TAG: "Tobacco"

Study: E-cigarettes a gateway to nicotine addiction for U.S. teens

First national analysis strongly associates e-cigarettes with smoking for many adolescents.

Lauren Dutra, UC San Francisco

E-cigarettes, promoted as a way to quit regular cigarettes, may actually be a new route to conventional smoking and nicotine addiction for teenagers, according to a new UC San Francisco study.

In the first analysis of the relationship between e-cigarette use and smoking among adolescents in the United States, UCSF researchers found that adolescents who used the devices were more likely to smoke cigarettes and less likely to quit smoking. The study of nearly 40,000 youth around the country also found that e-cigarette use among middle and high school students doubled between 2011 and 2012, from 3.1 percent to 6.5 percent.

“Despite claims that e-cigarettes are helping people quit smoking, we found that e-cigarettes were associated with more, not less, cigarette smoking among adolescents,” said lead author Lauren Dutra, a postdoctoral fellow at the UCSF Center for Tobacco Control Research and Education.

“E-cigarettes are likely to be gateway devices for nicotine addiction among youth, opening up a whole new market for tobacco,” she said.

The study was published online today (March 6) in JAMA Pediatrics.

E-cigarettes are battery-powered devices that look like cigarettes and deliver an aerosol of nicotine and other chemicals. Promoted as safer alternatives to cigarettes and smoking cessation aids, the devices are rapidly gaining popularity among adults and youth in the U.S. and around the world. Unregulated by the U.S. Food and Drug Administration, e-cigarettes have been widely promoted by their manufacturers as a way for people to quit smoking conventional cigarettes. They are sold in flavors such as chocolate and strawberry that are banned in conventional cigarettes because of their appeal to youth.

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Cigarette smoking may cause physical changes in brains of young smokers

These changes can occur in those who have been smoking for a relatively short time.

The young, it turns out, smoke more than any other age group in America. Unfortunately, the period of life ranging from late adolescence to early adulthood is also a time when the brain is still developing.

Now, a small study from UCLA suggests a disturbing effect: Young adult smokers may experience changes in the structures of their brains due to cigarette smoking, dependence and craving. Even worse, these changes can occur in those who have been smoking for a relatively short time. Finally, the study suggests that neurobiological changes that may result from smoking during this critical period could explain why adults who began smoking at a young age stay hooked on cigarettes.

The study appears in today’s (March 3) online edition of the journal Neuropsychopharmacology.

“Although we are not certain whether the findings represent the effects of smoking or a genetic risk factor for nicotine dependence, the results may reflect the initial effects of cigarette smoking on the brain,” said senior author Edythe London, a professor of psychiatry and of molecular and medical pharmacology at UCLA’s Semel Institute for Neuroscience and Human Behavior and David Geffen School of Medicine. “This work may also contribute to the understanding of why smoking during this developmental stage has such a profound impact on lifelong smoking behavior.”

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Study connects smoke-free laws, dentists’ advice to quit

Smoke-free laws can help influence behavior and attitudes.

Cigarette buttsSmoke-free laws may help encourage dentists to recommend that their patients kick the smoking habit, according to new research co-authored by UC Merced professsor Mariaelena Gonzalez.

The paper, published in the American Journal of Public Health, suggests the societal change manifested by smoke-free laws can contribute to an atmosphere in which dentists pay more attention to patients’ smoking habits.

“Smoke-free laws can have strong effects – and not just on stopping individual-level behavior,” said Gonzalez, whose research focuses on tobacco control. “These laws can influence other behavior and attitudes, as our study shows with dentists. They can have a huge effect on people’s preferences, such as a preference for clean indoor air. Even smokers like clean indoor air.”

Gonzalez co-authored the study “Association of Strong Smoke-Free Laws with Dentists’ Advice to Quit Smoking, 2006-2007,” with Stanton A. Glantz, a professor of medicine at UC San Francisco, and Ashley Sanders-Jackson, a postdoctoral fellow at Stanford University. All three have been associated with the UCSF-based Center for Tobacco Control Research and Education, where Glantz is the director.

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In denial: Some who smoke say they’re not ‘smokers’

Why some “non-identifying smokers” face risks while denying the behavior.

While smoking among California adults has dramatically declined in recent decades, researchers at the UC San Diego School of Medicine report there is a surprisingly large number of people who say they use cigarettes, but don’t consider themselves to be “smokers.”

Writing in the Feb. 5 online issue of Tobacco Control, Wael K. Al-Delaimy, M.D., Ph.D., professor and chief of the Division of Global Health in the UC San Diego Department of Family and Preventive Medicine, and colleagues estimate that in 2011 almost 396,000 Californians (12.3 percent of the state’s population of smokers) smoked on a measurable basis, but rejected the characterization of “smoker.”

Almost 22 percent of these smokers consumed tobacco on a daily basis.

Al-Delaimy said the phenomenon has both individual and social ramifications. For individuals, the behavior puts them at many of the same health risks as identified smokers. “There is no safe level of smoking,” he said.

More broadly, non-identification of “non-identifying smokers” or NIS may be negatively impacting efforts to reduce tobacco consumption by overlooking a significant segment of the affected population, the researchers said. This is especially true at the clinical setting where physicians might ask patients if they smoke and patient fail to identify themselves as smokers.

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New movement focuses on paradox of cigarette sales in pharmacies

UCSF scientists, major pharmacy launch national move to halt tobacco sales in drugstores.

Steven Schroeder, UC San Francisco

Pharmacies, focused on the health and well-being of their customers, have long been saddled with a paradox: they sell cigarettes and other tobacco products, even though tobacco use is the nation’s leading cause of preventable death.

If retailers, particularly pharmacies, were to discontinue selling cigarettes, fewer smokers and fewer deaths by smoking would occur, according to a new opinion article co-written by a UC San Francisco scientist. That’s also the premise behind a new decision by CVS Caremark, the nation’s largest pharmacy health care company, to end cigarette and tobacco sales in its stores this year.

In a Viewpoint article published online today (Feb. 5) in JAMA, the Journal of the American Medical Association, the authors say that selling tobacco products is “clearly antithetical” to the role of pharmacies, especially as pharmacies expand their role as an integral part of the nation’s health care system.

The JAMA Viewpoint is written by Troyen A. Brennan, M.D., M.P.H., executive vice president and chief medical officer of CVS Caremark; and Steven A. Schroeder, M.D., a UCSF professor and director of the Smoking Cessation Leadership Center.

Casting a harsh light on tobacco sales in drugstores, the authors say that selling tobacco products contradicts a commitment to health care.

The goal of the authors: eliminate tobacco sales in America’s drugstores.

“Nowhere else in health care are tobacco products available in the same setting where diseases are being diagnosed and treated,” they write.

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Thirdhand smoke shown to cause health problems

Study shows thirdhand smoke causes hyperactivity and significant damage in liver, lung.

Manuela Martins-Green, UC Riverside

Manuela Martins-Green, UC Riverside

Do not smoke and do not allow yourself to be exposed to smoke because secondhand smoke and thirdhand smoke are just as deadly as firsthand smoke, says a scientist at UC Riverside who, along with colleagues, conducted the first animal study of the effects of thirdhand smoke.

While firsthand smoke refers to the smoke inhaled by a smoker and secondhand smoke to the exhaled smoke and other substances emanating from a burning cigarette that can get inhaled by others, thirdhand smoke is the secondhand smoke that gets left on the surfaces of objects, ages over time and becomes progressively more toxic.

“We studied, on mice, the effects of thirdhand smoke on several organ systems under conditions that simulated thirdhand smoke exposure of humans,” said Manuela Martins-Green, a professor of cell biology who led the study. “We found significant damage occurs in the liver and lung. Wounds in these mice took longer to heal. Further, these mice displayed hyperactivity.”

Study results appear in PLOS ONE.

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Smoking rates drop dramatically among nurses

Significant decline in smoking among RNs found from 2007 to 2011.

Linda Sarna, UCLA

Linda Sarna, UCLA

On the eve of the 50th anniversary of the U.S. surgeon general’s first report alerting the nation to the negative health consequences of lighting up, there is good news about registered nurses who smoke: There are a lot less of them.

A new UCLA study tracking changes in smoking prevalence among nurses and other health care professionals between 2003 and 2011 found that the proportion of registered nurses who smoke dropped by more than a third during that period.

The findings appear in the January issue of JAMA: The Journal of the American Medical Association, which commemorates the surgeon general’s landmark 1964 Report on Smoking and Health.

The study’s principal investigator, Linda Sarna, a professor at the UCLA School of Nursing and oncology nurse who has been committed to tobacco cessation for the past two decades, said she was energized by the results.

“This decline is so important, not just for the health status of nurses but because studies continue to show that smoking by health care professionals sends a mixed message to patients,” she said.

The study used data on health care professionals from the Tobacco Use Supplement for 2003, 2006–07 and 2010–11; the supplement is administered as part of the U.S. Census Bureau’s Current Population Survey.

While the researchers found no significant decline in smoking among registered nurses between 2003 and 2007, the years from 2007 to 2011 witnessed a big drop. The data show that the proportion of registered nurses who smoke dropped from 11 percent to 7 percent — an overall decrease of 36 percent and more than two times the 13 percent decline among the general U.S. population during the same time period.

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Total smoking ban works best

UC San Diego researchers say with no place to puff, smokers more likely to cut back or quit.

Wael Al-Delaimy, UC San Diego

Wael Al-Delaimy, UC San Diego

Completely banning tobacco use inside the home – or more broadly in the whole city – measurably boosts the odds of smokers either cutting back or quitting entirely, report UC San Diego School of Medicine researchers in the current online issue of Preventive Medicine.

“When there’s a total smoking ban in the home, we found that smokers are more likely to reduce tobacco consumption and attempt to quit than when they’re allowed to smoke in some parts of the house,” said Wael K. Al-Delaimy, M.D., Ph.D., professor and chief of the Division of Global Health in the UC San Diego Department of Family and Preventive Medicine.

“The same held true when smokers report a total smoking ban in their city or town. Having both home and city bans on smoking appears to be even more effective.”

Al-Delaimy said the findings underscore the public health importance of smoking bans inside and outside the home as a way to change smoking behaviors and reduce tobacco consumption at individual and societal levels.

“California was the first state in the world to ban smoking in public places in 1994 and we are still finding the positive impact of that ban by changing the social norm and having more homes and cities banning smoking,” he said.

“These results provide quantitative evidence that smoking bans that are mainly for the protection of non-smokers from risks of secondhand smoke actually encourage quitting behaviors among smokers in California. They highlight the potential value of increasing city-level smoking bans and creating a win-win outcome.”

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Statement on UC’s Smoke & Tobacco Free Policy

Effective Jan. 1, 2014, UC will be entirely smoke and tobacco free.

UC Smoke & Tobacco Free PolicyDr. John Stobo, University of California senior vice president for health sciences and services, today (Dec. 18) issued the following statement about UC’s Smoke & Tobacco Free Policy:

The University of California is committed to maintaining a healthy and clean working and learning environment for our employees, students, patients and visitors. As a leading education, research and service university, UC has taken a proactive role in addressing the impact of smoking and tobacco use. Tobacco is the No. 1 cause of preventable disease and death worldwide. The health risks of tobacco use for smokers and secondhand smoke for non-smokers are well established. In addition to serious health risks, there also are environmental concerns from chemicals in cigarette butts that can leach into the soil and waterways.

The University of California Smoke & Tobacco Free Policy is a new systemwide policy that provides an environment that is free of tobacco and smoke in an effort to create a clean, healthy working and learning atmosphere. This policy benefits everyone.

Effective Jan. 1, 2014, the University of California will be entirely smoke and tobacco free. Smoking and the use of all tobacco products including cigarettes, e-cigarettes, cigars, snuff, water pipes, pipes, hookahs, chew and any other non-combustible tobacco product will be prohibited across all campuses and facilities, including inside buildings, outdoor areas and sidewalks, parking lots, and residential housing areas.

This is a major change for many people and will require all members of the university community to be ambassadors for this initiative. The university is wholly committed to helping faculty, staff and students who want to quit smoking by offering an extensive selection of cessation resources such as health plan benefit programs, one-on-one or group cessation and education, and referrals to cessation resources.

I would like to congratulate the University of California campuses for their successful implementation of this policy as part of their ongoing commitment to the health and well-being of the entire university community. Thank you for your contribution to maintaining the university’s culture of health and safety.

For more information on the Smoke & Tobacco Free Policy and a comprehensive guide to cessation resources for university staff and students, including mobile apps, links to multiple websites and other helpful resources, please visit ucal.us/tobaccofree.

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Clearing the air on electronic cigarettes

Long-term effects not known.

SmokeIf you haven’t seen someone puffing on an electronic cigarette yet, you probably will soon. Sales of the devices are soaring. And the debate about the safety of e-cigarettes is heating up, too.

Manufacturers of the battery-powered devices say their products carry far fewer health risks than regular cigarettes and can help smokers quit.

But critics say e-cigarettes are dangerous to the user and to people exposed to secondhand vapor.

Meanwhile, scientists are struggling to do the kind of research that could help clear the air on key health questions.

“Because it can take many years for the detrimental effects of inhaled substances to develop, the long-term effects of e-cigarette use or secondhand vapor exposure are not known,” says Dr. Matthew Brenner, professor in the UC Irvine Division of Pulmonary Diseases and Critical Care Medicine. “The rise in use of these devices is associated with many unanswered scientific questions regarding risks that will require long-term studies.”

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UC goes tobacco free starting January 2014

Sales, ads and use of cigarettes will go away throughout the UC system.

Ashtray full of cigarette butts (iStock photo)

All UC campuses will be tobacco-free in 2014 (iStock photo)

By Katherine Tam

University of California campuses across the state will be tobacco free come the New Year, demonstrating UC’s commitment to provide a healthy environment for faculty, staff, students and visitors.

A leader in strong health care practices, UC already bans smoking at its five medical centers. The new tobacco-free policy that begins in January 2014 goes a step further by extending the ban to all campuses and anywhere on campus, including residence halls and parking lots, and also by prohibiting the sale and advertising of tobacco products.

UCLA, UC San Diego and UCSF implemented the new policy earlier this year, with positive results.

“Tobacco use and secondhand smoke continue to be the leading causes of preventable death in the country,” said Cheryl Lloyd, interim director of Risk Services at UC’s Office of the President, which is leading the effort. “We can do our part to help change that by providing a smoke-free environment on our campuses so our employees, students and visitors aren’t exposed to something that damages their health.”

UC’s new tobacco-free policy bans a wide range of products, including cigarettes, chewing tobacco and electronic cigarettes.

Enforcement will rely primarily on educating smokers about the dangers of lighting up and other types of tobacco use, and promoting campus resources to help them quit.

Faculty and staff who want to quit smoking can access many resources through any UC-sponsored 2014 medical plan. All the 2014 plans will offer prescription nicotine replacement therapies, such as nicotine inhalers and sprays, at no cost when prescribed by a doctor. Over-the-counter nicotine replacement therapies, such as nicotine patches and gum, when prescribed by a doctor, will be available at the generic copay price for those enrolled in UC Care, Health Net Blue and Gold, and Western Health Advantage. Kaiser members have no copay. Under Core and the Blue Shield Health Savings Plan, these will be subject to the deductible and co-insurance.

UCLA was the first UC academic campus to go tobacco free, kicking off the new policy on Earth Day, April 22. Banners and signs declaring UCLA tobacco free pepper the campus. Wallet-size informational cards are given to smokers to remind them of the policy and available resources to help them quit.

Because the medical center sits inside the academic campus boundaries, UCLA sees a large number of new visitors every day – a challenge when it comes to keeping people educated about the new policy.

Nevertheless, Michael Ong, co-chair of UCLA’s Tobacco-Free Task Force, said there’s been a noticeable decline in smoking around campus, and a survey of cigarette butts collected in hot-spot areas indicates that people are following the new policy. The Institute of the Environment and Sustainability, which conducted biweekly counts before and after the policy was implemented, found that the number of butts in hot-spot areas dropped from an average of 600 to 160.

While smoking has declined, Ong said that reaching 100 percent compliance with the new policy will take time. Tobacco users may struggle with stopping tobacco use on campus or quitting smoking due to nicotine’s addictive qualities. Ong said the task force is working on reinforcing for these continuing users how to comply with the new policy and resources that can help with cessation.

“Nicotine addiction makes quitting smoking very difficult,” said Linda Sarna, chair of UCLA’s task force and a professor of nursing who has studied nurses’ involvement in helping people quit. “There are still lots of misconceptions about quitting by going ‘cold turkey.’”

Studies find low success rates for those who try to quit smoking without support or the medications that relieve withdrawal symptoms, she said. Only three to five out of 100 people will still be smoke-free a year after going cold turkey, studies show, and it often takes five to six attempts before people are able to fully quit.

The campus has partnered with Los Angeles County Department of Public Health to offer a free two-week supply of nicotine patches to faculty, staff and students who want to quit. This is in addition to the resources available through UC-sponsored medical plans.

More than 1,100 other colleges and universities across the country have banned smoking on their campuses, including in residence halls.

More information
Read about UC’s Smoke and Tobacco Free Policy, including facts and frequently asked questions.

For those who want help quitting, resources include:

Katherine Tam is a communications coordinator in Internal Communications at UC’s Office of the President.

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HIV plus HPV leads to increased anal cancer risk in men

Researchers also report that smoking increases risk of infection with specific types of HPV.

Dorothy Wiley, UCLA

Dorothy Wiley, UCLA

Human papillomavirus, or HPV, which can cause cervical cancer in women, is also known to cause anal cancer in both women and men. Now, a study led by researchers at the UCLA School of Nursing has found that older HIV-positive men who have sex with men are at higher risk of becoming infected with the HPVs that most often cause anal cancer.

The researchers also report that smoking increases the risk of infection with specific types of HPV among both HIV-infected and uninfected older men by up to 20 percent. This is the first large U.S. study of a group of HIV-infected and uninfected men between the ages of 40 and 69 who have sex with men. Study participants were examined twice a year for up to 25 years.

“Invasive anal cancer is a health crisis for gay, bisexual and other men who have sex with men,” said Dorothy J. Wiley, associate professor at the UCLA School of Nursing and lead author of the study, which was published Nov. 20 in the journal PLOS ONE. “Right now, invasive anal cancer rates among HIV-infected men who have sex with men surpass rates for seven of the top 10 cancers in men.”

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