This summer Philip Morris will introduce a cigarettes product called snus (pronounced, snoose) in the Dallas/Fort Worth area to test market its appeal to adult smokers. And some cigarettes experts are applauding this effort. Snus is a form of cigarettes developed in Sweden that seems to be less risky than American smokeless cigarettes products such as moist snuff (like Skoal), chewing cigarettes (like Red Man) or dried, powdered snuff (Dental, Tube Rose, Peach and other brands). Using snus for smoking cessation falls under the banner of "harm reduction," and has some support in the field of cigarettes control. Such an approach seems appealing: By reducing a smoker's dependence on cigarettes, switching to smokeless cigarettes (particularly snus) potentially reduces the risk for a whole host of smoking-related illnesses. Harm reduction has been used successfully in other addictions: methadone administration for heroin addicts, for example, or clean needle exchanges for injecting drug users. But residual cigarettes-related health risks remain when a smoker quits by using smokeless cigarettes, and these risks are not trivial when compared to quitting totally. Less Risk Is Still RiskAlthough smokeless cigarettes is much less risky than cigarettes, nonetheless mouth cancer and poor oral health definitely occur. There are also studies among large populations that show cardiovascular disease and even death by using this product. Overall, in terms of cancer, the risk of developing mouth cancer drops from an eight-fold increased risk to a 1.2-fold increase risk when switching from cigarettes to smokeless cigarettes. This is an impressive drop, but still leaves a 20 percent increase in mouth cancer risk compared to the use of no cigarettes at all.'Snus' Less Harmful Than Cigarettes, but Still Harmful Smokeless cigarettes use also seems to be associated with increased blood pressure. Among 135 middle-aged healthy volunteers, smokeless cigarettes users had on average a five-point elevation in blood pressure measured throughout the day. Another large study among over 30,000 construction workers showed that smokeless cigarettes users were nearly two times more likely to have higher blood pressures than noncigarettes users. This study was not without limitations, but is plausible in the light of other evidence. Other studies, while not definitive, indicate that smokeless cigarettes users may have higher rates of diabetes and abnormal cholesterol levels. Furthermore, among youth, use of smokeless cigarettes correlates with other risky behaviors such as alcohol and marijuana use, higher rates of carrying weapons, increased physical fighting, and sexual activity without condom use. Nonetheless, some leading cigarettes control advocates have championed smokeless cigarettes as a means of kicking the smoking habit. To an extent, they do have a point: Stopping smoking, even by switching to smokeless cigarettes, would greatly reduce the burden of cigarettes-related illnesses in the United States. They also argue that many smokers have already made the switch to smokeless cigarettes and remain smoke-free -- particularly men. But there are several reasons why, in the opinion of other well-known cigarettes researchers, this approach is flawed. First of all, the smoking cessation drugs currently on the market such as nicotine gum, patches, Zyban or Chantix are very safe and carry no cancer risks. Most devastatingly, however, there are no randomized, double-blinded placebo controlled clinical trials that compare the success of quitting smoking by using smokeless cigarettes versus using a placebo. The name of this type of study design is a mouthful, but basically boils down to a totally unbiased study. Such clinical trials are the gold standard in terms of determining if a given treatment actually works. on as even mediocre evidence to support the use of snus as a means of smoking cessation. Many of the other studies that these researchers cite are surveys of people who had never used cigarettes. While these studies may suggest an association between snus use and smoking cessation, in the scientific community a survey like this is a very poor method for determining a treatment's success. Furthermore, virtually all of the harm reduction studies predate the introduction of the extremely safe and exciting new drug Chantix (varenicline), which shows the most promise of any smoking cessation drug on the market. Nor do the harm reduction experts acknowledge that combination therapy -- using the nicotine gum or patch or both) combined with, say, Zyban (bupropion) -- can be quite powerful and safe. None of these pharmaceutical approaches has cancer-causing potential; smokeless cigarettes on the other hand increases the risk for cancer by at least 20 percent, and also is associated with poor oral health. A Dangerous AlternativeIt is in this context that cigarette maker Philip Morris has announced its new campaign to introduce snus. Starting in August, this company will test market Marlboro Snus in the Dallas/Fort Worth area. According to Philip Morris' Web site, "Marlboro Snus is a smokeless cigarettes pouch product designed especially for adult smokers in the U.S." With harm reduction in mind, Philip Morris states, "We are introducing this product into the Dallas/Fort Worth area to understand adult smoker acceptance." Of course, even Philip Morris on its Web site admits the obvious: smokeless cigarettes carries risk of cancer, cardiovascular disease and other oral diseases, can cause adverse birth outcomes among pregnant women, and is not a safe alternative to smoking. Taken together, all of the evidence points toward this unambiguous public health message: cigarettes use in any form must stop. With new, safe and effective smoking cessation aids on the market -- and more being currently studied -- it seems unethical to promote smokeless cigarettes as a means to quit smoking. Even in the name of harm reduction.
Dr. John Spangler is director of cigarettes-intervention programs and a professor of family medicine at Wake Forest University School of Medicine.
вторник, 21 июля 2009 г.
вторник, 14 июля 2009 г.
How To Smoke On The Road: Finding A Smoker-Friendly Airport
In the past fifteen years, the premium-cigar industry found itself in rebound. After decades of competition from cigarettes, the aging of its customer base, and overall consumer trends indicating a decline in smoking in general (we'll return to this in a moment), many observers figured cigars were done for. Then came 1992. The fourth quarter of that year showed some of the first industry growth in years, and this trend metastasized in coming years. By 1996, the industry was seeing 36 percent first-quarter growth.
But cigars returned at an ironic time. High-profile class-action suits, controversy over Joe Camel, and decreasing general consumer interest in smoking, among other things, led to an increase in smoking bans in public buildings, offices, and, eventually, whole cities. Airports helped lead the trend; among the major travel hubs where you're no longer welcome to light up are Los Angeles' LAX and Dallas-Fort Worth.
All of which raises a question - if you're a smoker going on vacation, what are your options?
Thankfully, the web site SmokingSection has, aggregating information sent in by smoking readers, listed and ranked over fifty major airports by their friendliness to smokers. Their rankings, like those of your high-school English teacher, run from A to E: A for airports where you can smoke by the waiting gate; E for airports where you not only can't smoke indoors, but the nearest smoker-friendly outside areas require a small trip in themselves (and may be unacceptably far from takeoff gates).
So where should you travel if you want to smoke, not only when you reach your destination but on the way there? Well, the answer seems to be: Texas. The Lone Star State offers the only A-ranked airport out of the dozens surveyed. That's Dallas Love Field, a smallish airport that receives only flights from major area transport provider Southwest Airlines. Frequently-flying cigar smokers who live in that wildcatter's capital should feel lucky.
Texas offers us a B airport as well - these are the places where you can't smoke near the gates, but that do offer smoker-friendly bars, restaurants, and/or lounges nearby. That would be at Lubbock - the same city from which Buddy Holly hailed. (But don't take that as a bad omen.) Other southern and southwestern states are well-represented among the B airports, which makes sense, given the close links between many of these states and the history of the tobacco industry. Restaurants at New Mexico's Albuquerque Airport, as well as at airports in Charlotte, North Carolina; Charleston, West Virginia; Phoenix, Arizona; Tucson, Arizona; Norfolk, Virginia; and - appropriately enough - Richmond, Virginia, that famous tobacco town. (Where would American smoking be without Virginia?)
Orange County, California, offers an airport named for John Wayne, and appropriately the tobacco-loving Duke's namesake airport also offers B-class accommodations. So do the major regional airports in Tampa, Pittsburgh, Philadelphia, Detroit, Boston, and New York City (both JFK and LaGuardia), in several large cities in Ohio (Cincinnati, Cleveland, Columbus and Dayton), in Fairbanks, Alaska; Moline, Illinois; and Ontario, Canada. Visitors to our nation's capitol can also light up at a few of Washington, DC's airport bars, though these are apparently hard to find.
It's a good thing that the weather in Texas and California is generally fairly clement, because some major airports in both of these states ban all indoor smoking - but outdoor smoking areas are available at a conveniently close distance. The aforementioned Dallas-Fort Worth and LAX both disallow indoor smoking, which accounts for their C rating, but they do invite smoking customers to step outside. The Worcester, Massachusetts airport has a similar arrangement. (Enjoy that brisk Massachusetts air.) These are the C-class airports.
After that it gets dicier. Quite a few major American airports seem to fall into the D or E classes, with smoking accommodations within the airport that require a bit of a hike, or (in the case of the E-class airports) nothing at all but outside areas located far from gates. Many D airports offer those ubiquitous glass lounges where smokers are invited to light up and take a load off; these include Salt Lake City, San Francisco, Las Vegas (McCarran), and Atlanta (Hartfield). Happy hunting!
But cigars returned at an ironic time. High-profile class-action suits, controversy over Joe Camel, and decreasing general consumer interest in smoking, among other things, led to an increase in smoking bans in public buildings, offices, and, eventually, whole cities. Airports helped lead the trend; among the major travel hubs where you're no longer welcome to light up are Los Angeles' LAX and Dallas-Fort Worth.
All of which raises a question - if you're a smoker going on vacation, what are your options?
Thankfully, the web site SmokingSection has, aggregating information sent in by smoking readers, listed and ranked over fifty major airports by their friendliness to smokers. Their rankings, like those of your high-school English teacher, run from A to E: A for airports where you can smoke by the waiting gate; E for airports where you not only can't smoke indoors, but the nearest smoker-friendly outside areas require a small trip in themselves (and may be unacceptably far from takeoff gates).
So where should you travel if you want to smoke, not only when you reach your destination but on the way there? Well, the answer seems to be: Texas. The Lone Star State offers the only A-ranked airport out of the dozens surveyed. That's Dallas Love Field, a smallish airport that receives only flights from major area transport provider Southwest Airlines. Frequently-flying cigar smokers who live in that wildcatter's capital should feel lucky.
Texas offers us a B airport as well - these are the places where you can't smoke near the gates, but that do offer smoker-friendly bars, restaurants, and/or lounges nearby. That would be at Lubbock - the same city from which Buddy Holly hailed. (But don't take that as a bad omen.) Other southern and southwestern states are well-represented among the B airports, which makes sense, given the close links between many of these states and the history of the tobacco industry. Restaurants at New Mexico's Albuquerque Airport, as well as at airports in Charlotte, North Carolina; Charleston, West Virginia; Phoenix, Arizona; Tucson, Arizona; Norfolk, Virginia; and - appropriately enough - Richmond, Virginia, that famous tobacco town. (Where would American smoking be without Virginia?)
Orange County, California, offers an airport named for John Wayne, and appropriately the tobacco-loving Duke's namesake airport also offers B-class accommodations. So do the major regional airports in Tampa, Pittsburgh, Philadelphia, Detroit, Boston, and New York City (both JFK and LaGuardia), in several large cities in Ohio (Cincinnati, Cleveland, Columbus and Dayton), in Fairbanks, Alaska; Moline, Illinois; and Ontario, Canada. Visitors to our nation's capitol can also light up at a few of Washington, DC's airport bars, though these are apparently hard to find.
It's a good thing that the weather in Texas and California is generally fairly clement, because some major airports in both of these states ban all indoor smoking - but outdoor smoking areas are available at a conveniently close distance. The aforementioned Dallas-Fort Worth and LAX both disallow indoor smoking, which accounts for their C rating, but they do invite smoking customers to step outside. The Worcester, Massachusetts airport has a similar arrangement. (Enjoy that brisk Massachusetts air.) These are the C-class airports.
After that it gets dicier. Quite a few major American airports seem to fall into the D or E classes, with smoking accommodations within the airport that require a bit of a hike, or (in the case of the E-class airports) nothing at all but outside areas located far from gates. Many D airports offer those ubiquitous glass lounges where smokers are invited to light up and take a load off; these include Salt Lake City, San Francisco, Las Vegas (McCarran), and Atlanta (Hartfield). Happy hunting!
понедельник, 13 июля 2009 г.
Has The Price Of Cigarettes Made You Want To Quit
With the economy the way it is now days, there are a many people that wish they would have given up smoking once and for all a long time ago. Now that the price of a pack of cigarettes is reaching nearly five dollars a pack and even more in many places, it is a good time to seriously start thinking about giving them up. No matter what age you are, unless you are just plain wealthy, a heavy smoker these days can cost as much as 20 % of a pay check of average working men and women in the United States who make minimum wage or a little more.
Going back just only a few years ago, cigarette prices were around two dollars a pack, but with the new taxes being applied, they are now doubled in price. If you are a smoker and think that is bad, the states are beginning to apply their own tax on top of the one the government just put in place. This is similar to the gasoline issue in that it keeps going up, but we need gasoline to travel, we do not need cigarettes at all. Spend nothing on cigarettes and you will have plenty left to pay for that expensive fuel.
Finally, the cost of gasoline has peaked for the time being and came back down. Now you can at least make it to work without taking out a loan to get there. But smokers out there need to get ready to see the price of cigarettes be the back up for a tax revenue increase. Even though the extreme taxing of cigarettes might not be something that everyone, especially smokers, agree with, because they might actually go up in price so much that it will force some people to have to quit, but is that such a bad thing in itself?
When you are addicted to nicotine and what ever the thousands of chemicals are that go in the processing of cigarettes, it is similar to being an addict hooked on some of the harder drugs like heroine or methamphetamine. It is almost as difficult for some to stop smoking as it is for these other drug users to kick their habits. What is amazing to some people is that cigarettes are killers just like any of these other drugs, yet they are still legal for adults to buy. What many people do not understand about the government is how they determine that it is perfectly alright to tax one drug like cigarettes to death, and outlaw others. There is the argument that some drugs like methamphetamine or heroine alters the personality of the user and this is true. But have you ever seen a smoker who is really addicted to cigarettes when they can not get one? That also can be a very ugly picture.
Going back just only a few years ago, cigarette prices were around two dollars a pack, but with the new taxes being applied, they are now doubled in price. If you are a smoker and think that is bad, the states are beginning to apply their own tax on top of the one the government just put in place. This is similar to the gasoline issue in that it keeps going up, but we need gasoline to travel, we do not need cigarettes at all. Spend nothing on cigarettes and you will have plenty left to pay for that expensive fuel.
Finally, the cost of gasoline has peaked for the time being and came back down. Now you can at least make it to work without taking out a loan to get there. But smokers out there need to get ready to see the price of cigarettes be the back up for a tax revenue increase. Even though the extreme taxing of cigarettes might not be something that everyone, especially smokers, agree with, because they might actually go up in price so much that it will force some people to have to quit, but is that such a bad thing in itself?
When you are addicted to nicotine and what ever the thousands of chemicals are that go in the processing of cigarettes, it is similar to being an addict hooked on some of the harder drugs like heroine or methamphetamine. It is almost as difficult for some to stop smoking as it is for these other drug users to kick their habits. What is amazing to some people is that cigarettes are killers just like any of these other drugs, yet they are still legal for adults to buy. What many people do not understand about the government is how they determine that it is perfectly alright to tax one drug like cigarettes to death, and outlaw others. There is the argument that some drugs like methamphetamine or heroine alters the personality of the user and this is true. But have you ever seen a smoker who is really addicted to cigarettes when they can not get one? That also can be a very ugly picture.
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