disparities — sex, age, race, ethnicity, state, county-level poverty and education, rural/urban continuum, and cancer site.

We found that about 660,000 people were diagnosed with and 343,000 people died each year from these cancers. Rates were higher among men, black men and women, and people in counties with low education or high poverty. Rates ranged by state from a low of 130 cases in Utah (126 in Puerto Rico) to a high of 248 cases in Kentucky. Incidence decreased 1.3 percent per year and mortality decreased faster, at about 1.6 percent per year; decreases were observed across most groups, but not at the same rate. Disparities persist among certain groups with higher rates or slower declines in rates.

We also looked at changes in cancer death rates from 1970 to 2014 and estimated that 1.3 million tobacco-related cancer deaths were averted since 1990, in part because of comprehensive cancer and tobacco control efforts to reduce tobacco use and other cancer risk factors, early detection of cancer, and improvements in cancer treatment.

MedicalResearch.com: What should readers take away from your report?

Response: Further reducing tobacco use can save thousands more people from getting and dying from cancer. Based on current estimates, about 36.5 million people smoke, and about half will die from a smoking related disease, unless programs are implemented to help them quit smoking. Comprehensive cancer and tobacco control programs actions can be done at the state and local level, such as:

• Promoting healthy, tobacco-free environments
• Increasing access to early detection and care for tobacco-related cancers
• Helping cancer survivors who use tobacco quit
• Better assisting communities disproportionately impacted by cancer

And of course, increasing the price of tobacco products and ongoing media campaigns, like Tips from Former Smokers, have a huge impact.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Ongoing surveillance efforts are needed to monitor changes in the number of new cases and deaths from tobacco-related cancers and whether there are differences among communities or groups of people. This work will provide insight into the impact of comprehensive cancer and tobacco control efforts and how to target these efforts in the areas where they’re needed most.

MedicalResearch.com: Is there anything else you would like to add?

Response: You can find more information at https://www.cdc.gov/cancer/tobacco/

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Henley SJ, Thomas CC, Sharapova SR, et al. Vital Signs: Disparities in Tobacco-Related Cancer Incidence and Mortality — United States, 2004–2013. MMWR Morb Mortal Wkly Rep 2016;65:1212–1218. DOI: http://dx.doi.org/10.15585/mmwr.mm6544a3.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

More Medical Research Interviews on MedicalResearch.com

Children Who Experience Early Parental Absence More Likely To Smoke or Drink Before Age 11

MedicalResearch.com Interview with:

Dr Rebecca Lacey, PhD Research Associate Epidemiology & Public Health Institute of Epidemiology & Health Faculty of Pop Health Sciences University College London

Dr. Rebecca Lacey

Dr Rebecca Lacey, PhD
Research Associate
Epidemiology & Public Health
Institute of Epidemiology & Health
Faculty of Pop Health Sciences
University College London

MedicalResearch.com: What is the background for this study?

Response: We know from previous research that children who experience parental absence, whether due to death, divorce or some other reason, are more likely, on average, to have poorer health in later life. This includes being more likely to smoke and drink as an adult. However, what we didn’t know before we conducted our study was whether children who experienced parental absence were more likely to engage in the early uptake of risky health behaviours in childhood. This is what we looked at in our study.

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Hookah Smoking in the US: Potential Threat to Young Adults

MedicalResearch.com Interview with:

Professor Michael Weitzman MD  New York University's College of Global Public Health and  The Departments of Pediatrics and Population Health New York University School of Medicine NYU Langone Medical Center

Dr. Michael Weitzman

Professor Michael Weitzman MD
New York University’s College of Global Public Health and
The Departments of Pediatrics and Population Health
New York University School of Medicine
NYU Langone Medical Center

MedicalResearch.com: What is the background for this study?

Response: There is a marked and rapidly increasing epidemic of hookah (waterpipe) use in the US. Hookah use appears to be as, or even more, dangerous than cigarette use. There are data suggesting that one hookah session is comparable to smoking 5 packs of cigarettes in terms of exposure to toxins. The CDC and WHO both have issued warnings that hookah pipe use may eradicate much or all of the progress of the past 50 years of tobacco control efforts.

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Electronic cigarettes increase endothelial progenitor cells in the blood of healthy volunteers

MedicalResearch.com Interview with:

Lukasz Antoniewicz MD PhD candidate Karolinska Institutet Department of Clinical Sciences Danderyd University Hospital Stockholm, Sweden

Dr. Lukasz Antoniewicz

Lukasz Antoniewicz MD, PhD candidate
Karolinska Institutet
Department of Clinical Sciences
Danderyd University Hospital
Stockholm, Sweden

MedicalResearch.com: What is the background for this study?

Response: Electronic cigarette sales increase exponentially on a global scale without knowledge about possible negative effects on human health. We performed an exposure study in young healthy volunteers and analyzed blood samples for endothelial progenitor cells and microvesicles. Increase in those markers may reflect vascular injury, inflammation and platelet activation.

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Can Low Dose Oral Nicotine Have Beneficial Health Effects?

MedicalResearch.com Interview with:

U. H. Winzer-Serhan Ph.D. Associate Professor Department of Neuroscience and Experimental Therapeutics Texas A&M Health Science Center

Dr. Ursula H. Winzer-Serhan

Ursala. H. Winzer-Serhan Ph.D.
Associate Professor
Department of Neuroscience and Experimental Therapeutics
Texas A&M Health Science Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Nicotine is a plant alkaloid that is naturally occurring in the tobacco plant. Smoking delivers nicotine to the brain where it acts as a stimulant. Tobacco and electronic cigarette smoking delivers many other chemicals to the body, which are harmful and can cause cancer.

However, the drug nicotine by itself is relatively benign and poses few health risks for most people. Nicotine acts in the brain on nicotinic receptors, which are ion channels that are widely expressed in the brain. They play an important role in cognitive functions. Research with rodents and in humans has shown that nicotine can enhance learning and memory, and furthermore, can protect neurons during injuries and in the aging brain. With the increasingly older population, it becomes more and more important to delay cognitive decline in the elderly. Right now, there is no drug available that could delay aging of the brain.

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Voltage and Flavoring Contribute To Overall Toxicity of Aerosols from E-Cigarettes

MedicalResearch.com Interview with:

Maciej L. Goniewicz, PhD Assistant Professor of Oncology Department of Health Behavior Division of Cancer Prevention and Population Sciences Roswell Park Cancer Institute Elm & Carlton Streets / Carlton House A320 Buffalo, New York 14263, USA

Dr. Maciej L. Goniewicz

Maciej L. Goniewicz, PhD PharmD
Assistant Professor of Oncology
Department of Health Behavior
Division of Cancer Prevention and Population Sciences
Roswell Park Cancer Institute
Elm & Carlton Streets / Carlton House A320
Buffalo, New York 14263, USA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We have previously identified several ingredients in e-cigarettes that may be potentially dangerous to users. The long-health effects of inhaling aerosol from e-cigarettes is currently unknown and we are looking for alternative ways to test the products safety. We have noticed previously that various brands and types of e-cigarettes differ in the toxicant levels and their potential toxic effects. So we systematically evaluated various product features and we were able to identify device power and flavoring additives as key components that significantly affect the potential toxicity of e-cigarettes. Interestingly, it was not nicotine or nicotine solvents but other additives in e-cigarettes that affected respiratory cells used in our study.

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Most Childhood Atopic Dermatitis Lasts About Three Years

MedicalResearch.com Interview with:

Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois

Dr. Jonathan Silverberg

Dr. Jonathan L. Silverberg MD PhD MPH
Assistant Professor in Dermatology
Medical Social Sciences and Preventive Medicine
Northwestern University, Chicago, Illinois

MedicalResearch.com: What is the background for this study?

Response: Some children with atopic dermatitis may have disease activity persist into adolescence and adulthood, although most children are thought to “grow out of it.” There have been a number of studies with varied results about how commonly atopic dermatitis actually persists later in life. Moreover, the risk factors for persistence of atopic dermatitis are unclear. We sought to systematically analyze the extant literature of research studies to determine the rates and predictors of atopic dermatitis persistence over time.
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NYU Researcher Discusses Nanoparticles in Sunscreens and E-Cigs

MedicalResearch.com Interview with:

Judith T. Zelikoff, PhD, Professor Department of Environmental Medicine NYU Langone Medical Center.

Dr. Judith Zelikoff

Judith T. Zelikoff, PhD, Professor
Department of Environmental Medicine
NYU Langone Medical Center.

MedicalResearch.com: Would you tell us a little about yourself?

Response: I am a tenured full professor in the Department of Environmental Medicine at the NYU School of Medicine with >25 years of experience studying the toxicology of inhaled single contaminants and complex mixtures including metals, nanoparticles, gaseous and particulate (PM) air pollutants, e-cigarettes and combustible products from cigarettes, biomass burning, and diesel exhaust. Over the last decade, studies in my laboratory has focused on the effects of maternal inhalation of environmental toxicants, including fine-sized ambient particulate matter during pregnancy (and/or during neonatal development) on fetal cardiovascular structure, obstetric consequences, and later life disorders including obesity, immune dysfunction, and decreased sociability and reproductive success in adult male and female offspring. Other early life studies associated with inhaled nicotine/tobacco products have demonstrated that maternal and neonatal exposure of mice to aerosols from e-cigarettes (with and without nicotine) alters neurodevelopment and produces hyperactivity in adult male offspring.

Our studies with smokeless tobacco products demonstrate dyslipidemia and non-alcoholic steatohepatitis in prenatally exposed adult offspring. One of my major scientific accomplishments are my early life inhalation exposure studies demonstrating, for the first time in some cases, that prenatal/neonatal exposure to environmental agents can produce effects persistent into adulthood that can increase susceptibility to a variety of disorders, including cardiovascular disease. In addition, I serve as the Community Outreach and Engagement Core (COEC)Director for our NYU NIEHS Core Center. In this regard, our COEC team partners with environmentally-impacted communities in the NY/NJ area to assess community concerns associated with environmental pollution and provide educational information that can help build community infrastructure. I am also extremely active as a leader in the Society of Toxicology having served as Secretary of the Society for 3 years and President of the Metals and Immunotoxicology SOT Specialty Sections where i received an Immunotoxicology Lifetime Achievement Award.

I currently serve as Chairperson of the SOT Committee for Diversity Initiatives and President of the Ethical, Legal and Social Specialty Section. I am currently a full member of a National Institute of Health Study and have also served on several other Federal/State Advisory Panels including the Institute of Medicine and National Research Council, EPA, NASA, NTP, and NJ Department of Environmental Protection. In addition to serving as an Associate Editor and Editorial Board member for numerous toxicology/environmental health journals, I currently serve as vice-President for the NYU School of Medicine Faculty Council.

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Large Proportion of Pregnant Women Use Alcohol and Tobacco in First Trimester

MedicalResearch.com Interview with:

Dr. Qiana L. Brown, PhD, MPH, LCSW Postdoctoral Research Fellow Columbia University Mailman School of Public Health Department of Epidemiology Substance Abuse Epidemiology Training Progra

Dr. Qiana Brown

Dr. Qiana L. Brown, PhD, MPH, LCSW
Postdoctoral Research Fellow
Columbia University
Mailman School of Public Health
Department of Epidemiology
Substance Abuse Epidemiology Training Program

MedicalResearch.com: What is the background for this study?

Dr. Brown: Prenatal substance use is a major public health concern, and poses significant threats to maternal and child health. Tobacco and alcohol are the most commonly used substances among pregnant women and non-pregnant women of reproductive age, and are leading causes of preventable adverse health outcomes for both mother and baby. Women with health insurance have more prenatal visits, and present for prenatal care earlier than uninsured women, which may increase their exposure to health messaging around substance abuse prevention at prenatal visits. Additionally, treatment for substance use disorders and maternal and child health care are part of the Essential Health Benefits covered by the Affordable Care Act, which may encourage patients and providers to engage in discussions around alcohol and tobacco use prevention during pregnancy.

Given these factors, we examined the relationship between health insurance coverage and both past month tobacco use and past month alcohol use among a nationally representative sample of reproductive age women in the United States. We sampled 97,788 women ages 12 to 44 years old who participated in the U.S. National Survey of Drug Use and Health in 2010 to 2014. Among these women, 3.28% (n=3,267) were pregnant. We specifically investigated whether the relationship between health insurance and alcohol or tobacco use differed between pregnant and non-pregnant women.
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Quitting Smoking Can Restore Normal Bacteria To Oral Microbiome

MedicalResearch.com Interview with:
Jiyoung Ahn, PhD, RD, MS
Associate Professor of Population Health
Associate Director of Population Sciences,
NYU Perlmutter Cancer Center  and
Brandilyn Peters (post-doctoral fellow, lead author)
NYU Langone School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Oral bacteria play important roles in oral health, and can influence the health of other body systems as well. We were interested in studying how cigarette smoking affects oral bacteria. To do this, we examined the oral bacteria in mouthwash samples from 112 current smokers, 571 former smokers, and 521 people who never smoked. We found that the mouth bacterial composition of current smokers differed dramatically from those who never smoked. However, the mouth bacterial composition of former smokers was similar to that of never smokers, suggesting that quitting can restore the oral bacteria back to a healthy state.

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There is No Safe Level of Passive Smoking Exposure

MedicalResearch.com Interview with:

Dr. Kate Frazer University College Dublin School of Nursing, Midwifery & Health Systems Dublin , Ireland

Dr. Kate Frazer

Dr. Kate Frazer
University College Dublin
School of Nursing, Midwifery & Health Systems
Dublin , Ireland

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Frazer: The review is an update of a 2010 Cochrane systematic review publication ‘Legislative smoking bans for reducing secondhand smoke exposure, smoking prevalence and tobacco consumption’.

The 2010 review identified

  • Evidence of secondhand smoke exposure and reduced cotinine levels after the implementation of legislative smoking bans.
  • Evidence of reduced admissions for acute coronary syndrome.
  • Limited evidence of an impact on active smoking rates.

The update was undertaken because more countries have since implemented legislative smoking bans since the review was published in 2010 and the body of research was growing in the intervening period.

The new review, published 4th February 2016, presents evidence from 77 observational studies in 21 countries.

MedicalResearch: What are the main findings?

Dr. Frazer: There is consistent evidence identifying reduced admissions in the post ban period for acute coronary syndrome/ acute myocardial infarction in 33 of 43 studies.

There is evidence of reduced mortality from smoking related illnesses in 8 out of 11 studies.

There is evidence of reduced admissions for asthma and chronic obstructive pulmonary disease, but the evidence of reduced admissions was not consistent in all studies.

There is evidence of an impact on perinatal health outcomes including low birth weight and risk of pre term birth, but the evidence was not consistent in all studies.

The evidence of an impact of legislative smoking bans on active smoking and tobacco consumption is not consistent. There have been reductions in smoking rates.

The impact of the ban on reducing admissions was observed in smokers and in non-smokers.

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Hookah Bars Raise Secondhand Smoke Risks For Employees

MedicalResearch.com Interview with:

Terry Gordon, PhD Professor, Department of Environmental Medicine at NYU Langone Medical Center and at New York University's College of Global Public Health

Dr. Terry Gordon

Terry Gordon, PhD
Professor, Department of Environmental Medicine
at NYU Langone Medical Center and at
New York University’s College of Global Public Health 

Medical Research: What is the background for this study? What are the main findings?

Dr. Gordon:I t is well established that the intentional inhalation of tobacco combustion products causes severe respiratory and cardiovascular health effects and, in fact, active smoking is the leading preventable cause of death in the US and worldwide.  Importantly, secondhand smoke exposure also causes a range of serious health problems in adults, adolescents, and children exposed in the home or at work. Secondhand smoke exposure can be as harmful as active smoking and is a major cause of both cancer and cardiovascular disease itself, as well as having countless other harmful effects. It was the scientific findings of these effects that led to many clean air regulations across the nation and enabled the FDA to regulate a number of tobacco products.  A growing number of studies in the U.S. and abroad have demonstrated poor indoor air quality in hookah bars, but none have looked at the effect of this on those who work in such establishments.

We, therefore, studied whether workplace exposure to secondhand hookah smoke affects the pulmonary and cardiovascular systems.  One of our main findings was that occupational exposure to secondhand hookah smoke produces systemic effects as seen by increases in inflammatory cytokines in the blood after a 10 to 12 hour work shift. This is very worrisome as more and more diseases are being linked to chronic inflammation.  Changes in heart rate suggested that the cardiovascular system was also altered during a single work shift.  The most dramatic effect, however, appeared to be an increase in exhaled carbon monoxide after the work shift.  The low temperature burning of charcoal used to heat the shisha in a water pipe produces large amounts of carbon monoxide, and we observed exhaled carbon monoxide levels as high as 90 ppm, which suggests significant exposure of workers to secondhand hookah smoke and the potential for impairment of hemoglobin to efficiently carry oxygen to the tissues.

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Electronic Nicotine Use Rises, Especially Among Smokers

Ralph S. Caraballo, PhD MPH Branch Chief, Epidemiology Branch Office on Smoking and Health National Center for Chronic Disease Prevention and Health Promotion CDC Atlanta GA

Dr. Ralph Caraballo

MedicalResearch.com Interview with:
Ralph S. Caraballo, PhD MPH
Branch Chief, Epidemiology Branch
Office on Smoking and Health
National Center for Chronic Disease Prevention and Health Promotion
CDC Atlanta GA

Medical Research: What is the background for this study? What are the main findings?
Dr. Caraballo: Electronic nicotine delivery system (ENDS) use has increased rapidly in the U.S. in recent years. The availability and use of ENDS raise new issues for public health practice and tobacco regulation, as it is unknown whether patterns of ENDS use enhance, deter, or have no impact on combustible tobacco product use. This study assessed past-month, lifetime, and frequency of ENDS use among current, former, and never adult cigarette smokers.

In 2014, overall lifetime and past-month ENDS use was 14.1% and 4.8%, respectively. By smoking status, 49.5% of current, 14.7% of former, and 4.1% of never cigarette smokers had used ENDS in their lifetime, whereas 20.6% of current, 4.0% of former, and 0.8% of never smokers used ENDS in the past month. Among current and former cigarette smokers who ever used ENDS, 44.1% and 44.7% reported using ENDS >10 days in their lifetime, respectively.

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