Monday, October 24, 2016

Stop smoking; it's even worse than you thought

"Even decades after cessation, cigarette smoking confers long-term risk of diseases including some cancers, chronic obstructive pulmonary disease, and stroke." — Dr. Stephanie London, National Institute of Environmental Health Sciences

I DON'T know many people who still smoke, but there's at least one I love who does. It's not Paul, BTW. 


When we met almost 25 years ago, Paul was a light smoker. Although he didn't smoke in the house or the car or around me, quitting was a non-negotiable demand on my part. 


Not trying to sound like Spock or something here, but it was just entirely illogical. Paul was extremely asthmatic as a child, he needs full lung capacity to play the trombone . . . and most of all, of course, the odds were high that smoking would not just impair his overall health but also shorten his life. Neither thing was okay with me.


Below are two articles containing recent data about smoking. The first is from ABC News and the second from NBC News.


FYI: Highest rate of smoking among men is in Arkansas and among women, Kentucky. The lowest for both men and women is Utah.





One-Fourth of US Cancer Deaths Linked With One Thing: Smoking


By Lindsey Tanner, AP Medical Writer

October 24, 2016

Cigarettes contribute to more than 1 in 4 cancer deaths in the U.S. The rate is highest among men in Southern states where smoking is more common and the rules against it are not as strict.


The American Cancer Society study found the highest rate among men in Arkansas, where 40 percent of cancer deaths were linked to cigarette smoking. Kentucky had the highest rate among women — 29 percent.


The lowest rates were in Utah, where 22 percent of cancer deaths in men and 11 percent in women were linked with smoking.


"The human costs of cigarette smoking are high in all states, regardless of ranking," the authors said.


They analyzed 2014 health surveys and government data on smoking rates and deaths from about a dozen smoking-linked cancers. Lung, throat, stomach, liver, colon, pancreas and kidney cancers were among those included, along with leukemia. The researchers estimated how many cancer deaths were likely attributable to smoking, and compared that with deaths from all cancers.


Results were published Monday in the JAMA Internal Medicine.


While U.S. smoking rates have been falling, 40 million U.S. adults are cigarette smokers and smoking is the top cause of preventable deaths, according to the federal Centers for Disease Control and Prevention.


NUMBERS


The study found that at least 167,000 cancer deaths in 2014 — about 29 percent of all U.S. cancer deaths — were attributable to smoking. A government estimate based on different methods says 1 in 3 U.S. cancer deaths are linked with smoking, and the study authors acknowledge they may have underestimated the true burden posed by cigarettes.


Most of the 10 states with the highest rates of smoking-attributable cancer deaths were in the South, while most of the 10 states with the lowest rates were in the North or West.


Among men, where smoking is generally more common, the cigarette-linked cancer death rate was highest in blacks at 35 percent, compared with 30 percent for whites and 27 percent for Hispanics. Among women, whites had the highest cigarette-linked cancer death rate — 21 percent, compared 19 percent for blacks and 12 percent for Hispanics.


EXPLANATIONS


The researchers say nine of 14 states with the least comprehensive smoke-free indoor air policies are in the South. The average cigarette excise tax in major tobacco states, mostly in the South, is 49 cents, compared with $1.80 elsewhere. The tobacco industry heavily influences these policies and most of the U.S. tobacco crop is grown in the South, the researchers said. The region also has relatively high levels of poverty, which is also linked with smoking.


REACTION


Dr. Hilary Tindle of Vanderbilt University in Nashville, Tennessee, said the results reflect what she sees as a tobacco researcher and internal medicine specialist in the South. She was not involved in the study.


Smoking is more of a social norm there, and while her medical center has an indoor smoking ban, she said it's not unusual to walk through cloud of cigarette smoke outside the entrance.


Tindle said the study results highlight the need for stronger tobacco control measures and show why doctors should discuss smoking at every patient visit, encourage smokers to quit and inform them about effective ways to do so.


Smoking Permanently Damages Your DNA, Study Finds


By Maggie Fox

September 21, 2016

Smoking scars DNA in clear patterns, researchers reported Tuesday. Most of the damage fades over time, they found — but not all of it.


Their study of 16,000 people found that while most of the disease-causing genetic footprints left by smoking fade after five years if people quit, some appear to stay there forever.


The marks are made in a process called methylation, which is an alteration of DNA that can inactivate a gene or change how it functions -- often causing cancer and other diseases.


"Our study has found compelling evidence that smoking has a long-lasting impact on our molecular machinery, an impact that can last more than 30 years," said Roby Joehanes of Hebrew SeniorLife and Harvard Medical School.


Heart disease and cancer are both caused by genetic damage -- some of it inherited, but most of it caused by day-to-day living. Smoking is one of the biggest culprits.


The team examined blood samples given by 16,000 people taking part in various studies going back to 1971. In all the studies, people have given blood samples and filled out questionnaires about smoking, diet, lifestyle and their health histories.


They found smokers had a pattern of methylation changes affecting more than 7,000 genes, or one-third of known human genes. Many of the genes had known links to heart disease and cancers known to be caused by smoking.


Among quitters, most of these changes reverted to the patterns seen in people who never smoked after about five years, the team reported in the American Heart Association journal Circulation: Cardiovascular Genetics.


But smoking-related changes in 19 genes, including the TIAM2 gene linked to lymphoma, lasted 30 years, the team found.


"These results are important because methylation, as one of the mechanisms of the regulation of gene expression, affects what genes are turned on, which has implications for the development of smoking-related diseases," said Dr. Stephanie London of the National Institute of Environmental Health Sciences, who directed the team.


"Equally important is our finding that even after someone stops smoking, we still see the effects of smoking on their DNA," London said.


Some of the affected genes had not been associated with the damage caused by smoking before. It might be possible to use them as "markers" to see who is at risk of smoke-related diseases in the future.


They might also be targets for new drugs to treat the damage done by cigarette smoke, the researchers said.


Smoking is the biggest cause of preventable illness, killing more than 480,000 Americans every year, according to the Centers for Disease Control and Prevention.


Globally, it kills about 6 million people a year through cancer, heart disease, lung disease and other illnesses.


Smoking rates have plummeted in the U.S. and now only about 15 percent of U.S. adults smoke — and just 11 percent of high school students smoke.


Quitting has clear benefits, even late in life. But it doesn't wipe the slate clean.


"Even decades after cessation, cigarette smoking confers long-term risk of diseases including some cancers, chronic obstructive pulmonary disease, and stroke," London's team wrote. "The mechanisms for these long-term effects are not well understood. DNA methylation changes have been proposed as one possible explanation." 

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