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Opening statements are scheduled to begin in a trial against a tobacco company by the wife of a Florida smoker who died of lung cancer.

It’s the first trial since the state Supreme Court threw out a $145 billion punitive damage award stemming from a class-action suit against cigarette makers. But the high court upheld a jury’s findings that the tobacco companies sold dangerous products and hid the dangers of smoking, and said smokers could sue individually. About 8,000 such cases were filed by the January deadline.

The trial on the lawsuit brought by Elaine Hess was set to begin Wednesday. Her husband, Stuart Hess, was a smoker who she says tried many times to quit.

 

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Pay-for-Performance Gets Doctors to Push Smoking Cessation

Paying providers of health care to refer patients for help in quitting smoking really makes a difference.

A study, appearing in the current issue of the Archives of Internal Medicine, looked at programs that tie physician pay to the quality of care. The key measure was clinics’ referrals of patients in Minnesota to a tobacco quit line. Researchers compared clinics that were paid bonuses for making such referrals — $5,000 for 50 referrals and $25 for each referral beyond the initial 50 — to clinics that didn’t have a financial incentive.

It turned out that the clinics that were in the pay-for-performance program made 1,483 referrals to the quit line, an average of 11.4% of their patients who were smokers. Those that didn’t have the chance to earn extra money made 441 referrals, an average of 4.2% of their smokers.

The researchers, led by Lawrence An of the University of Minnesota, noted some important factors for success beyond cold cash. For one, Minnesota health plans collaborated to make the referral process easy for the clinics. The clinics were also rewarded regardless of what health plan their patients belonged to, meaning that they could make the same recommendation to all smokers.

Blue Cross and Blue Shield of Minnesota, which funded the study and payments to the clinics with money from a tobacco settlement, decided along with a number of other Minnesota health plans to continue with the program around smoking cessation, albeit with lower financial awards, a spokeswoman tells us.

 

We spend an inordinate amount of time telling people, no, pleading with people to quit smoking. The point being that is important for smokers to realize that quitting smoking is the name of the game because it kills you and it hurts others. With that in mind here are 11 thoughts and facts about second hand smoke you probably did not know,

  • Secondhand smoke has been classified by the Environmental Protection Agency (EPA) as a known cause of cancer in humans (Group A carcinogen).
  • Secondhand smoke exposure causes disease and premature death in children and adults who do not smoke. Secondhand smoke contains hundreds of chemicals known to be toxic or carcinogenic, including formaldehyde, benzene, vinyl chloride, arsenic ammonia and hydrogen cyanide.
  • Secondhand smoke causes approximately 3,400 lung cancer deaths and 22,700-69,600 heart disease deaths in adult nonsmokers in the United States each year.
  • Nonsmokers exposed to secondhand smoke at work are at increased risk for adverse health effects. Levels of secondhand smoke in restaurants and bars were found to be 2 to 5 times higher than in residences with smokers and 2 to 6 times higher than in office workplaces.
  • Since 1999, 70 percent of the U.S. workforce worked under a smoke-free policy, ranging from 83.9 percent in Utah to 48.7 percent in Nevada.  Workplace productivity was increased and absenteeism was decreased among former smokers compared with current smokers.
  • Eighteen states – Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New Mexico, New York, Ohio, Rhode Island, Washington and Vermont – as well as the District of Columbia prohibit smoking in almost all public places and workplaces, including restaurants and bars. Montana and Utah prohibit smoking in most public places and workplaces, including restaurants; bars will go smokefree in 2009. New Hampshire prohibits smoking in some public places, including all restaurants and bars. Four states – Florida, Idaho, Louisiana and Nevada – prohibit smoking in most public places and workplaces, including restaurants, but exempt stand-alone bars. Fifteen states partially or totally prevent (preempt) local communities from passing smokefree air ordinances stronger than the statewide law. Iowa, Nebraska and Oregon have passed legislation prohibiting smoking in almost all public places and workplaces, including restaurants and bars, but the laws have not taken effect yet.
  • Secondhand smoke is especially harmful to young children. Secondhand smoke is responsible for between 150,000 and 300,000 lower respiratory tract infections in infants and children under 18 months of age, resulting in between 7,500 and 15,000 hospitalizations each year, and causes 430 sudden infant death syndrome (SIDS) deaths in the United States annually.
  • Secondhand smoke exposure may cause buildup of fluid in the middle ear, resulting in 790,000 physician office visits per year.  Secondhand smoke can also aggravate symptoms in 400,000 to 1,000,000 children with asthma.
  • In the United States, 21 million, or 35 percent of, children live in homes where residents or visitors smoke in the home on a regular basis. Approximately 50-75 percent of children in the United States have detectable levels of cotinine, the breakdown product of nicotine in the blood.
  • Research indicates that private research conducted by cigarette company Philip Morris in the 1980s showed that secondhand smoke was highly toxic, yet the company suppressed the finding during the next two decades.
  • The current Surgeon General’s Report concluded that scientific evidence indicates that there is no risk-free level of exposure to secondhand smoke. Short exposures to secondhand smoke can cause blood platelets to become stickier, damage the lining of blood vessels, decrease coronary flow velocity reserves, and reduce heart rate variability, potentially increasing the risk of heart attack.

This is tough to watch but it cannot help but drive the point home that if you continue to smoke, you will end up like the person in this video. As we has maintained from day one of this blog, does not care how you quit, whether it’s with our product or not, we just want you to quit.

A key mechanism by which smoking triggers genetic changes that cause lung cancer has been unravelled.

Researchers have shown exposure to cigarette smoke slows production of a protein called FANCD2 in lung cells.

This protein plays a key role in repairing damage to DNA, and causing faulty cells to commit suicide before they go on to become cancerous.

The study, led by Oregon Health and Science University, appears in the British Journal of Cancer.

LUNG CANCER
Most common cancer in the world with 1.3 million people diagnosed every year
Second most common form of cancer in the UK after breast cancer
Over 38,300 new cases, and more than 33,000 deaths in the UK each year
Smoking responsible for 90% of cases in the UK

It raises hopes of improved treatments for the disease.

Lead researcher Dr Laura Hays said: “These findings show the important role FANCD2 plays in protecting lung cells against cigarette smoke and may explain why cigarette smoke is so toxic to these cells.”

The researchers suspect other proteins also play a role in fixing DNA and weeding out defective cells.

However, their work showed that cells with very high levels of FANCD2 were resistant to the toxic effects of smoke – suggesting this protein is key.

Artificial windpipe

The researchers created an artificial windpipe in the lab to replicate the environment of a smoker’s lung.

They then studied the effects of cigarette smoke on different proteins in cells and found that FANCD2 levels were low enough to allow DNA damage.

FANCD2 is part of a family of proteins involved in an inherited condition called Fanconi anaemia.

People with the condition are more likely to develop cancers at a young age and have low levels of these proteins.

Dr Lesley Walker, director of cancer information at Cancer Research UK, said: “This interesting piece of science adds to our understanding of why smoking is so deadly.

“Smoking is the single biggest preventable cause of cancer and causes nine out of ten cases of lung cancer.

“But the good news is that quitting works – after five years without smoking your risk of a heart attack will have fallen to half that of a smoker.

“And after ten years your risk of lung cancer will have halved too.”

So quit smoking! Why not quit smoking?  Just quit.

Tobacco is the leading preventable cause of death in the world, and yet it causes one in ten deaths among adults. In 2005, tobacco caused 5.4 million deaths, or an average of one death every six seconds. At the current rate, the death toll is projected to reach more than eight million annually by 2030 and a total of up to one billion deaths in the 21st century.
Last month the World Health Organisation (WHO) announced World No Tobacco Day to highlight the dangers of cigarettes and their effects on younger generations. The WHO also revealed shocking statistics, such as tobacco kills 50 per cent of its users. This means, of the 1.3 billion smokers alive today, 650 million will be killed by tobacco.

1. Why is smoking addictive?
Nicotine is a psychoactive drug, which the body accepts like a “normal” messenger substance stimulating the electrical activity of the brain. It has calming effects, especially at times of stress. Smoking is a physical addiction, which is almost as strong as that of heroin, since nicotine also induces structural changes in the brain of smokers. When nicotine is suddenly withdrawn, normal functions in the brain and other parts of the body are disturbed resulting in withdrawal symptoms.
2. What damage does smoking do to the body?
Smoking causes many premature deaths from diseases that are largely preventable:Heart disease: Smoking is responsible for 30 per cent of all heart attacks and cardiovascular deaths. Cancer: At least 30 per cent of all cancer deaths are caused by smoking. Lung disease: More than 80 per cent of all lung problems, mainly chronic bronchitis and emphysema can be avoided by not smoking. Peripheral artery disease: Smoking is the main cause of peripheral artery occlusion, and this is extremely dangerous when associated with diabetes.
Premature ageing of the skin: It also causes premature wrinkling of the skin of the face. On average, smokers look five years older than non-smokers of the same age.

Others: It also contributes to stomach ulcers and osteoporosis, reduces female fertility and causes premature births and infant death.

3. Why can smoking be even worse for men?
Younger and middle-aged men are at a higher risk for premature arteriosclerosis and heart attacks than women of the same age. Therefore, male gender may be considered a risk factor in itself. Smoking does not just add on some risk, it multiplies the chances of developing heart disease.
As smoking causes damage to blood vessels, it also impairs erections in middle-aged and older men and may affect the quality of their sperm. It can have the effect of sedating sperm and can impair their mobility.

4. What are the best ways to quit smoking?
Self-help is, in fact, the only way to quit smoking. Others can give advice and support, but in the end it is up to the individual. To succeed you must have sufficient motivation to carry yourself through the task ahead. At least two-thirds of smokers are likely to find it difficult to give up smoking. However, it is not their fault that they find it difficult. They do not continue smoking because they are weak-willed or irresponsible, but because they are addicted. There are various motivations for trying to quit smoking:
The most important is concern for health and well-being. The onset of minor ailments, such as coughs, sore throats, breathlessness, indigestion, and feeling generally less well and less fit, are early signs that the body has had enough.
Some smokers come to resent the feeling of being controlled by their need to smoke, and are motivated to stop by their desire to regain control and self-mastery.
To help make up your mind about stopping, make a list of all the reasons that are important for you. Make a similar list of all the positive benefits of smoking you will miss and any withdrawal difficulties you anticipate when you stop. Weigh up the lists and tell yourself that any suffering you may endure will be temporary and may last only a few weeks
You must be prepared to work hard at stopping smoking. Here are the steps to take:
Plan to stop on a particular day. Choose a time when you are not under too much pressure from other tasks and when you can avoid situations that you know will make it more difficult. Don’t put it off for too long unless you have to. Make plans to keep away from smokers and other tempting situations after you have stopped.
Plan to stop smoking completely on your target day. Cutting down gradually is less effective. Telling too many people that you are going to stop is not always helpful. To be constantly asked how you are getting along can bring the subject to your mind just when you are learning not to think about it
Prepare on a small card a list of your reasons for stopping. You may need to have this in your pocket or close at hand if things get difficult and your motivation falters after you have stopped. On the night before your target day, make sure all cigarettes, ashtrays and lighters are removed from your home. Of course we realize that sometimes you have to go through hell with a lot of different methods before you come to see us. That’s ok. Just as long as you quit in the end!

5. How can quitting smoking be made easier?
There is no drug for smoking that can cure your problem for you without you having to make any effort. However, there are some treatments that you can use to aid your self-help:
Counseling and support, either in single sessions or in groups. It is also important that partners do not smoke or stop smoking at the same time. Otherwise, the smoker gets “re-infected” time and again.
Hypnosis and acupuncture may help some people, but not everyone is susceptible to these techniques.
Nicotine substitution like patches or chewing gum can help overcoming the habit of lighting a cigarette, and the dose can be tapered down over time.
No one is born as a smoker. In all drug addictions, psychosocial factors determine the initial exposures. Addiction may subsequently develop if the drug has effects that people like or find rewarding. Younger people may think that it is “cool” to smoke because it makes them appear more “grown-up”. Ultimately, it is up to you to finally decide to quit smoking, on your terms.

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