Showing posts with label Tobacco. Show all posts
Showing posts with label Tobacco. Show all posts
Wednesday, April 23, 2008
Health commissioner: Tobacco companies target girls
In Jefferson County, 30 percent of mothers smoke during pregnancy. Over 20 percent of Indiana high school girls smoke, along with over 10 percent of girls in middle school. Marketing may be responsible for some of those numbers."It's clear that the tobacco companies target women and young girls," said Dr. Judy Monroe, Indiana state health commissioner.Monroe spoke to an audience including doctors, nurses, community members and a handful of young girls during a special presentation at King's Daughters' Hospital on Tuesday night. The presentation was part of the Influence Women's Health Forum, a program to educate Indiana communities about women's health issues.The forum began last year in response to a marketing campaign featuring Camel No. 9 cigarettes, a brand Monroe said was targeted directly to young women. Part of the campaign featured "ladies only" nights where women were given a variety of free items including manicures, makeup, cell phone accessories and cigarettes."They really had to take me off the ceiling. I was outraged when I heard this," Monroe said.Yet marketing tobacco to women is nothing new. Brands like Lucky Strike started advertising directly to women around World War II. In the 1970s, Virginia Slims were introduced. One advertisement for the slender cigarettes proclaimed that they were made "especially for women because they are biologically superior to men."Advertising, especially in magazines, has continued to feature women smoking in the hopes of conveying various messages to target audiences."There has been an increased effort to target young women in recent times," Monroe said.In Indiana, smoking rates are higher for middle school girls than boys. "They've got a market," Monroe said. "They're going to go where the money is."Part of the Influence Women's Health forum, which is an ongoing state initiative, is to empower women to become educated on the issues and advocate for change. Monroe praised KDH for its smoke-free campus."That's really a powerful message for a hospital to give the community," she said.In response to an audience member's question about what else can be done at the community level to decrease smoking rates, Monroe responded that education is a key component."I think raising youth awareness is one area where we can do more," she said.Another audience member cited Mr. Potato Head as an example of the strides made to decrease smoking's appeal to youngsters. The popular children's toy featured a pipe until 1987."Habits and attitudes, they do start early," Monroe said.A seventh-grader in the audience asked Monroe what she could do to help keep her peers from lighting up. The student said the topic had been covered in her health class and that "a lot of girls looked very upset" when the teacher showed cigarette ads that could appeal to young girls."Getting upset about it is a really healthy thing," Monroe said. "They're targeting you."Monroe encouraged the student to talk about the issues with friends, parents and teachers to find creative ways to promote a non-smoking lifestyle.While the forum is focused on women's health issues, Monroe knows the addiction affects everyone in the state. Smoking costs Indiana over $2 billion in total medical costs each year and results in over 9,800 deaths. For Monroe, who is also a family physician, the numbers behind the dollar signs demand action."As a physician, the quality of life is the one that always pulls at my heartstrings," she said.Elizabeth Auxier, the tobacco cessation program coordinator at KDH, first heard Monroe speak at a Shape Up Indiana event and knew the local community could benefit from her expertise."The message was so right," Auxier said. "We were just honored that she could make it down here."Help is available for Indiana residents who want to quit smoking by calling the Indiana Tobacco Quitline at 1-800-QUIT-NOW.
Tuesday, April 22, 2008
Pregnant Smokers Raise Their Child's Risk Of Stroke, Heart Attack
ScienceDaily (Mar. 5, 2007) — Women who smoke during pregnancy can cause permanent vascular damage in their children -- increasing their risk for stroke and heart attack, researchers said today at the American Heart Association's 47th Annual Conference on Cardiovascular Disease Epidemiology and Prevention.
See also:
The Netherlands Atherosclerosis Risk in Young Adults (ARYA) study showed that participants who were exposed to smoke when their mothers were pregnant resulted in permanent cardiovascular damage that could be detected in young adulthood.
"This is the first report to demonstrate this association," said Cuno S. Uiterwaal, M.D., Ph.D., lead researcher and associate professor of clinical epidemiology at the University Medical Center Utrecht in The Netherlands. "This is a preventable risk factor. Women need to stop smoking, especially in pregnancy, not only for their own health, but for their unborn child."
Smoking during pregnancy can result in intrauterine growth retardation and low birth weight. Active and passive smoking in young adults also is associated with cardiovascular disease. But until the Dutch study, researchers were unsure whether this is due to a cumulative effect of smoke or whether children are vulnerable at specific periods, such as during gestation.
The study's 732 participants were born in 1970-73 and vascular risk measurements were performed in 1999-2000. Uiterwaal and colleagues found that adult offspring of the 215 mothers who smoked during pregnancy had thicker walls of the carotid arteries in the neck. The carotid artery intima-media thickness (CIMT), an ultrasound measurement of the thickness of the inner walls of the neck arteries, is used to determine the level of atherosclerosis. Offspring whose pregnant mothers were exposed to smoke had 13.4 micrometers thicker CIMT by young adulthood when compared to the offspring of mothers who did not smoke in pregnancy, researchers reported.
Even after the researchers adjusted for other risk factors in the young adults such as age, gender, body mass index, pulse pressure and cholesterol levels, the CIMT remained 9.4 micrometers thicker in children of mothers who smoked. Adjustment for current smoking by both mothers and fathers or the number of pack years (one "pack year" is 20 cigarettes smoked/day for one year) smoked by study participants also did not change this association.
"While it is difficult to separate the problem of current smoking and smoking during pregnancy, this study indicates that smoking in pregnancy has an independent effect," Uiterwaal said.
If both parents smoked during pregnancy, the children as young adults had thicker CIMT than other participants with either one smoking parent or parents who didn't smoke. Offspring of mothers who smoked the highest number of cigarettes during pregnancy had thicker CIMT than those born to mothers smoking less than the average or those who did not smoke.
"Our findings suggest that both smoking by mothers themselves in pregnancy and exposure to passive smoking are important," he said. "More exposure leads to more vascular damage in the offspring."
The researchers found that pregnancy was a critical period for damage from smoke exposure. They compared the children of mothers who didn't smoke during pregnancy and were currently not smoking to the children of mothers who didn't smoke in pregnancy but smoked now. They found no difference in CIMT. However, children from mothers who smoked in pregnancy, but who didn't currently smoke had significantly thicker CIMT compared to offspring of abstaining mothers. "There is the possibility that the compounds in tobacco smoke go through the placenta and directly damage the cardiovascular system of the fetus," Uiterwaal said. "The damage appears to be permanent and stays with the children."
When study participants were born, about 30 percent of the mothers smoked during pregnancy. But the current rate has dropped to between 5 percent and 7 percent due to health warnings, Uiterwaal said.
"There are still substantial numbers of mothers who smoke during pregnancy," he said. "This is just another reason for expectant mothers not to smoke." This is the first study in which researchers have dealt with this issue. Uiterwaal said further evidence should come from additional studies that show similar results.
Michiel L. Bots, M.D., Ph.D., second author of the study and associate professor of clinical epidemiology at the University Medical Center Utrecht in The Netherlands, presented the findings at the American Heart Association meeting.
The study's other co-author is Diederick E. Grobbee, M.D., Ph.D.
The ARYA study was funded by The Netherlands Organization of Health Research and Development Council.
Adapted from materials provided by American Heart Association, via EurekAlert!, a service of AAAS.
See also:
The Netherlands Atherosclerosis Risk in Young Adults (ARYA) study showed that participants who were exposed to smoke when their mothers were pregnant resulted in permanent cardiovascular damage that could be detected in young adulthood.
"This is the first report to demonstrate this association," said Cuno S. Uiterwaal, M.D., Ph.D., lead researcher and associate professor of clinical epidemiology at the University Medical Center Utrecht in The Netherlands. "This is a preventable risk factor. Women need to stop smoking, especially in pregnancy, not only for their own health, but for their unborn child."
Smoking during pregnancy can result in intrauterine growth retardation and low birth weight. Active and passive smoking in young adults also is associated with cardiovascular disease. But until the Dutch study, researchers were unsure whether this is due to a cumulative effect of smoke or whether children are vulnerable at specific periods, such as during gestation.
The study's 732 participants were born in 1970-73 and vascular risk measurements were performed in 1999-2000. Uiterwaal and colleagues found that adult offspring of the 215 mothers who smoked during pregnancy had thicker walls of the carotid arteries in the neck. The carotid artery intima-media thickness (CIMT), an ultrasound measurement of the thickness of the inner walls of the neck arteries, is used to determine the level of atherosclerosis. Offspring whose pregnant mothers were exposed to smoke had 13.4 micrometers thicker CIMT by young adulthood when compared to the offspring of mothers who did not smoke in pregnancy, researchers reported.
Even after the researchers adjusted for other risk factors in the young adults such as age, gender, body mass index, pulse pressure and cholesterol levels, the CIMT remained 9.4 micrometers thicker in children of mothers who smoked. Adjustment for current smoking by both mothers and fathers or the number of pack years (one "pack year" is 20 cigarettes smoked/day for one year) smoked by study participants also did not change this association.
"While it is difficult to separate the problem of current smoking and smoking during pregnancy, this study indicates that smoking in pregnancy has an independent effect," Uiterwaal said.
If both parents smoked during pregnancy, the children as young adults had thicker CIMT than other participants with either one smoking parent or parents who didn't smoke. Offspring of mothers who smoked the highest number of cigarettes during pregnancy had thicker CIMT than those born to mothers smoking less than the average or those who did not smoke.
"Our findings suggest that both smoking by mothers themselves in pregnancy and exposure to passive smoking are important," he said. "More exposure leads to more vascular damage in the offspring."
The researchers found that pregnancy was a critical period for damage from smoke exposure. They compared the children of mothers who didn't smoke during pregnancy and were currently not smoking to the children of mothers who didn't smoke in pregnancy but smoked now. They found no difference in CIMT. However, children from mothers who smoked in pregnancy, but who didn't currently smoke had significantly thicker CIMT compared to offspring of abstaining mothers. "There is the possibility that the compounds in tobacco smoke go through the placenta and directly damage the cardiovascular system of the fetus," Uiterwaal said. "The damage appears to be permanent and stays with the children."
When study participants were born, about 30 percent of the mothers smoked during pregnancy. But the current rate has dropped to between 5 percent and 7 percent due to health warnings, Uiterwaal said.
"There are still substantial numbers of mothers who smoke during pregnancy," he said. "This is just another reason for expectant mothers not to smoke." This is the first study in which researchers have dealt with this issue. Uiterwaal said further evidence should come from additional studies that show similar results.
Michiel L. Bots, M.D., Ph.D., second author of the study and associate professor of clinical epidemiology at the University Medical Center Utrecht in The Netherlands, presented the findings at the American Heart Association meeting.
The study's other co-author is Diederick E. Grobbee, M.D., Ph.D.
The ARYA study was funded by The Netherlands Organization of Health Research and Development Council.
Adapted from materials provided by American Heart Association, via EurekAlert!, a service of AAAS.
Prenatal Exposure To Drugs, Alcohol And Tobacco Affect The Brain Into Early Adolescence, Scans Show
ScienceDaily (Apr. 8, 2008) — Although behavioral studies clearly indicate that exposure to drugs, alcohol and tobacco in utero is bad for a baby's developing brain, specific anatomic brain effects have been hard to tease out in humans. Often users don't limit themselves to one substance, and demographic factors like poverty can also influence brain development.
Now, a new study using magnetic resonance imaging (MRI) brain scans, led by Children's Hospital Boston neurologist Michael Rivkin, MD, suggests that prenatal exposure to cocaine, alcohol, marijuana or tobacco (alone or in combination) may have effects on brain structure that persist into early adolescence. The findings, published in Pediatrics, are of public health significance, the researchers say, since it's estimated that more than 1 million babies born annually in the United States have been exposed to at least one of these agents in utero.
Researchers at Children's and Boston Medical Center employed volumetric MRI imaging to study the brain structure of 35 young adolescents prenatally exposed to cocaine, marijuana, alcohol or tobacco. The children, who averaged 12 years old at the time of imaging, were part of part of an historic cohort of children assembled by Deborah Frank, MD at Boston Medical Center and followed there since birth. Prenatal exposures were confirmed by a combination of maternal history, urine testing of the mother or urine or meconium (stool) testing of the infants at birth.
"We found that reductions in cortical gray matter and total brain volumes were associated with prenatal exposure to cocaine, alcohol or cigarettes," says Rivkin, who is first author on the study. "Importantly, although volume reductions were associated with each of these three prenatal exposures, they were not associated with any one of these substances alone after controlling for other exposures."
Notably, the effects were found to be additive--the more substances a child was exposed to in utero, the greater the reduction in brain volume.
Rivkin notes that the study is also the first to document joint long-term neuroanatomic effects on the brain of prenatal cocaine, cigarette and alcohol exposures. Moreover, while previous studies have documented brain effects of prenatal alcohol exposure, these studies were mostly limited to children with fetal alcohol syndrome, a diagnosis that was excluded in the current study.
Although investigators initially set out to study cocaine exposure, they were struck by the finding of brain effects of prenatal tobacco exposure. "Approximately 20 percent of women who smoke continue to smoke during pregnancy," Rivkin says. "From the vantage point of preventive health care, it is important to determine the consequences on brain structure of prenatal exposure to cigarettes, alone and in combination with other substances."
Rivkin emphasizes that the number of children studied was too small to find statistically significant effects of single substances after controlling for exposure to other agents. The study was also too small to consider the effects of different levels of exposure. But the overall results are highly suggestive. "We're hopeful to be able to study the whole sample of 150 children followed at Boston Medical Center, which will permit such determinations," Rivkin says.
Both investigators concur that health care providers should offer pregnant women comprehensive care to help them reduce use of all psychoactive substances. Public health campaigns should not ignore the risks of some substances while focusing on others, as it may well be that the greater the number of total prenatal exposures, the higher the chance there will be adverse and lasting consequences for the developing brain.
This research was published in the April issue of Pediatrics. The study was funded by the National Institute on Drug Abuse.
References to earlier work:
SAMHSA, U.S. Department of Health and Human Services, National Survey on Drug Use and Health, 2005.
Hamilton BE et al., Births: Preliminary data for 2005, National Center for Health Statistics, 2005.
Adapted from materials provided by Children's Hospital Boston
Now, a new study using magnetic resonance imaging (MRI) brain scans, led by Children's Hospital Boston neurologist Michael Rivkin, MD, suggests that prenatal exposure to cocaine, alcohol, marijuana or tobacco (alone or in combination) may have effects on brain structure that persist into early adolescence. The findings, published in Pediatrics, are of public health significance, the researchers say, since it's estimated that more than 1 million babies born annually in the United States have been exposed to at least one of these agents in utero.
Researchers at Children's and Boston Medical Center employed volumetric MRI imaging to study the brain structure of 35 young adolescents prenatally exposed to cocaine, marijuana, alcohol or tobacco. The children, who averaged 12 years old at the time of imaging, were part of part of an historic cohort of children assembled by Deborah Frank, MD at Boston Medical Center and followed there since birth. Prenatal exposures were confirmed by a combination of maternal history, urine testing of the mother or urine or meconium (stool) testing of the infants at birth.
"We found that reductions in cortical gray matter and total brain volumes were associated with prenatal exposure to cocaine, alcohol or cigarettes," says Rivkin, who is first author on the study. "Importantly, although volume reductions were associated with each of these three prenatal exposures, they were not associated with any one of these substances alone after controlling for other exposures."
Notably, the effects were found to be additive--the more substances a child was exposed to in utero, the greater the reduction in brain volume.
Rivkin notes that the study is also the first to document joint long-term neuroanatomic effects on the brain of prenatal cocaine, cigarette and alcohol exposures. Moreover, while previous studies have documented brain effects of prenatal alcohol exposure, these studies were mostly limited to children with fetal alcohol syndrome, a diagnosis that was excluded in the current study.
Although investigators initially set out to study cocaine exposure, they were struck by the finding of brain effects of prenatal tobacco exposure. "Approximately 20 percent of women who smoke continue to smoke during pregnancy," Rivkin says. "From the vantage point of preventive health care, it is important to determine the consequences on brain structure of prenatal exposure to cigarettes, alone and in combination with other substances."
Rivkin emphasizes that the number of children studied was too small to find statistically significant effects of single substances after controlling for exposure to other agents. The study was also too small to consider the effects of different levels of exposure. But the overall results are highly suggestive. "We're hopeful to be able to study the whole sample of 150 children followed at Boston Medical Center, which will permit such determinations," Rivkin says.
Both investigators concur that health care providers should offer pregnant women comprehensive care to help them reduce use of all psychoactive substances. Public health campaigns should not ignore the risks of some substances while focusing on others, as it may well be that the greater the number of total prenatal exposures, the higher the chance there will be adverse and lasting consequences for the developing brain.
This research was published in the April issue of Pediatrics. The study was funded by the National Institute on Drug Abuse.
References to earlier work:
SAMHSA, U.S. Department of Health and Human Services, National Survey on Drug Use and Health, 2005.
Hamilton BE et al., Births: Preliminary data for 2005, National Center for Health Statistics, 2005.
Adapted from materials provided by Children's Hospital Boston
Many Moms Use Cigarettes, Marijuana, Alcohol During Pregnancy; Dads Don't Help, Study Suggests
ScienceDaily (Mar. 21, 2008) — Despite public health campaigns, a surprising number of women continue to use substances such as tobacco, marijuana and alcohol during pregnancy and their usage rebounds to pre-pregnancy levels within two years of having a baby, according to a new University of Washington study.
Men's patterns of substance use during their partners' pregnancies were even bleaker. Men typically are not targeted by these campaigns, and their levels of binge drinking, daily smoking and marijuana use remained fairly stable before, during and after pregnancy, the study showed.
This is important, according to the study's lead authors Jennifer Bailey and Karl Hill, because men's substance use may make it harder for women to stop using while they're pregnant and may make it more likely that mothers will resume smoking or drinking after their child is born. Bailey and Hill are affiliated with the Social Development Research Group in the UW's School of Social Work.
"The months after childbirth are critical for intervening with mothers," said Bailey, who is a UW research scientist. "For example, many already have done the hard work of quitting smoking and haven't smoked a cigarette in six months or more. We should support that effort so that they can continue as nonsmokers. However, we know if dad is smoking or drinking it is more likely that mom will resume smoking or drinking."
The research is the first comprehensive look at mothers' and fathers' substance use on a month-by-month basis during a three-year period that included pregnancy. Substance use around pregnancy presents a wide variety of risks to fetuses and infants including fetal alcohol syndrome, cognitive and behavioral problems and impairments, asthma and higher incidences of sudden infant death syndrome.
The study found that:
77 percent of women cigarette smokers and 50 percent of the women who smoked marijuana used those substances at some time during pregnancy.
38 percent of women cigarette smokers and 24 percent of marijuana users reported using those substances throughout their pregnancies.
While overall rates of cigarette and marijuana use and binge drinking for women declined during pregnancy, those rates began rising again during the first six months following the birth of a baby.
Month by month during pregnancy, rates of smoking among all pregnant women varied between 17 percent and 21 percent, binge drinking was between 2 percent and 3 percent and marijuana use was between 8 percent and 9 percent.
Data for the study came from the Seattle Social Development Project which is following the development of 808 Seattle children who are now young adults. The participants are interviewed every three years, and for this study data covered the period when they were 21 to 24 years of age. In interviews, they were asked about their month-by-month incidences of binge drinking (5 or more alcoholic drinks in a two-hour period) and their use of cigarettes and marijuana. They were also asked a number of questions about life events, including the birth of a child. One hundred and thirty-one women and 77 men reported the birth of 244 children during this period.
The high rate of marijuana use rivaled that of cigarette smoking and came as a surprise to the researchers, according to Hill, who is a research associate professor of social work. He said it may be partly attributed to study participants who came from a high-risk, low-income urban sample.
He and Bailey said the findings emphasize the need for more public health messages and preventive interventions.
"Women who are pregnant want the best for their baby and typically reduce their drinking and smoking," said Bailey. "But after birth part of their motivation to limit alcohol use and quit using cigarettes and marijuana is taken away. If their partner is still smoking, for example, they might think, 'Boy, that cigarette smells good.'"
"There are two ways we need to reach parents," said Hill. "Pregnancy health care providers need to talk to both fathers and mothers about their smoking, drinking and marijuana use. Pregnancy seems like such a great public health opportunity to reach parents, but no one is talking to dads and this study shows that they are not changing their substance use behavior. What dads do matters and we want them to reduce their substance use.
"We also need to change the way society presently looks at the social norms of using these drugs. Right now there is little discussion about marijuana use during pregnancy, although it may be a relatively prevalent problem."
The study was funded by the National Institute on Drug Abuse. Co-authors are J. David Hawkins and Richard Catalano, founding and current directors, respectively, of the Social Development Research Group, and Robert Abbott, a UW professor of educational psychology. The paper was published in the journal Birth Issues in Perinatal Care.
Adapted from materials provided by University of Washington.
Men's patterns of substance use during their partners' pregnancies were even bleaker. Men typically are not targeted by these campaigns, and their levels of binge drinking, daily smoking and marijuana use remained fairly stable before, during and after pregnancy, the study showed.
This is important, according to the study's lead authors Jennifer Bailey and Karl Hill, because men's substance use may make it harder for women to stop using while they're pregnant and may make it more likely that mothers will resume smoking or drinking after their child is born. Bailey and Hill are affiliated with the Social Development Research Group in the UW's School of Social Work.
"The months after childbirth are critical for intervening with mothers," said Bailey, who is a UW research scientist. "For example, many already have done the hard work of quitting smoking and haven't smoked a cigarette in six months or more. We should support that effort so that they can continue as nonsmokers. However, we know if dad is smoking or drinking it is more likely that mom will resume smoking or drinking."
The research is the first comprehensive look at mothers' and fathers' substance use on a month-by-month basis during a three-year period that included pregnancy. Substance use around pregnancy presents a wide variety of risks to fetuses and infants including fetal alcohol syndrome, cognitive and behavioral problems and impairments, asthma and higher incidences of sudden infant death syndrome.
The study found that:
77 percent of women cigarette smokers and 50 percent of the women who smoked marijuana used those substances at some time during pregnancy.
38 percent of women cigarette smokers and 24 percent of marijuana users reported using those substances throughout their pregnancies.
While overall rates of cigarette and marijuana use and binge drinking for women declined during pregnancy, those rates began rising again during the first six months following the birth of a baby.
Month by month during pregnancy, rates of smoking among all pregnant women varied between 17 percent and 21 percent, binge drinking was between 2 percent and 3 percent and marijuana use was between 8 percent and 9 percent.
Data for the study came from the Seattle Social Development Project which is following the development of 808 Seattle children who are now young adults. The participants are interviewed every three years, and for this study data covered the period when they were 21 to 24 years of age. In interviews, they were asked about their month-by-month incidences of binge drinking (5 or more alcoholic drinks in a two-hour period) and their use of cigarettes and marijuana. They were also asked a number of questions about life events, including the birth of a child. One hundred and thirty-one women and 77 men reported the birth of 244 children during this period.
The high rate of marijuana use rivaled that of cigarette smoking and came as a surprise to the researchers, according to Hill, who is a research associate professor of social work. He said it may be partly attributed to study participants who came from a high-risk, low-income urban sample.
He and Bailey said the findings emphasize the need for more public health messages and preventive interventions.
"Women who are pregnant want the best for their baby and typically reduce their drinking and smoking," said Bailey. "But after birth part of their motivation to limit alcohol use and quit using cigarettes and marijuana is taken away. If their partner is still smoking, for example, they might think, 'Boy, that cigarette smells good.'"
"There are two ways we need to reach parents," said Hill. "Pregnancy health care providers need to talk to both fathers and mothers about their smoking, drinking and marijuana use. Pregnancy seems like such a great public health opportunity to reach parents, but no one is talking to dads and this study shows that they are not changing their substance use behavior. What dads do matters and we want them to reduce their substance use.
"We also need to change the way society presently looks at the social norms of using these drugs. Right now there is little discussion about marijuana use during pregnancy, although it may be a relatively prevalent problem."
The study was funded by the National Institute on Drug Abuse. Co-authors are J. David Hawkins and Richard Catalano, founding and current directors, respectively, of the Social Development Research Group, and Robert Abbott, a UW professor of educational psychology. The paper was published in the journal Birth Issues in Perinatal Care.
Adapted from materials provided by University of Washington.
Subscribe to:
Posts (Atom)