U.S. Cigarette Smoking Rates Fall to Historically-Low Levels

The U.S. Centers for Disease Control and Prevention (CDC) offered some good news on November 8 when it released data showing that smoking rates in the U.S. are the lowest they’ve ever been. Unfortunately, there was some bad news to go with it.

 

  • Smoking rates have fallen by 67% since 1965 when the U.S. government first began tracking smoking rates.
  • An estimated 14% of adults smoked in 2017, down from 15.5% in 2016.
  • The rates were even lower among adults 18-24: from 13% in 2016 to 10% in 2017.

In a press release, CDC Director Robert Redfield said:

“This new all-time low in cigarette smoking among U.S. adults is a tremendous public health accomplishment – and it demonstrates the importance of continued proven strategies to reduce smoking. Despite this progress, work remains to reduce the harmful health effects of tobacco use.”

While smoking rates fell, other forms of tobacco use remain prevalent, including e-cigarettes, hookahs, cigars, smokeless tobacco, and water pipes. About 47 million Americans use tobacco in some form.

When adding those other categories, 16.2% of adults, or 47 million people, used tobacco products of some kind in 2017, according to the CDC. The second-most used products behind cigarettes were cigars, cigarillos or filtered little cigars, with 3.8% of adults (9.3 million people) saying they used them. [2]

E-cigarettes have been touted as a smoking cessation method, and many people swear by it. However, overall, the nicotine delivery devices have proven to be more harmful than helpful.

Brian King, a deputy director in the CDC’s office on smoking and health, said:

“If e-cigarette use was responsible [for declines in cigarette use], you would expect to see a perfect correlation, but that’s not what we’re seeing. If anything, e-cigarettes have complicated the tobacco product landscape.”

A Pricey Coping Mechanism

The CDC says in the report that certain groups of people were more likely to use tobacco than others, including: [1]

  • People with incomes below $35,000
  • Those who had a GED
  • The uninsured
  • Those insured by Medicaid or who received public assistance

Among ethnic groups, non-Hispanic American Indian/Native Americans, multiracial Americans, and white or black adults were the most likely to use tobacco.

Adults who identified as lesbian, gay, or bisexual were also more likely to use, as well as those who were divorced, separated, widowed, single, never-married, or not living with a partner.

Adults living in the Midwest or the south tended to use tobacco the most.

Have you started to see a pattern yet? In many cases, tobacco users tended to be those facing hardship and stress. Indeed, the CDC mentioned in its report that psychological distress was associated with an increase in tobacco use, with 40.8% of adults who reported distress saying they used tobacco compared to 18.5% who reported not being severely distressed.

NCI Director Dr. Norman E. Sharpless said in the press release:

“For more than half a century, cigarette smoking has been the leading cause of cancer mortality in the United States. Eliminating smoking in America would, over time, eliminate about 1/3 of all cancer deaths. The persistent disparities in adult smoking prevalence described in this report emphasize the need for further research to accelerate reductions in tobacco use among all Americans.”

Government Crackdown

https://www.123rf.com/photo_34581221_hand-holding-an-electronic-cigarette-over-a-dark-background.html?term=e%2Bcigarettes&vti=ljyupdbyuqghko4iqh-1-12

FDA Commissioner Scott Gottlieb said he was encouraged by the findings and said the FDA is committed to accelerating declines. [3]

“We’ve taken new steps to ultimately render combustible cigarettes minimally or non-addictive and to advance a framework to encourage innovation of potentially less harmful products such as e-cigarettes for adults who still seek access to nicotine, as well as support the development of novel nicotine replacement drug therapies. At the same time, we’re also working to protect kids from the dangers of tobacco product use, including e-cigarettes.”

In September, the agency warned 5 e-cigarette makers, including Juul, that they had 2 months to prove to the FDA that they’d taken steps to prevent the sale of their products to young people.

The companies were told that their failure to do so could result in the agency requiring them to change their sales and marketing practices, stop their distributing of products to retailers who sell to kids, and the removal of flavored e-cigarettes and nicotine products from the market.

Then, in early October, the FDA raided the Juul offices and confiscated thousands of documents as part of its effort to pressure the company into doing more to keep its products out of the hands of young people.

Juul e-cigarettes, which look like USB drives, are extremely popular among high-schoolers. The devices come with pods filled with nicotine liquid that is available in 6 flavors. Each pod delivers as much nicotine as up to 2 packs of cigarettes. [4]

Sources:

[1] ABC News

[2] CNBC

[3] CBS News

[4] Vox

Study: E-Cigarettes, Tobacco Linked to Increased Risk of Oral Cancer

An analysis shows that tobacco use increases the risk of oral cancer (duh). But e-cigarettes, too, were linked to an increased risk of oral cancer, particularly if people used the nicotine-delivery devices alongside tobacco products. [1]

Oral cancer includes cancers of the lips, tongue, cheeks, the floor of the mouth, the hard and soft palate, sinuses, and the throat.

For the study, Benjamin Chaffee and co-author Neal Benowitz of the University of California evaluated exposure to known carcinogens based on recent use of different nicotine and tobacco product types, and whether they were used individually or together.

Data for the analysis was gathered from the Population Assessment of Tobacco and Health, in which a population of U.S. adults gave urine samples to be analyzed for tobacco-specific nitrosamines (TSNAs) N’-nitrosonornicotine (NNN), a known oral and esophageal carcinogen, 4-(methynitrosamino)-1-(3)- pyridyl-1-butanol (NNAL), a metabolite of lung carcinogen (NNK), and total nicotine equivalents. [2]

Related Read: 30 Minutes of Vaping Equals 5 Minutes of Cigarette Smoking

Chaffee and Benowitz categorized participants based on their method of nicotine intake. [1]

  • Combustibles (cigarettes, cigars, water pipe, pipes, blunts (cigars containing cannabis)
  • Smokeless (moist snuff, chewing tobacco, snus)
  • E-cigarettes
  • Nicotine replacement products

Recent use was defined as use within the prior 3 days, and non-use was defined as no use within the previous 30 days.

In all categories of use, participants showed elevated levels of nicotine and TSNA concentrations relative to non-users. [2]

Smokeless tobacco users had the highest TSNA exposures, regardless of whether they used products individually or together with other products.

Participants who used only e-cigarettes were exposed to lower levels of NNN and NNAL than other product users, though they had a similar amount of nicotine exposure.

But a majority of people who used e-cigarettes also used combustible tobacco products, and this raised their TSNA levels to that of exclusively cigarette-smokers. In turn, most non-cigarette tobacco users were found to be exposed to carcinogen levels comparable to or higher than those who used only cigarettes.

Study: Cigarettes are Behind a Shocking 30% of Cancer Deaths

The results of the analysis were presented at the General Session of the International Association for Dental Research (IADR), which was held in conjunction with the IADR Pan European Regional (PER) Congress at the ExCeL London Convention Center from July 25 to 28, 2018.

Sources:

[1] The Health Site

[2] MedicalXpress

Tobacco Doesn’t Just Kill Smokers; It Kills the Environment

About 90% of all lung cancers are caused by cigarette smoking. Smoking kills 7 million people a year, speeds aging, destroys the heart and cardiovascular system, and leads to asthma and COPD. But cigarettes don’t just wreak havoc on the human body; they also wreak havoc on the environment through deforestation, pollution, and littering. [1] [2]

In May, the World Health Organization (WHO) released a study detailing the environmental costs of tobacco, adding to the mind-blowing $1.4 trillion in healthcare costs and lost productivity. The report looks at the immediate environmental damage caused by tobacco consumption, as well as “the post-consumption waste and health implications that continue to play out long after the tobacco has been smoked.” [3]

WHO Director-General Dr. Margaret Chan said:

“Tobacco threatens us all. Tobacco exacerbates poverty, reduces economic productivity, contributes to poor household food choices, and pollutes indoor air.” [2]

Source: TobaccoFreeCo.org

A few of the main take-aways from the report:

  • There are more than 7,000 toxic chemicals in tobacco waste – some of them cancer-causing – and these substances also pollute the environment.
  • Tobacco smoke has created thousands of tons of human carcinogens, toxicants, and greenhouse gases.
  • Cigarette butts and other tobacco waste account for a huge amount of trash. According to a 2014 study, tobacco waste constitutes more than a third of the refuse collected during coastal cleanups. Additionally, nearly two-thirds of all cigarettes purchased every day wind up tossed in the streets, grass, and water. Too few people “flick their butts” into a trash receptacle. [3]

Tobacco-leaf curing requires burning enormous quantities of wood, which contributes to deforestation. Larger tobacco growers also use coal, which emits carbon dioxide, the main greenhouse gas implicated in global warning. [4]

Read: The True Cost of Smoking Revealed

As if that’s not disgusting enough, the planet is littered with millions of kilograms of non-biodegradable cigarette butts.

Pollution aside, tobacco is a drain on the world’s resources, including energy and water, and requires the extensive use of harmful chemicals. [2]

The report states:

“From start to finish, the tobacco life cycle is an overwhelmingly polluting and damaging process.” [4]

Mammoth amounts of insecticides, herbicides, GMOs, fungicides, and fumigants are applied to tobacco plants. Many of these products are so harmful to health and the environment that they’ve been banned in some countries.

The WHO is calling on world governments to work toward controlling tobacco pollution by enacting measures such as banning tobacco marketing and advertising, promoting plain product packaging, and making all public spaces and workplaces smoke-free. [3]

World health experts are also urging governments to implement tobacco taxes. It is one of the least-used tobacco control methods, but raising tobacco taxes and prices is remarkably effective, according to Dr. Oleg Chestnov, the WHO’s Assistant Director-General for NCDs and Mental Health.

At the moment, governments rake in about $270 billion in yearly tobacco excise tax revenues. But the WHO says this could increase by more than 50% to bring in an additional $141 billion by simply increasing taxes on packs of cigarettes by $0.80 a pack.

Additionally, the WHO wants to make it mandatory for tobacco companies to supply information on the amount of environmental damage their operations contribute to. At the moment, some large manufacturers do report on their use of environmental resources and waste streams, but ‘the data is limited and opaque.” [4]

The authors wrote:

“All producers should be required to compensate for the environmental harms caused by deforestation, water use, waste, etc. through offsets in order to ultimately reduce the long-term ecological harm their business causes.” [4]

Read: Tobacco Industry Forced to List Ingredients in their Products

Chan said:

“By taking robust tobacco control measures, governments can safeguard their countries’ futures by protecting tobacco users and non-users from these deadly products, generating revenues to fund health and other social services, and saving their environments from the ravages tobacco causes.” [3]

Sources:

[1] Web MD

[2] CNN

[3] Consumerist

[4] RTT News

TobaccoFreeCo.org


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Study: Excessive Cadmium Linked to Higher Risk of Endometrial Cancer

Women who have excessive cadmium in their bodies may be at increased risk for developing endometrial cancer, researchers from the University of Missouri reported in a recent study.

Accounting for 92% of cancers of the uterus, endometrial cancer, or uterine cancer, is the most common type of reproductive cancer in women in the United States. The disease is caused by cells in the endometrium growing out of control.

Cadmium is a “highly persistent” toxic metal which mimics estrogen in the body. According to lead author Jane McElroy, an associate professor in the University of Missouri Medical School’s Department of Family and Community Medicine, and a team of researchers, cadmium builds up in the body over time. It has been linked to “a variety of adverse health effects,” including kidney damage, calcium imbalance, and an increased risk of pancreatic, breast, and endometrial cancer.

Apart from exposure on the job, excess cadmium usually enters the body through 1 of 2 ways: by eating foods that contain the metal, and by smoking tobacco. Smoking tobacco is cadmium’s second port of entry to the body due to the fact that tobacco plants absorb it from the soil. In urine tests, heavy smokers were found to contain twice as much cadmium as non-smokers.’

Related: High Levels of Heavy Metals Found in Popular Chocolate Brands

Cadmium & Cancers

It’s logical to assume cadmium fuels hormone-dependent cancers because the toxic metal has similar effects to that of the female hormone, estrogen.

McElroy explained:

“Endometrial cancer has been associated with estrogen exposure. Because cadmium mimics estrogen, it may lead to an increased growth of the endometrium, contributing to an increased risk of endometrial cancer.”

However, it was the lack of information about the link that led researchers to dig deeper.

Additionally, past studies have suggested that even low levels of cadmium may significantly shorten the protective caps of DNA on the ends of chromosomes, called telomeres. [2]

Telomeres are associated with aging, and shortened telomeres may increase the risk for cardiovascular disease, diabetes, various age-related conditions, and cancer.

Studying the Link

Researchers gathered data from the cancer registries in Arkansas, Iowa, and Missouri to identify cases of endometrial cancer. Participants included 631 women with a history of endometrial cancer, and 879 women with no history of the disease who served as a control group. [3]

The women completed a 200-question survey about risk factors potentially associated with endometrial cancer. Once the questionnaires were completed, the participants were asked to collect their own urine and saliva samples for the researchers, so they could analyze them for cadmium.

McElroy said:

“When comparing the cadmium levels of the individuals with endometrial cancer to the control group, we found a statistically significant increased risk of the cancer associated with a woman’s cadmium levels. We found the rate of endometrial cancer incidence increased by 22% in individuals with increased cadmium levels.”

More research is necessary to determine how strong the link is between excess cadmium and endometrial cancer, but based on the limited information available, there are some things you can do to limit your cadmium exposure.

McElroy explained:

“We all have cadmium present in our kidneys and livers, but smoking has been shown to more than double a person’s cadmium exposure.

Also, we recommend being attentive to your diet, as certain foods such as shellfish, kidney and liver can contain high levels of cadmium. You don’t necessarily need to cut these from your diet, but eat them in moderation. This is especially true if women have a predisposition to endometrial cancer, such as a family history, diabetes or obesity.”

Moreover, studies have shown that quercetin, an antioxidant compound found in fruits and vegetables like onions and apples, may protect the body against cadmium exposure, while cilantro and chlorella can help the body detox from the substance.

Sources:

[1] Medical News Today

[2] Prevention

[3] Science Daily


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Opioid Use Now Tops Tobacco Use in the U.S.

A survey released by the federal Substance Abuse and Mental Health Services Administration (SAMHSA) shows that more people in the U.S. use opioid painkillers than tobacco, highlighting the tragic opioid crisis gripping the country. [1]

A federal review published in the spring showed that opioid prescriptions in the U.S. decreased for the 1st time in 2 decades, which suggests that doctors are finally starting to heed warnings about the drugs’ addictive properties. However, that decrease has not translated into fewer deaths. The SAMHSA report illustrates just how widespread the problem remains.

The problem is especially severe in Tennessee, where there are more opioid prescriptions written than people actually living in the state. There are 1.18 opioid prescriptions per every resident of Tennessee. More people died from overdoses in the state in 2014 than from car crashes or shootings. [2]

Source: CDC

Nationally, 37.8% of American adults are using some type of opioid painkiller, while 31.1% of U.S. adults use tobacco problems.

According to the 2015 National Survey on Drug Use and Health (NSDUH), a division of the Department of Health and Human Services (DHHS), more than 91.8 million Americans 18 and older used prescription painkillers last year. By comparison, 75.4 million U.S. adults used tobacco products. [1]

Those numbers creep even higher when children 12 and older are included; to 97.5 million and 78.3 million, respectively. And more than 12.5% of those users admitted to misusing the painkillers.

Danny Winder, director of the Vanderbilt Center for Addiction Research in Nashville, said:

“You’d like to think that is good news and reflects a reduction of tobacco use, but unfortunately that’s not the case. It’s a particularly pernicious problem because of its prevalence…Anytime you have a substance that is legally available and has addictive properties, that’s setting up the problem.” [2]

Actually, smoking rates have declined significantly in the U.S. in the last 50 years. From 2005 to 2015, smoking among adults declined from 20.9% to, or 45.1 million, to 15.1%, or 36.5 million. In the last year alone, the overall smoking rate fell 1.7 percentage points, resulting in the lowest prevalence since the CDC began collecting data in 1965.

However, you don’t generally associate tobacco use with hard drugs, yet many people who die from heroin overdoses begin with a dependence on prescription opioids. Even in those who don’t overdose or graduate to heroin, painkiller addiction can be devastating. In 2015, approximately 40% of unemployed people in the U.S. used a prescription opioid. [2]

Another disturbing finding from the survey is that in 2014, 27.0 million people aged 12 and older had reported using an illicit drug (10.2%). This percentage in 2014 was higher than those in every year from 2002 to 2013. [1]

The 2nd most common type of illicit drug use remained nonmedical painkiller use, but the percentage of people aged 12 or older in 2014 who were current nonmedical users of pain relievers (1.6%) was lower than the percentages in most years from 2002 to 2012.

The 2014 NSDUH estimated 66.9 million people aged 12 or older were tobacco users.

Dr. Richard Soper, chief at the Center for Behavioral Wellness in Nashville, said:

“We require tobacco companies to put warning labels on tobacco products; you don’t really see that in opioid products. As long as the FDA is continuing to approve opioids, there will still be access to it. There will still be doctors writing prescriptions.” [3]

In early 2016, the U.S. Food and Drug Administration (FDA) published draft guidelines outlining testing standards for generic drugs that have been produced to be harder to crush and dissolve or snort. The agency requires that generic drug makers be able to prove that their product is bioequivalent to the name brand drug. But under the new guidelines, manufacturers will also have to prove that their generic drug has the same anti-abuse properties as its name brand equivalent.

However, this is the same agency that approved OxyContin for use in children in August 2015.

Sources:

[1] Newsmax

[2] The Tennessean

[3] The Daily Caller

CDC


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