Thursday, September 24, 2009
Saving health and money
Last month, I asked for some data on the cost-effectiveness of preventive care. The American Journal of Public Health has obliged. In a new study reported by HealthDay, researchers evaluated the cost and health benefits to be gained by preventing several chronic diseases. They found that preventing a patient's hypertension would save $13,702 in lifetime medical spending, while prevention of diabetes would save $34,483, and preventing obesity would save $7,168. Unfortunately, those cost arguments for tobacco cessation programs turn out to be wrong: quitting smoking would result in an increase of $15,959 in lifetime medical costs.
Since only the abstract of the study is free, I also didn't get to find out how one would successfully prevent all these conditions. The key to preventing obesity, especially, seems like a secret we would all like to know.
Labels: Diabetes, health care cost, hypertension, obesity, prevention, smoking cessation
posted by Stacey Butterfield at
1:00 PM
0 Comments
Tuesday, September 22, 2009
Maybe it's not health care's fault.
The failure of the U.S. to match longevity statistics of other developed countries is well-known, but a column in today's New York Times offers a different explanation for the gap. To put it simply, it's lifestyle (particularly smoking) that sets us apart from these other countries, not the quality of our health care, according to researchers. "Dr. Preston and other researchers have calculated that if deaths due to smoking were excluded, the United States would rise to the top half of the longevity rankings for developed countries," the Times reports.
The good news is that many Americans have quit smoking in the past decade or so, so we should be seeing continuing gains in health. The bad news is that we're working hard to make up the difference by getting fatter.
Labels: longevity, obesity, smoking cessation
posted by Stacey Butterfield at
11:34 AM
0 Comments
Monday, September 21, 2009
Smokers finding air becoming rare in which to indulge
Outdoor smoking faces bans in big cities as the largest review to date concludes that public smoking bans reduce heart attacks by 26% annually, and the effects can be measured in as few as six months.
New York City’s health commissioner said a week ago that he wanted to ban smoking at parks and beaches. Mayor Michael R. Bloomberg released a response that he wanted "to see if smoking in parks has a negative impact on people’s health."
Yeah, it does, according to research in the Sept. 29 issue of the Journal of the American College of Cardiology. A systematic review and meta-analysis of 10 reports from 11 geographic locations in the North America and Europe compared heart attack rates before and after public smoking bans. The studies involved 24 million people and observations of the effect of the bans ranged from two months to three years.
Thirty-two states and cities have banned smoking in public places and workplaces. Recently entering into the fray is Rockville, Md., which voted the same night as New York's proposal to ban smoking within 40 feet of city parks and may push for a more comprehensive ban. A nationwide ban on public smoking could prevent as many as 154,000 heart attacks each year, the study concluded.
Steven Schroeder, MACP, director of the Smoking Cessation Leadership Center University of California, San Francisco, said, "Several years ago, the idea that secondhand smoke was harmful to the heart was a theory and one with some controversy attached, but this article moves us from the theoretical to fact and to practice. The reduction in heart attacks associated with public smoking bans is a big deal."
Labels: cardiology, smoking cessation
posted by Ryan DuBosar at
5:00 PM
1 Comments
Friday, March 13, 2009
Finally, a practical use for Twittering
One of our constant questions at ACP Internist is: What is Twitter really useful for? Everyone has a feed but no one is really saying anything. Just as we'd given up on a practical purpose for it, (surgery aside) we found two bread-and-butter applications for internal medicine: smoking cessation and weight loss.
Qwitter helps users track how many cigarettes they smoke, keep a journal, view progress over time and share info with supporters.
Next, you can Tweet what you Eat, using Twitter to set up a diary, track consumption, enter calories and find our how many are in the food you eat.
Personally, I think Twittering would help reduce smoking or eating just because it's something else to do with your hands. If you try these, or let patients try them, let us know how you fare.
Labels: diet, smoking cessation, social networking, weight loss
posted by Ryan DuBosar at
8:30 AM
2 Comments
Thursday, March 5, 2009
Smoking without the stigma
A press release that crossed our desks recently plugged an electronic, smokeless cigarette made by a European company called SuperSmoker. It's billed as a revolutionary way to kick the habit without giving up the look and feel of actually smoking.
The device itself looks just like a cigarette, comes in similar packaging and is available in normal, light, zero and menthol. But the "smoke" is really odorless water vapor that dissolves harmlessly into the air, thus not aggravating friends, family and co-workers and allowing smokers to stay inside talking to their non-smoking friends during breaks. The unit is powered by a rechargable battery.
The other part of its appeal is nicotine, contained in replacable cartridges, although the company maintains that it doesn't produce tar and has no cancer-causing substances. The FDA has not approved electronic cigarettes but it has caught on in some places, according to this article in the New York Times.
Will electronic smoking be the answer for the many who've tried and failed to kick the habit? Maybe, but won't smokers still be left with nicotine addiction?
Labels: smoking cessation
posted by Janet Colwell at
3:23 PM
0 Comments
Monday, February 23, 2009
Medical news of the obvious
Our focus this week is on smoking. A new study in BMJ finds that smoking is bad for you, even if you're rich! As reported by HealthDay, the authors conclude that "in essence, neither affluence nor being female offers a defense against the toxicity of tobacco." So much for the magical properties of our solid gold cigarette holder.
In other bad-but-perhaps-already-known news for women, a group of public health investigators have determined that tobacco companies are trying to make cigarettes appealing. To quote HealthDay again, cigarette ads "depict cigarette smoking as feminine and fashionable rather than the harmful and deadly addiction it really is."
And while we're on the subject, we've got to mention this study, even though its conclusions are far from obvious. A signficant proportion of surveyed smokers said that while the effects of smoking on their own health are not sufficient motivation to quit, they would stop smoking if they knew their pets were being harmed by the habit. Really, people? Really?
Labels: medical news of the obvious, smoking cessation
posted by Stacey Butterfield at
8:00 AM
0 Comments
Tuesday, October 28, 2008
Nicotine dependence: It's worse than you think
It's the best of times and worst of times for ending tobacco dependence, according to David Sachs, ACP Member, of the Palo Alto Center for Pulmonary Disease Prevention.
The best, because there are more tools than ever to help patients quit.
The worst, because most physicians have no idea how to treat patients effectively.
In part, that's because doctors don't know that nearly 75% of people seeking tobacco-dependent treatment are categorized as "highly" dependent-- meaning standard, OTC therapies won't work on them, Dr. Sachs said during a Chest 2008 press conference about a new study he authored. In the study, he and his colleagues analyzed pretreatment dependence severity from 1989-2006 and found severity increased 12% during that time, with those classified as "highly dependent" increasing 32%.
Doctors should measure dependence in their patients trying to quit. For treatment, they may need to increase drug doses and duration of use, try different drug combinations, and put more stress on minimizing withdrawal symptoms.
Dr. Sachs didn't have a pat answer for why dependence has increased in the last 15 years, so moderator Mark Rosen, FACP, speculated: "Can we attribute any of this (increase in dependence) to the stress of having Bush in the White House for the last eight years?"
Labels: Chest conference, smoking cessation
posted by Jessica Berthold at
11:36 AM
0 Comments
ACP Internist hosted Grand Rounds on June 16, wrapping up the best of the medical blogosphere. Click here for the complete wrap-up.
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Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.
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EverythingHealth is designed to address the rapid changes in science, medicine, health and healing in the 21st Century.
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Michael Benjamin, ACP member, doesn't accept industry money so he can create an independent, clinician-reviewed space on the Internet for physicians to report and comment on the medical news of the day.
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The alter ego of Kevin Pho, ACP Member, is the closest thing to royalty in the medical blog world.
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