E-cigarette use for quitting smoking associated with improved success rates

Date:

May 20, 2014

Source:

University College London

Summary:

People attempting to quit smoking without professional help are approximately 60 percent more likely to report succeeding if they use e-cigarettes than if they use willpower alone or over-the-counter nicotine replacement therapies such as patches or gum, finds a large survey of smokers. The study surveyed 5,863 smokers between 2009 and 2014 who had attempted to quit smoking without the aid of prescription medication or professional support. 20% of people trying to quit with the aid of e-cigarettes reported having stopped smoking conventional cigarettes at the time of the survey. 

People attempting to quit smoking without professional help are approximately 60% more likely to report succeeding if they use e-cigarettes than if they use willpower alone or over-the-counter nicotine replacement therapies such as patches or gum, finds a large UCL (University College London) survey of smokers in England. The results were adjusted for a wide range of factors that might influence success at quitting, including age, nicotine dependence, previous quit attempts, and whether quitting was gradual or abrupt.

The study, published in Addiction, surveyed 5,863 smokers between 2009 and 2014 who had attempted to quit smoking without the aid of prescription medication or professional support. 20% of people trying to quit with the aid of e-cigarettes reported having stopped smoking conventional cigarettes at the time of the survey.

The research, chiefly funded by Cancer Research UK, suggests that e-cigarettes could play a positive role in reducing smoking rates. "E-cigarettes could substantially improve public health because of their widespread appeal and the huge health gains associated with stopping smoking," says Professor Robert West of UCL's 
Department of Epidemiology & Public Health, senior author of the study. "However, we should also recognise that the strongest evidence remains for use of the NHS stop-smoking services. These almost triple a smoker's odds of successfully quitting compared with going it alone or relying on over-the-counter products."

Another survey by the same team found that most e-cigarette use involves first generation 'cigalike' products rather than second generation ones that use refillable cartridges and a wider choice of nicotine concentrations and flavors. Dr Jamie Brown of UCL's Department of Clinical, Educational and Health Psychology, lead author of both reports, says: "We will continue to monitor success rates in people using e-cigarettes to stop smoking to see whether there are improvements as the devices become more advanced."
Some e-cigarette users may want to continue using them indefinitely. "It is not clear whether long-term use of e-cigarettes carries health risks but from what is known about the contents of the vapour these will be much less than from smoking," says Professor West.

"Some public health experts have expressed concern that widespread use of e-cigarettes could 're-normalise' smoking. However, we are tracking this very closely and see no evidence of it. Smoking rates in England are declining, quitting rates are increasing and regular e-cigarette use among never smokers is negligible."

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Deaths attributed to low levels of education: Lack of education as deadly as smoking

 

Date:

July 8, 2015

Source:

New York University

Summary:

A new study estimates the number of deaths that can be linked to differences in education, and finds that variation in the risk of death across education levels has widened considerably. 

 

A new study by researchers at the University of Colorado, New York University, and the University of North Carolina at Chapel Hill estimates the number of deaths that can be linked to differences in education, and finds that variation in the risk of death across education levels has widened considerably.

The findings, published July 8 in the journal PLOS ONE, suggest that lacking education may be as deadly as being a current rather than former smoker.

"In public health policy, we often focus on changing health behaviors such as diet, smoking, and drinking," said Virginia Chang, associate professor of public health at NYU's Steinhardt School of Culture, Education, and Human Development and College of Global Public Health, and associate professor of population health at NYU School of Medicine. "Education -- which is a more fundamental, upstream driver of health behaviors and disparities -- should also be a key element of U.S. health policy."

Low levels of education are common. More than 10 percent of U.S. adults ages 25 to 34 do not have a high school degree, while more than a quarter have some college but no bachelor's degree. Yet studies show that a higher level of education is a strong predictor of longevity due to many factors, including higher income and social status, healthier behaviors, and improved social and psychological well being. Evidence from studies including natural experiments consistently show a strong association between education level and mortality and suggest that a substantial part of the association between education and mortality is causal.
Using the Centers for Disease Control and Prevention's National Health Interview Survey, the study team looked at data on more than a million people from 1986 to 2006 to estimate the number of deaths that could be attributed to low levels of education. Estimates of attributable mortality indicate the number of lives that could be potentially saved if adults had a higher level of education. They studied people born in 1925, 1935, and 1945 to understand how education levels affected mortality over time, and noted the causes of death, including cardiovascular disease and cancer.

The researchers estimated the number of deaths in the 2010 U.S. population for two scenarios with relevance for policy: having less than a high school degree, and having some college but not a bachelor's degree. Maximizing high school graduations rates and the completion of college among those who have already entered are viable policy targets.

They found that 145,243 deaths could be saved in the 2010 population if adults who had not completed high school went on to earn a GED or high school degree, which is comparable to the estimated number of deaths that could be averted if all current smokers had the mortality rates of former smokers. In addition, 110,068 deaths could be saved if adults who had some college went on to complete their bachelor's degree.

The disparities in mortality across different levels of education widened substantially over time. For example, mortality rates fell modestly among those with high school degrees, but mortality rates fell much more rapidly among those with college degrees. As a result, encouraging high school completion among adults who have not finished high school could save twice as many lives among those born in 1945 as compared to those born in 1925.

Deaths from cardiovascular disease played a greater role than deaths from cancer in these growing gaps in mortality and improvements in survival for well-educated people, likely due to advances in the prevention and treatment of cardiovascular disease among those with more education.

"Our results suggest that policies and interventions that improve educational attainment could substantially improve survival in the U.S. population, especially given widening educational disparities," said Patrick Krueger, assistant professor in the Department of Health & Behavioral Sciences at the University of Colorado Denver | Anschutz Medical Campus and the Institute of Behavioral Sciences at the University of Colorado Boulder. "Unless these trends change, the mortality attributable to low education will continue to increase in the future."

Healthy People 2020 -- an initiative to improve Americans' health decade by decade -- set goals for increasing the proportion of students completing high school by 2020. The researchers said that based on their findings, meeting these goals could have a substantial impact on future survival patterns.

"Broadly, life expectancy is increasing, but those with more education are reaping most of the benefits," Chang said. "In addition to education policy's obvious relevance for improving learning and economic opportunities, its benefits to health should also be thought of as a key rationale. The bottom line is paying attention to education has the potential to substantively reduce mortality."

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Menopausal women should increase exercise to reduce hot flashes, says new research

A team of researchers analysed data from 6,079 women, aged between 40 to 59 and of Hispanic descent, who had all taken part in the Collaborative Group for Research of the Climacteric in Latin America. 

As part of the research program they had all attended one of 20 urban health centers in 11 Latin American countries, completing surveys and providing health records, which were then used in the current study.

The surveys included questions on the women's menopause status, as well as a Menopause Rating Scale (MRS) questionnaire on menopause symptoms, including hot flashes, joint pains, depressed mood, anxiety, sexual problems, vaginal dryness, and bladder problems.

The women were also questioned on their level of activity.

If women scored 16 or more on the MRS questionnaire their menopausal symptoms were considered to be severe, and if they reported participating in less than three 30-minute sessions of physical activity a week their lifestyle was considered to be sedentary.

Using this criteria, 64% of the women were considered to have a sedentary lifestyle, with 16% of these sedentary women scoring highly enough on the MRS questionnaire for their symptoms to be considered severe, compared to only 11% of active women.

Sedentary women also had higher scores on the depression, anxiety, and insomnia scales; reported more menopausal symptoms in general; and were also more likely to be obese.

Commenting on the results, JoAnn V. Pinkerton, NAMS Executive Director, said, "Regular physical activity reduces the risk of breast and colon cancer, dementia, heart attacks, stroke, depression; loss of lean muscle mass, and bone loss and improves immune system function. One study showed that just one hour of walking daily cut the risk of obesity by 24%. Fewer hot flashes, fewer health risks, increased well-being -- who doesn't want these benefits?"

The study was published online on Wednesday on the website of The North American Menopause Society (NAMS), and will be published in the May 2016 print edition of Menopause.

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New study advises seniors to stay behind the wheel for good health

A team of researchers from Columbia University's Mailman School of Public Health looked at 16 previous studies which had reviewed the health of drivers aged 55 and over, and compared it to data from current drivers.

The findings showed that after seniors stopped driving the risk of developing depressive symptoms nearly doubled, and those who had given up driving were nearly five times as likely as to be admitted to a form of care home, such as a nursing home, assisted living community, or retirement home.

And although many seniors gave up driving due to a decrease in cognitive function and physical function, the studies showed that these abilities only worsened further after they quit.

Giving up driving also resulted in a 51% reduction in the size of senior's social circles, with women showing a greater decline in social health than men. This in turn could also contribute to the decline in health seen in other areas, "As older ex-drivers begin substituting outside activities with indoor activities around the home, these activities may not be as beneficial to physical functioning as working or volunteering on the outside," said co-author Thelma Mielenz, "When time comes to stop driving, it is important to make personalized plans to maintain mobility and social functions."

However the team pointed out that alternative transport arrangements are not necessarily enough to maintain good health, "What we need most of all are effective programs that can ensure and prolong an older adult's mobility, physical, and social functioning," advised senior author Guohua Li. 

The findings were published in the Journal of the American Geriatrics Society.

According to the American Automobile Association (AAA), seniors make up some of the safest drivers on the road, greatly reducing their risk of injury when behind the wheel thanks to wearing their seatbelt, obeying the speed limit, and not drinking and driving. And by 2030 of the 70 million+ people age 65 and older, around 85-90% of them will hold a driver's license. 

However increasing frailty does mean that they are more likely to suffer from injuries or even death when in a crash. Taking into account these risks the AAA launched its Lifelong Safe Mobility initiative in 2003 to help seniors to take control of the wheel for as long as possible and as safely possible, and continue to stay mobile even when they have ceased to drive

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