Britain Confirms Plan for Major Smoking Ban
By Mike Peacock Tue Nov 16, 2004
LONDON (Reuters) - The British government plans to impose a sweeping public smoking ban across England and Wales within two years and will consider curbs on television advertising of "junk food" aimed at children.
Food retailers and manufacturers will be expected to come up with a clear labeling system for healthy and unhealthy foods.
"All government departments will be smoke-free," Health Secretary John Reid told parliament on Tuesday.
"All enclosed public places and workplaces ... will be smoke-free. All restaurants will be smoke-free. All pubs and bars preparing and serving food will be smoke-free."
A government policy paper on public health said other pubs and bars will be free to choose whether to allow smoking, as will private clubs.
Officials said elements of the ban would be introduced from 2006 with the full embargo, which Reid said would cover "90-odd percent" of bars and restaurants, in place by the end of 2008.
Last week, the Scottish parliament decided to ban smoking in public buildings from 2006.
Shares in pub groups and tobacco firms tumbled even before the official announcement.
Britain's biggest pubs operator Enterprise Inns was hardest hit. Its shares lost 3.8 percent.
Shares in tobacco firms Gallaher and Imperial Tobacco fell 2 percent, while pub operators Mitchells & Butler, Punch Taverns and Wolverhampton & Dudley Breweries slid over 3 percent.
The wide-ranging White Paper targeted rising obesity in Britain, sexually transmitted infections and unhealthy workplaces as well as tobacco.
Reid said the government would ask media regulator Ofcom to consult on advertising to children on television adding: "we will work with the industry to limit other forms of advertising to children."
Further restrictions on tobacco advertising will be imposed, along with graphic picture warnings on cigarette packets.
"We will support Ofcom to strengthen the rules of broadcast advertising of alcohol, particularly to protect the under-18s," Reid added.
To tackle Britain's rising obesity problem, the government will work with food manufacturers and supermarkets to introduce by early 2006, a clear coding system for foods so people can understand at a glance what is healthy and what should be eaten only in moderation.
"We will develop a simple code for processed food to indicate fat, sugar and salt content for shoppers," Reid said.
The British Beer and Pub Association said the government's blueprint could drive bars away from serving food, back to being drinking-only dens as most profit still came from alcohol.
"With concern about binge drinking at its height it seems an extraordinary contradiction to introduce a policy designed to drive us to drink," said the group's Mark Hastings.
http://www.reuters.com/newsArticle.jhtml?type=healthNews&storyID=6829481
Scientists approach addiction source By Meredith Meyer
November 16, 2004 in News
California researchers have isolated a brain cell receptor that plays a key role in nicotine addiction, a significant finding for the 57 percent of University of Chicago smokers who, according to the 2004 statistics from the Student Health Assessment Survey, simply want to quit.
Researchers at the California Institute of Technology used genetic manipulations to demonstrate the addictive effects of a mutation in a subunit of a nicotinic acetylcholine receptor. When this receptor, designated as alpha4, was expressed in mice, the animals showed a greater sensitivity to nicotine. The mice were affected by concentrations of nicotine normally too low to have an effect on the animals.
Prior to the study, 12 brain cell receptors were known to be nicotine-activated. It was not known, however, that any one receptor was primarily responsible for nicotine addiction.
This finding has clear import for smokers who are trying to kick the habit. Developing a drug to block the alpha4 subunit would reduce smokers’ sensitivity to nicotine and make it easier to quit. But researchers are not yet sure what side effects such a drug might have.
“These receptors likely play important roles in the brain circuitry that reinforces healthy behavior like eating and drinking and studying,” said Dr. Daniel McGehee, who has worked on nicotinic receptor function since 1991 and is currently an assistant professor in the Department of Anesthesiology at the University of Chicago. “It is possible that blocking those receptors would alter the way we experience these healthy behaviors.”
In the 2004 Student Health Assessment Survey, 71 percent of students reported that they had not smoked cigarettes in the past year. Of the students who identified themselves as smokers, 15-20 percent consider themselves “light” or “infrequent” smokers. The national onset age of tobacco use is 16-17 years. 32 percent of Chicago students who smoke said they began the habit between 18-20 years of age.
Kelley Carameli, health education specialist at the Student Care Center (SCC), attributed these numbers, which fall below the national averages, to the importance students place on leading healthy lifestyles. “U of C students are great at researching and inquiring about their health,” she said. “They look at the research and make conscious decisions as to their own risks and benefits.”
Carameli said she finds that many of the students who do smoke plan to quit. “Unfortunately, when it comes to tobacco, students often assume that their use will be temporary to relieve stress, etcetera, but it eventually turns into an addiction that they find hard to fight and ‘put off’ until graduation, which only makes quitting harder.”
Many smokers, in an attempt to cut back, switch to cigarettes that are marketed as “light” or “mild.” In a 2002 study, researchers at Health Canada found that two of every three smokers of “light” cigarettes made the switch to light cigarettes because they believed they would suffer fewer health risks. 90 percent of the cigarettes sold in the United States are marketed as ‘light’ according to the Associated Press.
On March 21, 2003 an Illinois judge found Philip Morris’s marketing of light cigarettes to be in violation of the state’s Consumer Fraud and Deceptive Business Practices Act, and ordered the company to pay $10 billion in damages. A class-action lawsuit against the company was initiated in August 2004. The plaintiffs claim that the company fraudulently marketed Marlboro Lights as less harmful than other brands.
At a time when the price of a pack of cigarettes creeps ever higher, the past decade has shown a national rise in teenage smoking. The National Bureau of Economic Research (NBER) reported that, unlike adult smoking, youth smoking is not concentrated in lower socioeconomic groups and is relatively unaffected by increased cigarette prices.
This increase is especially dramatic among teenage girls, according to the NBER despite the fact that lung cancer has risen to the leading cause of cancer death in women.
The SCC offers free smoking cessation workshops and meets with students seeking a prescription for Zyban as a cessation method. The SCC is also sponsoring the national Great American SmokeOut campaign, which comes to Chicago’s campus on November 18.
http://maroon.uchicago.edu/news/articles/2004/11/16/scientists_approach_.php
Working For a Future of Cancer Chemoprevention
Source: University of Texas M. D. Anderson Cancer Center Released: Tue 16-Nov-2004, 13:40 ET
Newswise — Editor's Note: This is the sixth in a series of perspective pieces about trends in cancer research and prevention
Nowadays, a vial of blood taken by a family physician can sometimes forecast a person's risk of heart disease, and cholesterol-lowering drugs as well as a daily baby aspirin may be recommended to curb the threat. But in the future, a simple finger prick also may predict which cancers are destined to develop in an individual, years, even decades, down the road.
And based on a person's unique genetics - the milieu of factors that repair DNA damage, or push cells to grow - the patient of tomorrow also may be given a recipe of drugs that will prevent or delay those cancers from ever developing.
Their cocktail of cancer preventives might include refined forms of aspirin to prevent colon and breast cancer, trace minerals to protect against prostate cancer, or proven versions of ancient remedies, such as turmeric spice for breast cancer and good ole' cups of green tea daily, to repress oral cancer.
At the moment, a complete "chemoprevention" strategy - the use of a natural or synthetic substance to reduce the risk of developing cancer - is a goal to be reached in the future. By all accounts, routine use of such agents won't be here for a long time because much more needs to be understood about the changes that push a cell to become cancerous before that process can be stalled or reversed.
Still, more and more of the research effort at The University of Texas M. D. Anderson Cancer Center is devoted to finding such preemptive strikes - ways to block cancer from ever starting or from becoming clinically apparent.
M. D. Anderson was among the first to look for agents that may help prevent cancer - some three decades ago - and now is seen as a national leader in the field of chemoprevention. In fact, four of five classes of chemopreventive agents the National Cancer Institute has said are promising and so are "considered priority substances for study" are being investigated here, and some of the efforts involve national trials being led by M. D. Anderson researchers. Those compounds are retinoids, nonsteroidal anti-inflammatory drugs (NSAIDs), calcium compounds and selective estrogen receptor modulators (SERMs).
The research represents a completely new way of thinking about cancer, says Waun Ki Hong, M.D., head of the Division of Cancer Medicine at M. D. Anderson. "Cancer doesn't begin with the appearance of a tumor, just as cardiac disease doesn't start with a heart attack," he says.
"And just as we can control the risk of a heart attack with medication, we want to control the process of cancer development with drugs and supplements," says Hong, who is credited as a national pioneer in the chemoprevention movement, an effort he started at the Boston VA Medical Center before he moved to M. D. Anderson in 1984. In 2003, the American Association for Cancer Research (AACR) and the Cancer Research and Prevention Foundation (CRPF) recognized Hong with its second annual AACR-CRPF Award for Excellence in Cancer Prevention Research. The previous year's inaugural award went to Michael B. Sporn, M.D., of Dartmouth Medical School, for his work on the basic science of chemoprevention.
"As complicated as cancer is, oncology is decades behind cardiology in this respect, but we will get there. It is just going to require a lot of patience and hard work."
Adds Bernard Levin, M.D., vice president for Cancer Prevention and Population Sciences at M. D. Anderson, "Our work will never be done until we can say that we have reduced the risk of developing cancer very substantially - perhaps down to zero."
The retinoid story - first bid to reverse damage
When Hong began his work on chemoprevention three decades ago, researchers knew very little about the genetic changes that push a normal cell to divide and survive - the cross-circuitry that produces cancer. And they were still honing use of the tools that helped them cut out tumors (surgery), zap cancer from outside (radiation), or blast it from the inside (chemotherapy).
But Hong worked in the field of head and neck cancers, which, along with lung cancers, are among the most common and most difficult to treat. Many of these cancers are associated with smoking, so Hong reasoned that if he could find genetic changes in cells lining the airways that are exposed to carcinogens, then targeting these "precancer" cells for treatment could delay the onset of cancer in some people.
Hong did find an "initiation phase" in which genetic changes produce premalignant lesions, which then can morph into full-blown cancer cells. He then collaborated with Reuben Lotan, Ph.D., now a professor in the Department of Thoracic/Head and Neck Medical Oncology, who had been studying the role of vitamin A (retinol) and its chemical cousins, known as retinoids, in cancer cell growth and death. Lotan suspected, and later proved, that tobacco smoke hampered efficient functioning of retinoids, and after a series of experiments, Lotan and Hong began to study whether retinoids could reverse precancerous changes in the lungs of former smokers.
Thus, the first such chemoprevention trial of its kind was launched. In the early 1990s, they demonstrated that high dose retinoids could, indeed, stop precancerous growths in the mouth and oral cavity from turning into cancer, allowing them to return to a normal state. The pioneering work provided the first proof that cancer could be reversed.
That effort continued. A different formulation of retinoid, known as 13-cis retinoic acid, has been found to prevent the development of second primary tumors in patients who have successfully completed treatment for head and neck cancers. Scott Lippman, M.D., professor and chair of M. D. Anderson's Department of Clinical Cancer Prevention, led the phase III trial, testing 13-cis retinoic acid in 1,265 patients with early stage lung cancer.
Yet another chemical cousin has shown itself to be a chemopreventive. Lotan and associate professor Jonathan Kurie, M.D., discovered in a trial of 226 patients that 9-cis retinoic acid restored health to lung cancer cells that were already precancerous.
Despite the fact that the researchers suspect retinoids may ultimately prove to be too toxic for everyday use, these studies have lead to important insights. And they earned M. D. Anderson four large federal grants of more than $30 million over the past 13 years to expand and build upon its comprehensive lung cancer chemoprevention study. The funds pay for chemoprevention trials as well as parallel genetic, molecular and pharmacologic studies in the lab, says Hong, all aimed at putting a damper on the world's most dangerous cancer.
"Super aspirins" tested in leading cancer killers
One third of all cancer cases are associated with smoking tobacco, so, of course, the best way to prevent those cancers is to never pick up a cigarette, or to throw them away.
But while the 45 million people in the United States who have quit smoking have reduced their risk of developing lung cancer, the genetic damage caused by smoking does not entirely disappear, M. D. Anderson researchers say. Half of all newly-diagnosed lung cancers occur in former smokers, and so investigators are trying other ways, besides retinoids, to prevent the genetic damage from turning into cancer.
One of the most promising approaches to lung cancer chemoprevention is the use of a so-called "super aspirin," says Kurie, in the Department of Thoracic/Head and Neck Medical Oncology.
He is conducting a clinical trial testing whether celecoxib, a non-steroidal anti-inflammatory drug (NSAID) known by the trade name Celebrex, can repair precancerous lung damage in current and former smokers.
Celecoxib works by blocking of cycloxygenase-2, or "COX-2," an enzyme that is over-produced when cells become inflamed. Studies have shown, however, that many tumors, including those for small-cell lung cancer, also contain a lot of COX-2, possibly because of the body's natural immune reaction to the cancer. Lotan found this year that, like some retinoids, NSAIDs may be effective in controlling cancer because they push cancerous cells to self-destruct.
In the ongoing placebo-controlled trial, which has accrued 85 patients so far, Kurie takes a biopsy of lung cells before, after and during the six-month study to see if twice-daily 400 milligrams doses of celecoxib can reverse damage due to smoking. "It's a biomarker study in which we will be able to see evidence of activity quickly," he says. "If positive, we will move on to a national study."
Not only is the power of COX-2 inhibitors being tested at M. D. Anderson in the number one cancer killer, lung cancer, but in the second deadliest national cancer - colorectal cancer.
And so far, it already has been proven to have an effect in people who inherit a form of colon cancer known as familial adenomatous polyposis (FAP), in which hundreds of precancerous polyps form in the colon and rectum. In 1999, the Food and Drug Administration (FDA) approved the use of celecoxib for FAP patients, based on work conducted at M. D. Anderson and St. Marks Hospital in London. In the study, led by Patrick Lynch, M.D., celecoxib reduced the number of polyps by 30 percent.
"It was an important event in the field of chemoprevention," says Levin. Colorectal cancer prevention trials do not focus on cancer occurrence, because of time constraints, but rather look at the incidence of adenomatous (glandular) polyps, which are known to increase colon cancer risk.
Based on that study, Lynch, an associate professor in the Department of Gastrointestinal Medicine and Nutrition, is heading another international trial in FAP looking at use of celecoxib combined with eflornithine (DFMO), a drug used to treat African sleeping sickness, but which is suspected of having anti-cancer properties.
Yet another trial, led by Lynch, will be evaluating the efficacy of celecoxib in children who are carriers of the mutated FAP gene, and who have little or no evidence yet of polyps. This international study will follow the recently completed pediatric phase I trial conducted by Lynch and colleagues at the Cleveland Clinic.
Levin is researching the issue as co-principal investigator of a multi-center international trial of celecoxib, evaluating its role in preventing recurrence of precancerous polyps.
Researchers say that any drug used for a long time has to be proven to be safe, and that is equally true for the popular COX-2 inhibitors, which are most often used to treat arthritis and pain. For example, a different COX-2 inhibitor drug known as Vioxx was withdrawn from the market in September, 2004, because it doubled cardiovascular problems in a clinical trial testing if it could prevent colon polyp recurrence. Clinical trials such as Levin's that is testing celecoxib, also as a chemopreventive against recurrence of large polyps, have not been halted although data is being intensely scrutinized by cardiovascular experts for similar problems to assure long-term patient safety.
Aspirin, which also has the properties of a COX-2 inhibitor, has itself shown that it may help prevent colon cancer. A study published last year in The New England Journal of Medicine showed that a low-dose baby aspirin proved effective as a modest colon cancer chemopreventive, reducing the number of precancerous polyps by 19 percent.
Results from the prospective, randomized clinical trial of more than 1,000 participants, offered "the strongest indication to date that aspirin can have a significant effect on recurrence of colon adenomas," says one of the study's lead researchers, Robert Bresalier, M.D., professor and chair of the Department of Gastrointestinal Medicine and Nutrition at M. D. Anderson.
Surprisingly, the study found that the effect of a baby aspirin was greater than that of a full strength tablet, which only reduced polyps by four percent. Research is under way to understand why this is so.
Bresalier also is studying the effect of taking a combination of vitamin D and calcium on the development of polyps in people who are an average risk for developing colon cancer. Previous work has suggested that both supplements could offer some protection, so "it makes sense to look at them together," says Bresalier. The 2,400-participant trial is being conducted at nine institutions, including M. D. Anderson.
And still other strategies to prevent colon cancer also are being tested here, including a clinical trial that pits aspirin against the NSAID Sulindac.
Despite promising results testing COX-2 inhibitors, none of M. D. Anderson's researchers suggest that healthy people take these drugs to ward off cancer. "We need to be sure that the long-term benefits of these and other chemopreventives outweigh any major side effects before prescribing these medications for continuous usage over many years," says Levin.
Lotan suspects that for long-term cancer control, people may benefit from combining an NSAID with a safe synthetic retinoid known as fenretinide, which has been shown in an Italian clinical trial to help premenopausal women control their risk of breast cancer. Researchers at M. D. Anderson plan to initiate such a trial.
"People are probably impatient with us, hoping that we can say they should take a baby aspirin for the rest of their lives to prevent cancer," says Hong. "But I don't think aspirin by itself is strong enough, or good enough, to modulate carcinogenesis."
Agents to ward off top gender-based cancers
M. D. Anderson physicians and researchers also have been taking on the two big gender-specific cancers - breast and prostate - in both large and small chemoprevention studies.
In breast cancer, the researchers are intent upon improving what is already the biggest chemoprevention success story to date - the use of tamoxifen, a selective estrogen receptor modulator (SERM), to ward off recurrence of breast cancer.
M. D. Anderson, as a single institution, was the largest recruiter of patients nationally in the trial that proved the value of tamoxifen. Under the guidance of Therese Bevers, M.D., an associate professor of the Department of Clinical Cancer Prevention and director of the Cancer Prevention Center and the Prevention Outreach Programs,M. D. Anderson also is one of the top recruiters in the trial that is now seeking to find a better alternative to tamoxifen.
Tamoxifen blocks the effects of the estrogen in the body, and because 80 percent of breast cancers are dependent on estrogen hormones, the drug has a powerful anti-cancer effect - it decreases the risk of invasive cancer by half in women at risk, says Bevers. But tamoxifen is associated with some serious side effects, so researchers are testing the newer SERM, raloxifene, in one of the largest breast cancer prevention studies ever. The trial, known as STAR (The Study of Tamoxifen and Raloxifene), has recruited more than 19,000 volunteers at more than 400 centers, including 217 at M. D. Anderson, and an additional 170 at M. D. Anderson satellite sites.
Raloxifene, used to prevent osteoporosis, may have fewer side effects than tamoxifen, Bevers says. But while the results of STAR likely will be known in the next year or two, approaches are being investigated at M. D. Anderson that will help speed up investigation of even newer classes of estrogen blockers and other chemopreventive agents such as COX-2 inhibitors, she says.
For example, Banu Arun, M.D., is identifying biomarkers in breast cancer cells that will quickly tell researchers whether or not potential chemopreventive drugs are having any effect. "This is so important because long-term chemoprevention trials are expensive and take a long time to conduct. It would be best if promising agents can be screened first," says Arun, an associate professor in the Department of Breast Medical Oncology. "Evidence taken directly from these studies will help move larger chemoprevention studies forward."
Arun is looking for such markers in an M. D. Anderson clinical trial testing use of celecoxib in preventing breast cancer - believed to be the only trial of its kind in the United States. She also is researching how the newest classes of estrogen blockers change the biology of breast cells. To do that, Arun uses a minimally invasive technique known as ductal lavage to collect and examine cells from breast milk ducts. She says that, so far, "COX-2 overexpression is strongly implicated in progression of breast precancer to malignancy."
Retinoic acids also are being tested as a breast cancer chemopreventive. Gordon Mills, M.D., Ph.D., a professor and chair of the Department of Molecular Therapeutics, is examining the effects of retinoic acid and birth control pills on breast and ovarian tissue in patients who have a strong family history of the disease.
Hints that prostate cancer also may respond to a strategy of chemoprevention has lead to the largest cancer prevention study ever undertaken - a study of selenium and vitamin E supplements in 32,400 men across the United States, Canada and Puerto Rico.
Known as SELECT (the Selenium and Vitamin E Cancer Prevention Trial), the trial is based on observations from two previous studies that failed, but which offered a new direction, says Lippman, the national medical oncology leader of the trial, which is expected to take more than a decade.
One earlier study had tested whether selenium, a trace element, could help prevent non-melanoma skin cancer. In the end, skin cancer rates were not reduced, but the expected incidence of prostate cancer fell by two-thirds. The other study explores use of vitamin E to prevent lung cancer, and results showed no effect of vitamin E on lung cancer rates, but prostate cancer incidence fell.
Data from cell and animal studies also suggests that selenium "may slow the progression of subclinical prostate cancer, which is equivalent to prevention," says Lippman.
Not only is Lippman a national coordinator of SELECT, but he also serves as M. D. Anderson's principal investigator on a newly created consortium of six research centers that are working together on cancer prevention. The National Cancer Institute's Division of Cancer Prevention recently devoted $42 million to the group, directing them to work as hard and fast as they can on the development of cancer preventive compounds.
Projects funded by the consortium cover the spectrum of cancers and are designed to quickly test the cancer preventive potential of new agents. But several of the first studies launched at M. D. Anderson are looking at very old remedies.
Arun, for example, is intrigued by the Far Eastern spice turmeric (also known as curcumin), which has demonstrated anti-cancer properties in laboratory and animal studies of lung, colon and breast cancer conducted by Bharat Aggarwal, M.D., a professor in the department of Bioimmunotherapy Research. "This Far Eastern spice, one of the main ingredients of curry, has been used medicinally and as a food for centuries, and has no side effects, which makes it an ideal chemoprevention agent," says Arun. "We are finding curcumin can suppress markers of cell proliferation."
And Vassiliki Papadimitrakopoulou, M.D., an associate professor in the Department of Thoracic/Head & Neck Medical Oncology, is testing whether the active substance contained in green tea, epigallocatechin gallate, can act like an anti-cancer drug, stopping precancerous lesions in the mouth and throat from morphing into tumors.
Green tea has long been suspected of having beneficial health effects, based on decades of research conducted in China, Southeast Asia and Japan. "Epidemiological studies conducted in the 1980s suggested that people in those countries who drink a certain number of cups of green tea, or more, each day, appear to be protected against a variety of cancers, including stomach, prostate, colorectal, and head and neck cancers," says Papadimitrakopoulou. New laboratory research has found that epigallocatechin gallate, a tannin with potent antioxidant activity, suppresses signals that instruct a cell to grow.
In Papadimitrakopoulou's ongoing "blinded" study, volunteers with precancerous conditions of the oral cavity are split into four groups, three of which are given different doses of a pill that contain the green tea extract. The other group is given an inert "placebo" tablet.
At the start and end of the three-month trial, which has recruited 21 patients so far, volunteers are given a biopsy of the worrisome lesion. Results so far "have been encouraging," says Papadimitrakopoulou. "From a natural pool of agents that we are studying, this is one of the most promising."
The (bumpy) road ahead
What most excites Lippman and other researchers at M. D. Anderson is the notion that cancer and other common diseases of aging may be linked by common pathways that could be strategically disrupted by simply taking pills every day.
And the current number one pathway candidate, in many researchers' eyes, is inflammation, the immune system's reaction to cell and tissue injury. Cancer often originates at the site of chronic inflammation, and the interplay between the two is being increasingly studied.
Lippman ticks off on his fingers the role that inflammation plays in "heart disease, Alzheimer's disease, the chronic diseases associated with aging, and even obesity," and says that NSAIDs and statins, which also reduce inflammation, are now being tested in cancer, as well as in Alzheimer's disease; aspirin and statins, he further notes, have long been used to prevent heart attacks.
Whether it is NSAIDS, statins or any agent, "the science behind inflammation is moving so rapidly that we may now be able to think about designing trials to test agents that will prevent, or delay, several diseases all at once," says Lippman.
Still, none of M. D. Anderson's chemoprevention experts - including Lippman, Lotan, Levin and Hong - suggest that people take a little celecoxib here, a dose of aspirin there, or mix tablespoons of turmeric into their cups of green tea as a way to "self medicate" against cancer.
They all stress that it will take time to prove that any substance can substantially reduce the risk of a disease in the average person without producing side effects. These studies will require giving young and healthy volunteers a drug for many years and then waiting until they have aged to see whether volunteers who used the agent developed fewer diseases compared to those who didn't.
"Like testing whether fluoride in water can prevent cavities, we will not have an answer for 20 to 25 years in the minimum," says Lotan. "You have to make sure that these agents have no side effects if taken for decades, and that is a risk not many drug companies or institutions want to take."
Most chemoprevention studies now test people who are at higher risk of developing cancer, such as former smokers, as a way to predict whether they will help those who are not at risk; few studies are like SELECT in which the only risk factor shared by participants is increased age. At the same time, researchers at M. D. Anderson are actively looking for molecular and genetic risk factors that identify people at highest cancer risk and those most likely to benefit from chemoprevention.
"We must do no harm," says Hong. "A cancer chemoprevention agent, used in young people who are not at risk for cancer, must be absolutely safe and non-toxic."
Levin and others emphasize that chemoprevention must not be substituted for other important lifestyle habits such as avoiding tobacco and exercising.
"Still, while we should be modest in claiming our work in the next decade will lead to new chemoprevention advances, we have promising leads from the laboratory that will enable us to conduct good trials in the future," says Levin. "The best is yet to come."
http://www.newswise.com/articles/view/508341/
Smuggling Ring Smoked Out At JFK Airport
By Eyewitness News' Sarah Wallace
(Queens-WABC, November 16, 2004) — The Eyewitness News investigators has learned a worldwide investigation is underway into an alleged cigarette ring at JFK airport
Law enforcement sources are now saying that at least nine federal state and local agencies are involved in this investigation at Kennedy Airport. One source is telling Eyewitness News that the scope of this investigation is so massive that the offices of two attorneys are also involved.
The investigation took place at building seven at Kennedy Airport. Now, dozens of agents are now cataloging cigarettes that have been seized in recent days. It is a quiet investigation and no one is talking.
But sources tell Eyewitness News the investigation involves the importation of U.S. brand cigarettes from Switzerland via DHL. One of the planes landed this morning and its cargo was immediately seized by agents. The focus was with one Internet company. They have a website offering cigarettes directly to customers. The problem is that the cigarettes are re-packaged with a U.S. stamp and not being taxed to the tune of hundreds of millions of dollars a year.
Also, under investigation are the recipients of the cigarettes. Some of the recipients may be reselling them illegally.
Now, the obvious question is how long have these cigarettes been getting into this country untaxed and what about U.S. customs? These are question that need to be answered and we will have much more on this developing story on Eyewitness News at 5:00 p.m.
http://abclocal.go.com/wabc/news/WABC_111604_smugglingring.html
Cotinine not linked to hearing loss
Posted By: News-Medical in Medical Research News Published: Tuesday, 16-Nov-2004
Levels of cotinine, a chemical that is made by the body from nicotine, which is found in cigarette smoke, does not appear to be linked to hearing loss, according to an article in the November issue of The Archives of Otolaryngology – Head & Neck Surgery.
According to the article, hearing loss is one of the most common conditions among adults 65 years and older. Several studies have linked cardiovascular disease with hearing loss, and others have shown that hearing loss may be affected by cigarette smoking, a known cardiovascular disease risk factor.
David M. Nondahl, M.S., of the University of Wisconsin-Madison, and colleagues investigated the relationship between levels of serum cotinine and hearing loss in 197 patients with new hearing loss and 394 patients without any hearing loss (aged 53-75 years) selected from the 2,800 participants in the five-year follow-up Epidemiology of Hearing Loss Study, 1998-2000. Serum cotinine levels were measured from blood samples obtained from the participants.
The researchers found no significant associations between serum cotinine levels and hearing loss. Among participants with hearing loss, 14 were current smokers, 96 were past smokers and 83 never smoked. Among participants with no hearing loss, 41 were current smokers, 183 were past smokers and 164 never smoked. Smoking information was not obtained for 10 participants.
“These results were not consistent with a previous report, which found cross-sectional associations between prevalent hearing loss and current smoking and environmental tobacco smoke exposure in the home. Longer-term longitudinal studies of smoking and/or serum cotinine levels and the subsequent development of hearing loss may help clarify these associations.” http://archoto.com
Exposure to Environmental Tobacco Smoke and Cotinine Levels — Fact Sheet
The National Institutes of Health's National Toxicology Program's 9th issue of the Report on Carcinogens listed ETS as a "known" human carcinogen, which indicates that there is a cause and effect relationship between exposure and human cancer incidence.
ETS is classified as a Group A carcinogen (known to cause cancer in humans) under the EPA's carcinogen assessment guidelines. Exposure to ETS causes lung cancer and has been linked to an increased risk for heart disease in nonsmokers.
ETS causes about 3,000 lung cancer deaths annually among adult nonsmokers. Scientific studies have also estimated that ETS accounts for as many as 35,000 deaths from ischemic heart disease annually in the United States. More research is needed to know exactly how recent changes in ETS exposure may affect lung cancer rates among adult nonsmokers.
ETS causes serious respiratory problems in children, such as greater number and severity of asthma attacks and lower respiratory tract infections. ETS exposure increases the risk for sudden infant death syndrome (SIDS) and middle ear infections for children.
Cotinine is a major metabolite of nicotine. Exposure to nicotine can be measured by analyzing the cotinine levels in the blood, saliva, or urine. Since nicotine is highly specific for tobacco smoke, serum cotinine levels track exposure to tobacco smoke and its toxic constituents.
In 1991, data showed that nearly 90 percent of the U.S. population had measurable levels of serum cotinine in their blood. The Centers for Disease Control and Prevention's National Report on Human Exposure to Environmental Chemicals found more than a 75 percent decrease in median cotinine (metabolized nicotine) levels for nonsmokers in the United States since 1991.
Children and teenagers, 3-19 years old, had higher levels of cotinine than did adults, 20 years old and above.
Involuntary exposure to ETS remains a common, serious public health hazard that is entirely preventable by adopting and enforcing appropriate regulatory policies. Smokefree environments are the most effective method for reducing ETS exposure. Healthy People 2010 objectives address this issue and seek optimal protection of nonsmokers through policies, regulations, and laws requiring smoke-free environments in all schools, work sites, and public places.
California, Connecticut, Delaware, Maine, Massachusetts, New York, and Rhode Island meet the nation's Healthy People 2010 objective to establish smoke-free indoor air laws covering public places and worksites. Because of comprehensive state laws, virtually all indoor workplaces in these states are now smoke free, including restaurants and bars.
The dramatic declines in serum cotinine levels among nonsmokers are a good indication that efforts to ensure clean indoor air through smoking restrictions in workplaces, restaurants and other public places are working. However, there are still too many people, especially young people, who continue to be exposed to environmental tobacco smoke (ETS).
http://www.news-medical.net/?id=6309
As cold weather creeps closer, veteran questions smoking ban
By Eric Weslander, Journal-World November 16, 2004
Speedy takes one more sip of his whiskey and Coke and decides it's time to light one up. It's 2:45 p.m. on a Friday.
"See what I've got to go through?" Speedy asks, being tilted back in his wheelchair as his friend Rowdy Brouhard pulls him out the front door of the Cross Town Tavern, 1910 Haskell Ave.
The city's 4-month-old smoking ban poses an unusual challenge for 72-year-old Raymond "Speedy" Perdue. Not only does he depend on friends to give him a ride to his neighborhood bar, he now depends on them to wheel him outside between drinks.
The weather's getting colder, a fact Perdue notices more than most because of poor blood circulation. And U.S. troops are fighting in Iraq, a fact Perdue mentions often.
Cigarette by cigarette, Speedy -- himself a veteran of wars in Korea and Vietnam -- is getting more ticked off at the City Commission, which passed the ban.
‘I'll die where I want'
"What the hell did I fight for?" he'd asked earlier that day, sitting with a pink electric blanket on his lap at his home on Haskell Avenue a few blocks from the bar. "If they want to dictate, go over to Iraq. I ain't kidding you ... I'm 72 years old, by God, and I'll die where I want to. And it ain't going to be out smoking in a (expletive deleted) snowdrift."
Perdue makes the half-mile trip to the tavern whenever he can get someone to give him a ride. He grew up in Lawrence and, long before he suffered the stroke that disabled all his limbs except his right arm, he earned the nickname "Speedy."
The name stuck. For his birthday this year -- July 4 -- friends from the tavern got him a sign for the back of his wheelchair that reads "Speedy #1" with a silhouette of an extended middle finger.
To Perdue, it's no stretch to equate patriotism with the freedom to smoke. In a 2000 Journal-World article about a newly formed Vietnam veterans' group, Perdue was photographed with a veterans' hat on his head and a cigarette in his hand.
Driving people away
He said he started smoking at age 5, when he asked for a drag from an older friend's Lucky Strike. The first puff made him so sick, he remembers, that he fell in a creek.
He dropped out of high school, went to work digging ditches and, when he tired of that, enlisted in the Air Force. He later worked as a painter at Kansas University.
After his stroke 16 years ago this month, a nurse told him he'd be dead in four months if he didn't stop smoking. Today his brand of choice is Gunsmokes, which he buys in bulk on an Indian reservation.
He smokes up to two packs a day, depending on whether it's a day he goes to the bar.
"I ain't dead yet," he said.
Though Perdue is concerned about the cold weather setting in, he said his anger about the smoking ban wasn't just about his own circumstances.
For one, he and Brouhard both say many people they know are driving to neighboring cities such as Linwood or Eudora to go to bars and smoke, which they say is leading to more drunken driving. Perdue also said he worried whether bar owners and employees could feed their families, as their incomes drop with less business.
Why no vote?
But Perdue's main problem with the smoking ban is that he thinks it was introduced in the wrong way. He knows supporters of the ban say it's a matter of public health, but at least, he said, it should be put to a public vote.
"I didn't fight in two wars, by God, for what they've got going on around here," he said. "I grew up in this town, and it wasn't like this a long time ago."
Asked to respond to Perdue's concerns, City Commissioner David Schauner repeated an explanation he's given before: The commission was told that because of a technicality in state law, it simply didn't have the authority to put the smoking question on the ballot. Instead, it must be put there by a petition with at least 3,764 signatures.
As of September, bar and restaurant owners said they'd collected roughly 4,000 signatures of registered voters and were planning to keep gathering the signatures through late November.
"Ultimately, Speedy will get what he wants," Schauner said. "He will get a vote of the people, and if the people say it stinks, they can vote it out."
http://www.ljworld.com/section/smoking/story/187790
Tanning Beds Proving More Problematic as Legal Restrictions Increase - Noted Dermatologist Joshua Fox, MD, Says Teens Run Greatest Risk of Exposure to Tanning Beds
The American Academy of Dermatology, the Food & Drug Administration and the American Cancer Society all encourage parents of teens to review the dangers of tanning beds with their children, and to prohibit their use. Legislators in some states are signing bills into law making it illegal for a teen to visit a tanning salon without parental consent. Please read on below about the serious health issues associated with tanning beds. Let your readers learn first from you about how to best protect their teenage children against the dangers of tanning beds.
(PRWEB) November 16, 2004 -- Advanced Dermatology PC, NY, NY 2004 – When Governor Arnold Schwartzenegger last month signed the bill that would make teen visits to a tanning salon illegal in California without parental consent, the issues surrounding the dangers of tanning beds – and the government’s role in protecting children from them – were thrust back into the spotlight. Indeed, California is only one of a number of states – including New York – that are considering or implementing parental/medical consent laws for teenagers, as they seek to use tanning beds or sunlamps to achieve that “golden glow” of a summer suntan.
According to Joshua Fox, MD, a leading New York-area dermatologist and founder of Advanced Dermatology, the short-term, bronzing effects of tanning bed use are simply not worth the possible long-term consequences of increased skin cancer risk and premature aging. “Particularly during the teenage years, continued use of a tanning bed or sunlamp can be quite dangerous,” Dr. Fox says, “Because it can increase your risk of developing malignant melanoma by more than 55%, and it can about double your chances of basal cell and/or squamous cell cancer as well.” While these forms of cancer have high cure rates, Dr. Fox notes, melanoma however is quickly becoming the fastest increasingly and deadliest form of cancer…particularly among young adults.
Why the Surge in Melanoma Cases?
Dr. Fox confirms that the dermatological community believes “very strongly” that the increased use of tanning beds by teenagers has contributed to the sharp rise in melanoma rates during the 1990s. Consider the following data from the American Academy of Dermatology and the American Cancer Society:
- Melanoma now ranks as the most common cancer among people ages 25 to 29.
- Each year, more than one million people – many of them teenagers – visit tanning salons
- From the 1970s to the 1990s, melanoma rates rose 60.5 percent in women and 26.7 percent in men, according to the American Cancer Society.
- Melanoma is linked to excessive sun exposure in the first 10 to 19 years of life, a period during which muck of almost 80 percent of a person's lifetime sun exposure occurs.
“The reason teens are so at risk is that they are still experiencing such tremendous growth at the cellular level,” Dr. Fox explains. “Their skin cells, like every other cell in their bodies, are dividing more rapidly than they do when we reach adulthood. And the more rapidly cells change, the higher the chances are that they will change detrimentally particularly when hit by the deleterious affects of the sun, and cancer will develop.”
Why the Surge in Tanning Bed Interest?
Many surveys have found that teens put tanning sessions at the tops of their “to-do” lists for one reason: vanity. From high school proms to college homecomings, from “date night” to “girls’ night out,” teens are aware of the cultural and societal pressures to look their best, and many of them have turned to tanning salons to help them in their quest.
But, according to Dr. Fox, a Wake Forest University study, published in July’s issue of the Journal of the American Academy of Dermatology, suggests there could be much more to it. “In the study, researchers found evidence that the UVA rays in tanning beds may actually stimulate the brain to produce endorphins, those ‘feel-good’ hormones that are released during such positive activities as exercise, but also during such negative behaviors as drug use or cigarette smoking.” The study authors concluded, “The relaxing and reinforcing effects of UV exposure contribute to tanning behavior in frequent tanners, and should be explored in greater detail.”
The Future of the Issue
Dr. Fox emphasizes that the American Academy of Dermatology, as well as the Food & Drug Administration and the American Cancer Society, encourages parents of teens to review the dangers of tanning beds with their children, and to prohibit their use. “There are many safe creams and gels on the market today that can give the appearance of a natural tan so called self tanner,” Dr. Fox explains, “Without the possibly devastating side effects of tanning beds and sunlamps.”
In addition, the AAD, the FDA and others have advocated to legislatures at the state and federal level to outlaw use of tanning beds for all but medicinal purposes. (Limited exposure to the UVA rays in tanning beds has been shown to be beneficial for psoriasis sufferers.) In New York, Assemblyman Scott Stringer (D-Manhattan) has sponsored a bill that would require teens to obtain written parental consent before they could tan. Assemblyman Stringer notes, “The tanning industry is completely unregulated. It is scientific fact that UV rays are harmful to our bodies. Tanning salons must recognize this and abide by the guidelines proposed in my bill to protect consumers."
According to Dr. Fox, “With the cooperative efforts of well-informed teenagers, involved parents, dedicated physicians and assertive organizational leaders at the local, state and federal levels, we can reduce the risk of serious illness – or even death – associated with the use of these tanning beds.”
Bio: Joshua L. Fox, M.D.
Joshua L. Fox, M.D. is a leading authority in the field of dermatology with an expertise in skin cancer, cosmetic surgery, and laser procedures. As an official spokesperson for the American Academy of Dermatology and the American Society of Dermatologic Surgery, Dr. Fox has been an expert resource on dermatologic topics for numerous television networks including ABC, CBS, CNN, NBC, Telemundo, talk shows, radio stations, newspapers and magazines. Dr. Fox has served on the board of the National Rosacea Foundation and has done clinical trials in both medical and laser therapy in Rosacea. He has received multiple research and clinical awards including recognition from Top Doctors, Who's Who, Journal of Dermatologic Surgery and Oncology, Community Service Award from the American Society of Dermatologic Surgery, the prestigious Husic Award as well certificates of recognition for service from multiple hospitals, civic, educational and community organizations. Dr. Fox has authored and presented papers of his research on lasers, cosmetic procedures, stretch marks, scars, skin cancer, bug bites, photosensitivity and various rashes.
As founder and director of Advanced Dermatology and The Center for Laser and Cosmetic Surgery, Dr. Fox and associates have expanded the practice to the one of largest in dermatology, laser & cosmetic surgery with more lasers than any hospital or dermatology practice on the eastern coast. Dr. Fox is a graduate of the New York University Medical Center of Skin and Cancer and has been on the advisory board of the Psoriasis Foundation and National Rosacea Foundation among others. He has also been a fellow of many societies including the International Academy of Cosmetic Surgery, International Academy of Cosmetic Dermatology, and the Society for Investigative Dermatology. Dr. Fox is the founder of the AAD Melanoma/Skin Cancer Prevention Program in Queens, New York since 1987. Dr. Fox has been Chief of Dermatology of several major teaching hospitals including Mt. Sinai Hospital of Queens and Jamaica Medical Center and is currently on the staff of ten NY area hospitals. Dr. Fox and Advanced Dermatology the Center for Laser & Cosmetic Surgery have been used as a resource center educating dermatologists, laser surgeons, & cosmetic surgeons and others about lasers, cancer and cosmetic surgery. www.advanceddermatologypc.com
http://www.emediawire.com/releases/2004/11/emw178994.htm
Taking an active stance on passive smoking -PA
By Fern Shen 11/16/2004
Craig Raphael's mother had a very mom-like reason for banning him from video arcades. They reeked of smoke, she said, and were bad for his health.
The Washington Post
Craig Raphael's mother had a very mom-like reason for banning him from video arcades. They reeked of smoke, she said, and were bad for his health.
Craig had an un-kid-like response. Rather than sulk, the Potomac, Md., teen set out to prove her wrong by studying how one's health is affected by other people's cigarette smoke (called "passive smoking"). He hoped he could change her mind; anyway, he needed something for his school science project. It turned out Mindy Raphael was right. "People do have decreased pulmonary (lung) function when they're around cigarette smoke," said Craig, 14.
Craig's research got lots of attention. He presented it to doctors and scientists at the annual meeting of the American Academy of Allergy, Asthma and Immunology this year. Organizers said he might be the youngest researcher ever to address the group.
Craig and his allergist dad, Gordon, got 10 healthy adults to measure their lung function before, during and after spending time in restaurants and lounges - places as smoky, if not smokier, than video arcades. The peak-flow meter he gave to each test subject is familiar to kids with breathing problems: You blow hard into it and a scale shows how well your lungs are working. Craig also gave his subjects carbon monoxide monitors, which measure cigarette smoke in the air.
After two hours, as the air got smokier, people's breathing had declined an average of 21 percent (in one case, by 40 percent). "Every one of them had a drop in lung function," said Craig, himself an asthma sufferer. "I didn't expect that."
The subjects also felt irritation in their eyes, noses and throats.
Craig submitted his study to the school science fair, which advanced him to the county level, where he won first place in the health and medicine category and honors from the American Cancer Society, the American Lung Association and the U.S. Public Health Service. Next, he testified before Maryland and Delaware lawmakers in support of the states' smoking bans.
Defending his study has been a good experience for Craig, who wants to be a doctor. But maybe the best news is that his favorite arcade is now smoke-free.
gomery County passed a smoking ban last year. So now I can do what I wanted to do in the first place!"
http://www.zwire.com/site/news.cfm?BRD=2259&dept_id=457355&newsid=13352521&PAG=461&rfi=9
Clear the air in bars -PA
Posted on Tue, Nov. 16, 2004
By Denny and Debbie Huber
You're a bartender. You work eight hours a day in a typical bar.
Even though you are not a smoker, you breathe almost a pack a day in secondhand smoke.
As even the tobacco companies now concede, you have a pretty good chance of dying early from heart disease or lung cancer.
Should you be forced to breathe known carcinogens in order to hold down a job?
Not according to a proposed state law now in committee in the Pennsylvania Senate.
This law would follow the lead of California, New York, Delaware, Maine, Massachusetts, Connecticut and Rhode Island.
In these states, smoking is not allowed in any workplace, including restaurants and bars.
While no one is forcing bartenders or waiters to work where they do, exposure to toxic smoke shouldn't be a condition of employment.