The Painless Stop Smoking Cure

Quit Smoking Magic

Quit Smoking Magic is the first and Only program of its type that literally can Force You to easily kick the habit in just days even if you have a shoestring budget and absolutely no will power. Benefits: Helps You to successfully quit smoking in as little as just days. Its as easy as taking candy from a Sleeping baby. This system takes just minutes to administer. This system can be done on a shoestring budget. Absolutely no chance of Any negative side effects. Works for almost Everyone 98% success rate thus far. You will never relapse with this program. Theres no Will-power necessary with Quit Smoking Magic. Powerful concept based on Real-life experiences rather than just theories. Quit Smoking Magic Teaches You: How to quit smoking cigarettes super-fast. How to stop your Cravings dead in their tracks. How to Never relapse with this nasty habit. How to avoid spending a ton of Money in your quest for quitting. How to quit smoking Now rather than later. How to Automatically kick this habit even without will-power. How to keep from having withdrawal symptoms and nasty mood swings. How to refrain from having Insomnia after quitting. How to avoid restlessness as well as changes in appetite. Read more...

Quit Smoking Magic Overview


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Author: Mike Avery
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My Quit Smoking Magic Review

Highly Recommended

The writer has done a thorough research even about the obscure and minor details related to the subject area. And also facts weren’t just dumped, but presented in an interesting manner.

When compared to other e-books and paper publications I have read, I consider this to be the bible for this topic. Get this and you will never regret the decision.

Advertising And Tobacco

Tobacco companies spend more than 5 billion annually to advertise and promote cigarettes and other tobacco products. Tobacco companies claim that the purpose and desired effect of marketing are merely to provide information and to influence brand selection among current smokers, although only about 10 percent of smokers switch brands in any one year. Since more than one million adult smokers stop smoking every year and almost half a million other adult smokers die from smoking-re-lated diseases, the tobacco companies must recruit an average of 3,300 new young smokers every day to replace those who die or otherwise stop smoking. Tobacco companies contend that smoking is an ''adult habit'' and that adult smokers ''choose'' to smoke. However, many medical researchers assert that cigarette smoking is primarily a childhood addiction or disease and that most of the adults who smoke started as children and could not quit. lations. The basic restrictions have been that companies cannot use...

Pollutants and Tobacco Smoke as Adjuvant Factors

The role of tobacco smoke, a complex mixture of various particles and organic compounds, has been extensively studied. The studies which have recently been reviewed consistently demonstrate that the risk of lower airway disease such as bronchitis, recurrent wheezing in infants as well as pneumonia is increased. Whether passive tobacco smoke exposure is causally related to the development of asthma is still disputed 8, 9 . smoked up to the end of pregnancy and continued to smoke after birth. In this subgroup of the cohort, a significantly increased sensitization rate regarding IgE antibodies to food proteins, particularly to hen's egg and cow's milk, was only observed during infancy, whereas sensitization rates later on were not different from children who had never been exposed to tobacco smoke. These observations might be related to the fact that in children the highest urinary cotinine concentrations are detected during the first years of life, when the child spends most of the time...

Small Cell Lung Cancer SCLC

Small cell lung carcinoma (SCLC) accounts for 20 to 25 of all bronchogenic carcinomas and is associated with the poorest survival of all histologic types 6 . SCLC is most often a lesion of the central portion of the lung but is occasionally found in the peripheral portions 2, 7 . In contrast to other major types of lung cancer, SCLC is highly sensitive to both chemotherapy and radiation therapy, which results in initial significant improvements in the survival of patients with this disease but the overall results remain unchanged in the following years due to development of drug resistance and death of the patients 8 . Yun et al 9 observed that the age-adjusted incidence per 100,000 person-years (standard Poisson regression analysis) for small cell carcinoma was 0.5 (95 CI 0.2-1.4) for never smokers, 3.5 (95 CI 0.4-27.3) for former smokers, and 11.1 (95 CI 1.5-82.9) for current smokers. In this study 9 83.6 , 14.5 , and 1.9 patients were current smoker, former smoker, and never...

General Health Issues or But I Want to Hang Out in the Sun in a Tiny Bikini Smoking Cigarettes and Drinking with My

Many adolescents may already be tobacco smokers or are exposed to tobacco smoking through friends and family. Smoking can be detrimental to adolescents with SLE for several reasons it may exacerbate Raynaud's phenomenon it is not recommended for anyone with pulmonary disease it provides additional risk for cardiovascular disease and there is evidence that it may be associated with decreased efficacy of medications such as hydroxychloroquine (11). In one study, patients with SLE who were cigarette smokers had significantly higher disease activity scores, suggesting that exposure to cigarettes should be avoided for all SLE patients (12). Healthcare providers should ask adolescents about possible cigarette use in a confidential setting, and provide options for tobacco cessation if the adolescent is a smoker.

Cigarette Smoking And The Risk Of Stroke

Heavy smoking (> 20 cigarettes day) increases both the incidence 37-41 and mortality from stroke 40,41 , Cigarette smoking is a major modifiable risk factor for subarachnoid hemorrhage 42-48 , In contrast, evidence concerning the role of tobacco in the risk of intracerebral hemorrhage is still controversial, yet it appears that heavy, but not light-to-moderate cigarette smoking, increases the risk 9,38,49,50 , Smoking is dose-dependantly associated with the risk of ischemic stroke 38,46 , Cessation of smoking reduces stroke risk 37,39 , with major reduction within 2-5 years after cessation 37,39,46 , indicating that part of the effects of smoking is reversible. The risk of stroke seems to return to the level of never-smokers in light smokers, but heavy smokers seem to retain an increased risk even though also they benefit from cessation 37 , There are several mechanisms by which smoking may cause stroke. Cigarette smoking causes an immediate, yet reversible increases in blood...

In addition to asking me to lose weight prior to surgery my doctor has asked me to quit smoking I dont think I can lose

Once again your doctor is not trying to sabotage your surgery. People who smoke do not do as well following any surgery requiring general anesthesia as nonsmokers. If you are a smoker it is likely that it will be more difficult to get you to breathe on your own following surgery than if you were a nonsmoker. Quitting even for a short period of time prior to surgery can make coming off the respirator easier. Quitting smoking on top of losing weight may seem like a major task, but you will be in much better shape for surgery if you do. If you remain off cigarettes long-term following surgery you will dramatically reduce your risk of heart disease, lung disease, and many forms of cancer. A smoke-free you, a lighter you, a healthier you. Think of how you can really change your life in the next six to twelve months. For some people a smoking cessation aid makes quitting a lot easier. One way to help determine if you might benefit from a smoking cessation tool is to answer one simple...

Cigarette Smoking And Cardiovascular Disease

Cigarette smoking-related cardiovascular diseases have been described widely. However, the mechanisms of their effects on cardiovascular system were not totally clear. The effects of nicotine and carbon monoxide on blood vessel walls, unfavorable lipid profiles, increased myocardial work and the decreased oxygen carrying capacity of the blood of smokers contribute to the overall effect of cigarette smoking on cardiovascular disease 3J. Of the increased cardiovascular risk caused by smoking, it is estimated that approximately one-tenth of this is due to smoking-induced changes in serum lipid 4 , The majority of studies indicate elevations in serum cholesterol, phospholipids, triglycerides, low-density lipoprotein (LDL) and increased hepatic lipase activity in smokers, with decreased serum high-density lipoprotein (HDL) cholesterol 5 , A mechanism to explain the link between smoking and some of the observed changes in serum lipid and lipoprotein concentrations includes the...

Development Of Physical Dependence On Nicotine

Nicotine is the chemical substance responsible for PHYSICAL DEPENDENCE on tobacco products. During the development of physical dependence on a drug such as nicotine, brain chemistry and function change. They return to normal in the presence of nicotine and come to depend on the drug for normal function. The change that results in normal function in the presence of nicotine is called neuroadaptation or TOLERANCE. When tolerance develops after a period of use of nicotine, or of any drug, the same dose produces less of an effect than previously. Tolerance develops to many of the effects of nicotine. It is well-known that people smoking their first cigarette often experience nausea and vomiting. However, after repeated exposure to cigarette smoke, these effects disappear. Their disappearance is the development of tolerance to the toxic effects of nicotine in the cigarette smoke. Tolerance also develops to the more desirable effects of nicotine such as pleasure and alertness. The...

Absorption Of Nicotine From Tobacco

Nicotine, which is absorbed into the body when tobacco products are used, can be absorbed by different routes and at different rates. Some products deliver nicotine in smoke that is inhaled. In tobacco smoke, nicotine is present in droplets that also contain water and tar. These droplets are carried by gases that include carbon monoxide, hydrogen cyanide, and nitrogen oxides. Such suspended droplets carried by gas are called an aerosol. When the aerosol is inhaled, the droplets are deposited in the small airways of the lungs, from which nicotine is absorbed into the blood stream. After absorption through the lungs, blood containing nicotine moves into the heart and then into the arterial circulation, including the brain. Nicotine reaches the brain within 10 to 15 seconds after a puff on a cigarette. This rapid delivery of nicotine to the brain produces more intensive effects than following slower delivery and provides the close temporal link between SMOKING and the development of...

Nicotine Delivery Systems and Treatment of

These medications are meant to provide nicotine to smokers as a substitute for nicotine formerly consumed from tobacco use. Nicotine medications reduce withdrawal symptoms and increase the likelihood that the individual will quit tobacco use. Two forms of nicotine medication are currently available. Nicotine chewing gum (nicotine polacrilex, also known as Nicorette) consists of nicotine in a gum that slowly releases nicotine during chewing. Each gum is typically chewed for about 30 minutes. People chew up to 16 pieces per day when trying to quit smoking. Nicotine patches are applied to the skin. They release nicotine slowly through the skin over 16 or 24 hours, depending on the patch used. Both forms of nicotine-replacement medication deliver doses of nicotine equivalent to that taken in by the average tobacco user. Nicotine chewing gum delivers about 1 to 2 mg per piece. Nicotine patches deliver from 5 to 21 mg, depending on the patch and its strength.

Elimination Of Nicotine From The Body

Nicotine in the body is eliminated primarily by breakdown by the liver. The rate of breakdown is such that the level of nicotine in the blood falls about one-half after two hours. This rate is also known as a half-life of two hours. The primary breakdown product of nicotine is cotinine. Cotinine levels in the body are about 10 times higher than those of nicotine. The half-life of cotinine is 16 hours, and cotinine persists in the body for 4 days after a person stops smoking. Cotinine levels can be measured as an indicator of how much nicotine a person is taking in.

Behavioral Aspects Of Tobacco Addiction

People continue to smoke both because they enjoy the direct drug effects of nicotine and because use of nicotine becomes associated with other pleasures through learning for instance, when the pleasurable effects of nicotine occur repeatedly in the presence of specific cues or events in the envi ronment. Eventually, those cues and events become a signal to smoke. For example, people often smoke after meals, while drinking a cup of coffee or an alcoholic beverage, during a break from work, while talking on the phone, or while with friends who smoke. After smoking in these situations hundreds of times, the user may find that these situations themselves produce a powerful urge for a cigarette. There are other learned pleasures that keep people smoking independent of the pharmacological effects of nicotine. Handling of smoking materials, and the taste, smell, or feel of tobacco smoke in the throat, all can become associated with the effects of nicotine and then become pleasurable in...

Nicotine Addiction In Youth

Ninety percent of all tobacco users begin smoking before the age of 20. The earlier in life one starts smoking, the more likely he or she is to become a regular smoker and the more cigarettes he or she will smoke as an adult. The development of addiction in youth involves a series of steps including nicotine addiction Initially, young people smoke for social and psychological reasons. The motivations include the influence of parents and friends who are smokers, and the positive images of smoking perpetuated in television and movies and in advertisements in magazines, at music and sports events, and on billboards. Personal factors also play a role. Some include poor school performance, low self-esteem, poor self-image, sensation seeking, rebelliousness, failure to take seriously the adverse effects of tobacco use, and depression or anxiety. While early stages of smoking usually consist of occasional sessions with friends, tolerance develops and withdrawal symptoms are experienced...

Treatment Of Nicotine Addiction

Treatment of nicotine addiction is discussed in the articles entitled Treatment Tobacco. The approach may be summarized as follows. Initial therapy usually does not include drugs. Smokers are encouraged to pick a day and just stop (go cold turkey). Some smokers participate in formal behavioral therapies, such as those available in smoking-cessation clinics. Those who are unable to stop on their own or with behavior therapies are more likely to be highly addicted to nicotine and are candidates for pharmacological (drug) therapy. The main drug therapies for smoking are nicotine-containing medications such as chewing gum or transdermal (skin) patches. (SEE ALSO Addiction Concepts and Definitions Adolescents and Drugs Reward Pathways and Drugs Tobacco Smokeless Tolerance and Physical Dependence Withdrawal Nicotine) BENOWITZ, N. L. (1988). Pharmacologic aspects of cigarette smoking and nicotine addiction. New England Journal of Medicine, 319, 1318-1330. U.S. Surgeon General. (1988). The...

Genetic mutations in lung cancer cells

Apart of chromosomal aberrations single gene mutations can appear in lung cancer cells. These mutations can be revealed with molecular biology techniques. Mentioned mutations do not often appear simultaneously in one cancer cell (less than 3 of tumour cells). They concern genes important for correct proliferation, differentiation and cell growth such as oncogenes and genes for signal proteins involved in a complicated network of intracellular signal transmission (predominantly genes for tyrosine and threonine-serine kinases). Accumulation of driver mutations in different genes is detected depending on history of tumour exposure to carcinogens. Failure of DNA repair and progressive genetic instability leads to appearance of mutation that drives cancer development, its growth and metastases 4 . Molecular type of lung cancer is partially consistent with histological type of tumour. Although frequency of occurrence of some driver mutations is extremely rare, in only 20 of NSCLC tumours...

Molecular biology methods in lung cancer diagnostics

Routine genetic testing for somatic mutations in lung cancer biopsies is becoming the standard for providing optimal patients care. However, it is unclear whether this testing should be routine for all lung cancer patients, because the prevalence of the most common mutations is very low especially in heavy smokers with squamous cell carcinoma. Moreover, great number of molecular biology methods and variety of biological material acquired from patients create a critical need for robust, well-validated diagnostic tests and equipment that are both sensitive and specific for mutations. An In Vitro Diagnostic Medical Device (IVD) is defined in Directive 98 79 EC of European Parliament and of the Council. IVD is described as any medical device which is a reagent, calibrator, control material, kit, equipment or system, whether used alone or in combination, intended by the manufacturer to be used in vitro for the examination of specimens, including blood and tissue donations, derived from the...

Self Help Therapies for Cigarette Smoking Cessation

Smoking is a proven risk factor for the three leading causes of death in the United States heart disease, cancer, and stroke. It is responsible for approximately 440,000 premature deaths in the United States each year and represents the single most preventable cause of death in our society (Centers for Disease Control and Prevention CDC , 2002a). Nevertheless, it is estimated that 45.8 million Americans continue to smoke (CDC, 2004). Additionally negative effects of environmental smoke among non-smokers have been firmly established, with mortality rates estimated at up to 38,000 annually as a result of involuntary smoking (CDC, 2002a). In addition to premature mortality, smoking was responsible in the period from 1995 to 1999 for approximately 157 billion in annual health-related economic losses (CDC, 2002a). Due to the well-known negative health consequences of smoking on the individual smoker, as well as to surrounding nonsmokers, and the economic costs of smoking, American society...

Smoking Cessation in the Overweight or Obese Patient

Cigarette smoking is a major risk factor for cardiopulmonary disease. Because of its attendant high risk, smoking cessation is a major goal of risk-factor management. This aim is especially important in the overweight or obese patient, who usually carries excess risk from obesity-associated risk factors. Thus, smoking cessation in such patients becomes a high priority for risk reduction. Evidence Statement Smoking and obesity together increase cardiovascular risk, but fear of weight gain upon smoking cessation is an obstacle for many patients who smoke. Evidence Category C. Rationale Both smoking and obesity are accompanied by increased risks for cardiovascular disease. Many well-documented health benefits are associated with smoking cessation, but a major obstacle to successful smoking cessation has been the attendant weight gain observed in about 80 percent of quitters. This weight gain averages 4.5 to 7 lb, but in 13 percent of women and 10 percent of men, weight gains in excess of...

Clinical Practice Guidelines For The Delivery Of Smoking Cessation Interventions

Clinical practice guidelines have been developed for the delivery of brief advice and evidence-based smoking cessation interventions in health care settings.76,77 Within cancer care settings, physicians, nurses and other cancer care providers can readily offer compelling advice to cancer survivors about the risks of continued smoking and the health benefits of quitting. Brief cessation counseling techniques known as the 5 A's model are widely recommended (1) Ask about smoking, (2) Advise about quitting, (3) Assess readiness to quit, (4) Assist, and (5) Arrange follow-up.78 Clinical practice guidelines for treating tobacco dependence were first published in 1996 and then updated in 2000,76 are based on an expert panel's comprehensive and systematic review of the evidence base for the management of tobacco-dependent patients. The eight key recommendations and findings are summarized in Table 1. Brief counseling involves assisting smokers to develop and use practical problem-solving and...

Efficacy of Smoking Cessation Interventions in Cancer

Very few randomized smoking cessation clinical trials with cancer patients have been published. These studies have utilized small sample sizes, focused primarily on hospitalized patients, and used nonrandomized designs. Both minimal and more intensive programs have been associated with dramatically high rates of cessation suggesting that the cancer survivor population is quite responsive to these cessation programs.63,79,80 In these studies, abstinence rates for the intervention (experimental) and usual care (control) conditions have been high, up to 70 in the first 6 months, far above the naturalistic quit rates reported in the general population of smokers (generally, 10 to 15 ).76 Gritz and colleagues62,68 compared the effects of usual care (standardized physician advice including education about the risks of smoking and the benefits of abstinence) to intervention (standardized advice with three types of self-help materials tailored to the special needs and concerns of head and...

Challenges Of Promoting Smoking Cessation In Cancer Survivorship

Clinical practice guidelines predominantly based on the experiences of primary care patients may not fully accommodate the specific needs and considerations of cancer survivors and their families. Part of the challenge of tailoring smoking cessation interventions to meet the special needs of cancer survivors is that, at present, little is known about the naturalistic factors that impede their smoking cessation efforts.84-87 Again, most studies understandably have focused on the treatment- and smoking-related characteristics of lung and head and neck cancer patients.19,35,40,64,68-70,72 In the general population of smokers, multiple patient-, provider-, and system-related barriers (e.g., inadequate provider training to deliver cessation interventions, and inadequate access to cessation treatments) may impede the delivery of smoking cessation interventions and the effective dissemination of the clinical practice guidelines. The context of cancer diagnosis has unique impact on all of...

Provider Related Barriers to Smoking Cessation

Inadequate staff training and provider attitudes may also deter the delivery of smoking cessation interventions. Despite the promulgation of the clinical practice guidelines, surveys report many primary health care providers feel unprepared to assist their patients in smoking cessation, and a majority of providers do not routinely advise or assist their patients in cessation attempts.76,101-104 Findings estimate that smoking status is assessed in 50-66 of clinic visits,103,105-107 and smoking cessation interventions are provided in 3-20 of smokers' visits.107,108 Within the cancer care setting, Sarna et al.109 surveyed 4000 members of the Oncology Nursing Society (ONS) to assess cessation practice patterns and attitu-dinal and skill set barriers to the provision of cessation advice and assistance. The most frequently reported perceived barriers to the delivery of smoking cessation interventions by oncology nurses in this sample were (1) lack of patient motivation, 74 (2) lack of time,...

Systems Level Barriers to Smoking Cessation

The removal of financial barriers for smokers in need of treatment for tobacco dependence is a public health priority in the United States, particularly for uninsured, underinsured, and underserved smokers. Although reimbursement for smoking cessation interventions is improving, there are limitations to the coverage of tobacco-dependence treatment, particularly intensive treatment. Less than 33 of employers provide coverage for smoking cessation interventions.111 These services require expensive co-payments, limited coverage for face-to-face counseling (instead favoring less costly web-based or printed materials for self-help programs), and referral to public health programs that may not meet the specific needs of cancer survivors. However, there have been promising advances in recent reimbursement trends. Once solely affiliated with corporate wellness programs, smoking cessation treatment is now shifting toward consideration for inclusion as a medical benefit.112 Further, based on...

Clinical Care Approaches For Promoting Smoking Cessation In Cancer Survivorship

Our smoking cessation program at Memorial Sloan-Kettering Cancer Center follows a stepped-care model (see Figure 1), with all cancer care providers able to provide step 1, minimum intensity counseling to patients. Step 2 includes moderate intensity counseling through referral to the smoking cessation program, in which certified Tobacco Treatment Specialists (TTSs) (nurse specialists) perform an intake assessment of smoking behaviors, develop a tobacco treatment plan, offer brief counseling for cessation, advise options for smoking cessation pharmacother-apy, and conduct serial follow-up assessments with patients and survivors to monitor smoking cessation status and outcomes. Recognizing the geographic range of cancer survivors treated at a tertiary cancer care center, the TTSs also refer to local resources in the community. Step 3 is intensive treatment for smoking cessation delivered by psychologists who provide specialized care of smokers at high risk for continued smoking in...

Future Directions For Promoting Smoking Cessation In Cancer Survivorship

At an individual treatment level, there is first a need to target and examine the effectiveness of established evidence-based treatments for tobacco dependence in cancer survivors. Interventions developed for the general population of smokers may be applicable to the cancer survivor population.22 For instance, Schnoll and colleagues, recognizing the potential barrier of psychological distress, are conducting a randomized clinical trial examining whether combination pharmacotherapy including bupropion (in addition to NRT and behavioral counseling) increases quit rates in head and neck cancer patients over and above NRT and behavioral counseling alone. Presumably, the more intensive treatment condition (addition of bupropion) will be superior and more responsive to the psychological needs of cancer survivors, many of whom report heightened psychological distress. These important findings will replicate work conducted in the general smoking population and may support treatment matching...

Treatment Of Smokeless Tobacco Addiction

Much evidence indicates that the use of smokeless tobacco produces addiction and leads to serious health consequences as does the use of smoked tobacco. However, little is known about effective treatment for smokeless tobacco (i.e., snuff or chewing tobacco) addiction. The general behavioral approach is similar to that for cigarette smoking, although the specific learned associations and cues are naturally somewhat different. Self-help materials are available from a variety of sources in the United States. Some strategies include the use of alternative activities, such as chewing gum, hard candy, sunflower seeds, nuts, toothpicks, or beef jerky. Formal treatment programs are also available in some parts of the country. At the present time, insufficient evidence exists to suggest that the use of established medications designed for helping cigarette smokers increases long-term cessation among users of smokeless tobacco. (See also Addiction Concepts and Definitions Relapse Prevention...

Smoking Cessation And Weight Gain

It is not clear whether weight gain during cessation is temporary or permanent, although the majority of studies indicate that some weight gain (about 5 pounds) is likely to be long-term. Although the mechanisms responsible for the weight gain are not clear, a number of hypotheses have been set forward. These include a metabolic effect for smokers this is supported by research indicating that smokers and nonsmokers have few differences in the amount of calories consumed. Another hypothesis is that smoking lowers the body's ''set point'' for weight and smoking cessation raises that set point to be equivalent to that of nonsmokers. A third hypothesis is based on the observation that an increase in caloric intake occurs in those who stop smoking, and increased consumption may be responsible for the weight gain. Although weight gain is likely to accompany cessation, actual weight gain during smoking cessation does not appear to be related to cessation outcomes. Nevertheless, in reaction...

Optimal Treatment of Small Cell Lung Cancer

Thirty years of clinical research activity in the field of small cell lung cancer (SCLC) treatment get me to conclude that standard treatment for this disease has not yet been precisely defined. Some recent editorial assertions are untrue, due to rapid evolution of knowledge or to simplification risks. We will try here to highlight some ideas whose application presently can optimise treatments of patients affected by this cancer.

Effects Of Smoking Cessation

There are a number of physiological effects that take place in the human body after cessation of smoking. About twenty minutes after cessation, the blood pressure and pulse rate return to normal, and the body temperature increases to normal. About 8 hours later, the carbon monoxide level in the blood drops to normal, and after 1 day, an individual s chance of a heart attack decreases. After two days, nerve endings start to regenerate, and the ability to smell and taste is improves. After two weeks, an individual s circulation improves and the functionality of the lungs increase by a maximum of 30 percent. After a year of smoking abstinence, the risk of coronary heart disease is reduced to half that of a smoker, and after five years of cessation, the risk of death by lung cancer is cut in half. After fifteen years, the risk of coronary heart disease is equal to that of a nonsmoker.

Research On Cessation Of Tobacco

Although the scientific study of smoking treatments dates from the mid-1900s, nonscientific and scientific treatments often overlap. Until the 1980s, there were still many observers who doubted that tobacco use was based on an addic tion to or dependence on nicotine. In the 1950s and 1960s, many experts believed that smoking was ''just a bad habit.'' Experts at that time failed to appreciate that tobacco use was a form of drug use instead, they saw smoking as the kind of habit that could be broken by taking certain behavioral steps. This attitude was the origin of the so-called behavioral techniques for stopping smoking. In the early part of the twentieth century, self-help movements were very popular and were directed against alcohol and other drug problems. Such efforts at behavioral changes have a long history in society. Perhaps because they are so commonplace, people tend not to seek professional help for dealing with minor behavioral problems. As a result, it should not be...

Nicotinereplacement Therapies

Nicotine-replacement therapies can help reduce the nicotine withdrawal symptoms after smoking cessation. Replacement therapies help individuals deal with their smoking gradually by separating the behavioral and pharmacological components of smoking. While physical symptoms of nicotine withdrawal are reduced, the individual can focus on dealing with the behavioral challenges of stopping. The most commonly used nicotine-replacement therapies are a gum that releases nicotine as it is chewed and a patch that slowly releases nicotine into the body through the skin. These therapies are available over-the-counter. Transdermal nicotine patches appear to be preferred by individuals over nicotine gum. They seem to have the fewest side effects and are associated with the greatest long-term abstinence rates. Nicotine nasal sprays and nicotine vapor inhalers that deliver nicotine through the respiratory system are less common forms of nicotine-replacement therapy. They became available in the...

On Selecting A Way To Stop Smoking

Smokers should be advised to take a long view of their efforts to stop smoking, understanding that if one method does not help them, they should try another, and another, until they have stopped smoking. Any one attempt to stop smoking can meet with poor success. With repeated attempts, the smoker may encounter some success. Also, repeated attempts give the smoker experience with assorted treatment techniques, so that the individual begins to learn for what helps and what does not help. Finally, there may be a kind of ''no more nice guy'' effect, so that the smoker gets fed up with failing to quit smoking. It is also important to realize that no two programs are delivered in exactly the same way. The individual characteristics of a therapist and the client's rapport with that therapist can contribute to a therapy's success. The person who wants help to stop smoking should investigate available community resources the library is good place to start. If the first attempt fails,...

Assessment Of Readiness To Quit Tobacco

The application of behavioral treatments to tobacco-dependent individuals begins with an assessment of preparation for change. Readiness to change negative health behaviors has conceptualized in the transtheoretical model originated by James Prochaska and Carlos DiClemente. This model posits that there are reliable Stages of Change in health awareness and motivation, and that appropriate treatments vary by the stage. There are five stages of change (1) pre-contemplation, a period where during the next 6 months, the tobacco user is not considering quitting (2) contemplation, a period when a tobacco user is seriously considering quitting in the next 6 months (3) preparation, a period when, a tobacco user who tried quitting in the previous year, thinks about quitting in the next month and (4) action, a 6 month period after the tobacco user makes overt changes to stop using tobacco products. The last stage, maintenance, is the longest and describes the tobacco-free period after cessation....

Nicotine Withdrawal Symptoms

The DSM-IV recognizes nicotine dependence as a substance-related disorder, with a well-defined withdrawal syndrome. The potential withdrawal symptoms include dysphoric or depressed mood insomnia irritability, frustration, or anger anxiety difficulty concentrating restlessness decreased heart rate and increased appetite or weight gain. The severity of the symptoms will depend on the severity of nicotine dependence. Withdrawal symptoms are strongest in the first few days after smoking cessation, and usually diminish within a month, although some smokers may continue to have withdrawal symptoms for many months. A number of other sequelae accompany smoking cessation. There is evidence that cognitive ability is impaired when smoking cessation is attempted. The cognitive deficits are correlated with disruptions in brain electrophysiologic function. Figure 1 shows that deficits in an arithmetic task follow a similar time course as changes in the brain s electrical activity. These effects...

Treatment Of Nicotine Withdrawal Symptoms

Two pharmacologic approaches, nicotine replacement therapy and drugs to manage symptoms associated with withdrawal, have been taken to reduce nicotine withdrawal symptoms. In addition, behavioral approaches for withdrawal have been tested. Nicotine replacement therapy. The purpose of nicotine replacement is to substitute a safer and controllable form of nicotine to the smoker to aid in cessation. Although nicotine replacement delivery systems vary, all attempt to reduce the amount of nicotine available during cessation so that an individual is weaned from nicotine addiction. Two nicotine replacement therapies are available over-the-counter nicotine polacrilex gum and the transdermal nicotine patch. Two other delivery systems are available through prescriptions an oral nicotine inhalation system and a nasal nicotine spray. The effectiveness of each of the systems has been well-established in randomized, controlled trials. Symptom treatment. A number of drug therapies have been approved...

Alcohol And Tobacco

There is greater evidence of sex-role convergence in Tobacco use. In 1955, 52 percent of adult men smoked, compared with 25 percent of adult women. Since then, the proportion of men who smoke has decreased markedly while rates among women have held fairly steady. Among adults aged 35 and older in 1993, 27 percent of men and 21 percent of women were current smokers. Among youths aged twelve to seventeen, girls have surpassed boys in their rates of current cigarette use (10 percent of girls compared with 9 percent of boys in 1993). Because boys are more likely than girls to use smokeless tobacco products, however, their overall rates of nicotine addiction still exceed girls' rates. Biener (1987) reviews factors that have contributed to the convergence in male and female smoking. Product developments such as filtered and low-tar cigarettes have made smoking easier for women to tolerate physically. Tobacco companies have targeted Advertising to make smoking attractive to young women. Once...

Comparison Of Addiction To Nicotine And Other Drugs

Nicotine addiction is similar to and as powerful as addiction to other drugs, such as HEROIN, ALCOHOL, and COCAINE. All these drugs have psychoac-tivity and produce pleasure. They increase the likelihood that people will spend time looking for them and engaging in rituals while taking them and that users will continue to take them in the face of risk to their well-being and health. The psychoactivity of nicotine is subtle and does not interfere with normal functioning in daily life. Thus nicotine s psy-choactivity differs from that of heroin and cocaine, which produces more intense euphoria and may be disruptive to everyday functioning. Despite this difference, nicotine is addictive. A subtle psychoactive effect, especially when experienced with each puff of smoke, taken hundreds of times a day, exerts a powerful effect on behavior over time. The magnitude of effect becomes apparent when each puff of cigarette is considered as a dose of nicotine. A smoker who takes 8 puffs per...

History Of Tobacco

Tobacco was introduced to Europeans by Native Americans at the time of Columbus's exploration of the New World (1492-1506). The first written records of tobacco use date from this time, but there is archaeological evidence for tobacco's wide use in the Americas as early as c.e. 600-900. Native Americans considered tobacco as sacred, a plant used in social, fertility, and spiritual ritual. For Acute nicotine poisoning was a central aspect of the practice of shamanism in many parts of South America. South American shamans would smoke or ingest tobacco to the point of producing a nicotine-mediated trance or coma. The dose of nicotine could be titrated to produce a coma state resembling death, but from which the shaman would recover. Recovery from apparent death enhanced the perception of the shaman's magical powers. In 1492 Columbus encountered natives in His-paniola smoking tobacco in the form of large cigars. Enticed by the sacred and special regard in which they held tobacco,...

Nicotine And Tobacco

TOBACCO is a tall, herbaceous plant, the leaves of which are harvested, cured, and rolled into cigars, shredded for use in cigarettes and pipes, and processed for chewing or snuff. Tobacco has become a commercial crop in almost all tropical countries as well as in many temperate ones. The main source of commercial tobacco is Nicotiana tabacum, although Nicotiana rustica is also grown and is used in Asian tobaccos. Tobacco has been developed to yield a wide range of morphologically different types, from the small-leaved aromatic tobaccos to the large, broad-leaved cigar tobaccos. Tobacco is native to South America, where it was used in a drink for ritual purposes long before inhaling the smoke of the dried plant material was first documented by the Maya more than 2,000 years ago. Tobacco was then traded and grown in Central America it moved into Mexico and the Caribbean and eventually into North America by about 800 A.D. The Arawaks of the Caribbean smoked tobacco, and during...

Molecularly targeted therapies in lung cancer

Excessive stimulation of epidermal growth factor receptor increases proliferation of cancer cells in different kinds of tumours, i.a. in non-small-cell lung cancer. Cell growth signal is transmitted from EGFR (HER1), after its heterodimerisation with other member of HER family (ERBB2 - HER2, HER3 or HER4), through phosphorylation of Pi3K AKT and RAS RAF MAPK mTOR pathway. The phosphorylation takes place due to EGFR tyrosine kinase activity, which performs hydrolysis of ATP to ADP and free phosphate. Tyrosine kinases are a part of EGFR but also other cell receptors and signalling proteins. Phosphorylation disorder initiated by EGFR tyrosine kinase is associated with the development of NSCLC that is independent from tobacco smoke carcinogens. Blocking of EGFR function may be achieved by using small molecule tyrosine kinase inhibitors (TKI) or monoclonal antibodies (such as cetuximab), which bind to extracellular domain of EGFR. Inhibition of tyrosine kinase function by TKI-EGFR is much...

Patient Related Barriers to Smoking Cessation

There are several patient level barriers for smoking cessation in cancer survivors including high nicotine dependency, urgency of cessation advice, cancer-specific health beliefs, psychological distress, disease and treatment variables, social network influences and misreporting of smoking status. Table 3. Smoking Cessation in Cancer Survivors High psychological distress High nicotine dependence Abrupt cessation vs. commitment to Patients diagnosed with tobacco-related cancers typically report long histories of heavy tobacco use.62,68,86 Heavy cumulative tobacco exposure is associated with strong nicotine dependency and severe withdrawal symptoms (i.e., cravings, restlessness, difficulty concentrating, insomnia, etc.) following smoking abstinence. Thus, cessation approaches in cancer survivors may require consideration of combined pharmacotherapies to address both nicotine withdrawal and other common symptoms such as anxiety and depression. The perceived urgency for abrupt and...

Nicotine Tolerance And Dependence

Nicotine is the pharmacologic agent that acts on the central nervous system (CNS). Its actions are seen in the brain where it operates on cholin-ergic receptors. The cigarette is a very fast and effective delivery system and effects occur rapidly after a single inhalation of tobacco smoke. Nicotine quickly crosses the blood-brain barrier and, once in the brain, interacts with brain receptors. Nicotine alters moods and acts on pleasure-seeking receptors in the brain, including dopamine and serotonin. The nicotine alkaloid affects numerous body systems It raises blood pressure and the heart rate. It also affects the peripheral nervous system (PNS) and both stimulant and depressive effects are observed in cardiovascular, endocrine, gastrointestinal, and skeletal systems. Initial exposure to nicotine is not a pleasant experience, often causing sickness, intoxication, and disruptions in physiologic functioning. After a period of daily smoking (assumed to be at least a few weeks), the body...


Cigarette smoking is a major risk factor for cardiopulmonary disease. Because of its attendant high risk, smoking cessation is a major goal of risk-factor management. This aim is especially important in the overweight or obese patient, who usually carries excess risk from obesity-associated risk factors. Thus, smoking cessation in these patients becomes a high priority for risk reduction. Smoking and obesity together apparently compound cardiovascular risk, but fear of weight gain upon smoking cessation is an obstacle for many patients. Therefore, the panel recommends that All smokers, regardless of their weight status, should quit smoking. Evidence Category A. Prevention of weight gain should be encouraged and if weight gain does occur, it should be treated through dietary therapy, physical activity, and behavior therapy, maintaining the primary

Stopping smoking

Smokers have lower fertility than non-smokers The many toxic substances in tobacco smoke have negative effects on sperm count, follicle development, ovulation, transport of the egg through the fallopian tubes, fertilisation and embryo development yes, pretty much every aspect of fertility Women who smoke need nearly twice as many IVF cycles to conceive as non-smokers. The risk of early pregnancy loss after IVF treatment is twice as high for women who smoke as for non-smokers. Quitting smoking can be extremely difficult, because nicotine is a very addictive substance, but if you and or your partner smoke, make a pact to kick the habit before you start IVF treatment. Many effective methods are available to make quitting smoking easier. To find out how you can help yourself to stop smoking once and for all


Prenatal exposure to smoking has been linked with a number of impairments to the fetus, including impairments to memory, learning, cognition, and perception. Such impairments may result from chronic fetal hypoxia, a loss of oxygen to the cells that may impair normal development of the central nervous system. Maternal smoking during pregnancy also affects the respiratory system of a fetus, and newborns of smokers tend to have reductions in expiratory flows. It may also alter the developing lung and result in respiratory illness in the infant. Low birth weight is another factor commonly associated with prenatal exposure to smoking, and even passive smoking that is, from the father or another person in the vicinity of the mother seems to affect an infant's weight. Some studies have shown an average decrease in birth weight of about 200 grams in newborns whose mothers smoked throughout pregnancy. The risk of a low-birth-weight infant has also been estimated to be two to four times greater...

Effects Of Nicotine

The first pharmacological studies of nicotine were initiated in 1843 by Orfila. Nicotine is an Nicotine Effects in the Body. The actions of nicotine in a human body are complex. They depend on the amount of nicotine given, the route of administration (e.g., by mouth or intravenously), the time over which the dose is given, and the individual's history of exposure to nicotine. In high doses, nicotine produces nausea, vomiting, convulsions, muscle paralysis, cessation of breathing, coma, and circulatory collapse. Such high doses are seen after accidental absorption of a nicotine-containing insecticide or an overdose of nicotine. In lower doses, such as those used by people who consume tobacco products, the effects are very different. They include a speed up in heart rate and blood pressure increased force of contraction of the heart constriction of blood vessels in the skin, producing cool, pale skin constriction of blood vessels in the heart relaxation of skeletal muscles increased...

Nicotine Addiction

Addiction to nicotine is well documented. The development and characteristics of nicotine addiction are described in detail in a report from the U.S. Surgeon General published in 1988. In this report, The Health Consequences of Smoking Nicotine Addiction, the surgeon general presents criteria for nicotine addiction including the following 1. Highly controlled or compulsive use. Smokers have great difficulty abstaining. Seventy percent of the 45 million smokers in the United States today report that they would like to quit and can not. 2. Psychoactive effects. Nicotine, as described earlier in this article, has pronounced effects on the brain. 3. Drug-reinforced behavior. Tobacco use is motivated by a desire for the effects of nicotine. People do not smoke cigarettes that do not contain nicotine. Very few people choose to smoke cigarettes that deliver very low doses of nicotine. (See also the article on tobacco.) Other factors lead to the conclusion that nicotine is addictive 1. It is...

Nicotine Abuse

Smoking remains a major public health problem. According to the World Health Organization, there are 1.1 billion smokers worldwide. According to the U.S. Center for Disease Control, there are 46.2 million adult cigarette smokers in the United States. Tobacco use in the United States results in > 440,000 deaths each year (about one in five deaths.) The economic costs (medical costs and lost productivity) of tobacco use are > 150 billion. Tobacco contains nicotine, which binds to nicotinic acetylcholine receptors. These receptors bind acetylcholine, but they also are activated by nicotine, an action inhibited by curare. Tobacco is a stimulant that improves alertness, memory, and mood, but it also forms a strong physical and psychological chemical dependence (addiction). Furthermore, nicotine can increase anxiety, restlessness, and disturb metabolism. The continual activation of nicotinic acetylcholine receptors can cause a person to become addicted to smoking, requiring...

Tobacco Dependence

One commonly used pharmacological treatment for tobacco dependence is a nicotine-containing gum called Nicorette. The main reason to quit smoking cigarettes is its powerful association with lung cancer, emphysema, and other medical problems. Yet nicotine, the active ingredient in cigarettes, is another drug that is associated with pleasant effects and with withdrawal discomfort, thereby making it an extremely addicting drug. Providing cigarette smokers with nicotine replacement in the form of a gum will help them avoid the health risks associated with smoking cigarettes. One problem with Nicorette is that it is difficult to chew correctly and therefore people need to be trained in how to chew it in order to derive the therapeutic effect. Recently, a patch has been developed that is placed on the arm and automatically releases nicotine. A method that shows good potential as a treatment, the patch was made avail able in the early 1990s. Detoxification from nicotine may also be...

Tobacco and Nicotine

Tobacco is one of the most powerful stimulant plants known, and nicotine its active principle is one of the most toxic of all drugs. An average cigar contains enough nicotine to kill several people. When tobacco is smoked, most of the nicotine is destroyed by the heat of burning. (To kill people with a cigar, you'd have to soak the cigar in water till it turned dark, then make people drink the liquid.) Nicotine is so strong and dangerous that the body very quickly develops tolerance to it to protect itself. If a person begins smoking regularly, tolerance to the poisonous effects of nicotine develops in a matter of hours (as compared to days or weeks for heroin and months for alcohol). In the form of cigarettes, tobacco is the most addictive drug known. It is harder to break the habit of smoking cigarettes than it is to stop using heroin or alcohol. Moreover, many people learn to use alcohol and heroin in nonaddietive ways, whereas very few cigarette smokers can avoid becoming addicts....

Lung Biology In Health And Disease

Pathogenesis and Therapy of Lung Cancer, edited by C. C. Harris 37. Biology of Lung Cancer Diagnosis and Treatment, edited by S. T. Rosen, J. L. Mulshine, F. Cuttitta, and P. G. Abrams 58. Lung Cancer Differentiation Implications for Diagnosis and Treatment, edited by S. D. Bernal and P. J. Hesketh 74. Epidemiology of Lung Cancer, edited by J. M. Samet 122. Biology of Lung Cancer, edited by M. A. Kane and P. A. Bunn, Jr. 140. Multimodality Treatment of Lung Cancer, edited by A. T. Skarin

An Ounce of Prevention

The key message of this comprehensive scientific analysis Cancer is a preventable disease, and as many as 375,000 cases of cancer (at current cancer rates) could be prevented each year in the United States alone through healthy dietary choices. The recommendations include adopting a predominantly plant-based diet, rich in a variety of vegetables, fruits, grains, and legumes, maintaining a healthy weight, and performing at least one hour of vigorous exercise each week. According to the National Cancer Institute, 80 percent of cancers are due to factors that have been identified and can potentially be prevented. Lifestyle choices are the most significant contributor, with 30 percent due to tobacco use, and as much as 50 percent due to food choices.

Incidence and mortality

In Table 1 absolute numbers and age-standardized rates of incidence and mortality are presented for selected regions and countries 1 . In 2008 it was estimated that nearly every seventh case of male malignoma was prostate cancer (899 thousand new cases, 13.6 of the total). Therefore, in men prostate cancer was the second most diagnosed cancer after lung cancer. Approximately three quarters of these cases were diagnosed in more developed countries. The highest incidence rates were measured in Australia, New Zealand, Northern and Western Europe and Northern America. Moderate incidence rates were found in South

Acetylmethadol See LAlpha

Born exposed to alcohol and illicit drugs while in the uterus a far larger number have been exposed, in utero to sedatives and nicotine. The increased recognition of such drug-exposed babies parallels the dramatic increase in drug use, both licit and illicit, by women since the beginning of the 1970s. Drug-addicted women often use multiple substances including ALCOHOL, NICOTINE, MARIJUANA, Tranquilizers, Cocaine, and Opioids (e.g., Heroin and Methadone). The drugs are carried across the placenta from mother to fetus. The clinical presentation of the newborn (neonate) depends on the substance, the amount and frequency used during pregnancy, and the time since last use. Withdrawal will occur in 55 to 94 percent of infants exposed to heroin and other opioids. Infants of regular heavy users usually have a low birth weight, because of intrauterine growth retardation and frequent premature births.

Prevention Implications

Adolescent drug use must be considered in relation to the normal developmental challenges of adolescence. Because individuals use drugs in different ways for many reasons, no single prevention program will be effective with all groups at all ages. Understanding the factors that determine the link between the usage of one drug to the usage of another has important policy implications for developing prevention and educational programs. The sequential nature of drug use, as it is now understood, would indicate that prevention efforts targeted toward reducing or delaying adolescents' initiation into use of alcohol and cigarettes would reduce these adolescents' use of marijuana and other drugs. Similarly, efforts targeted toward reducing adolescents' marijuana use might reduce the rates of these adolescents' progression to ''higher'' stages of drug involvement. Prior drug use is a risk factor for progression that is, the use of one drug may increase the likelihood of use of another drug,...

Novel Biomarkers in Pancreatic Cancer

Another candidate cell marker investigated was aldehyde dehydrogenase 1A1 (ALDH1A1), which has been identified to label cancer stem cells in breast cancer (Ginestier et al., 2007), colon cancer (Huang et al., 2009), lung cancer (Jiang et al., 2009) and head and neck squamous cancer (Chen et al., 2009). ALDH1 is a member of the aldehyde dehydrogenase gene (ALDH) superfamily playing an important role in the metabolism of endogenous and exogenous aldehydes. This NAD(P)(+)-dependent enzyme is also involved in the formation of molecules that are important in cellular processes, like retinoic acid (acting like modulator of gene regulation and cell differentiation), betaine and gamma-aminobutyric acid and exhibits additional, non-enzymatic functions, being able to bind to some hormones (Yoshida et al., 1998). The ALDH1 gene expression is ubiquitous in many human tissues the protein is found localized mainly in the cellular cytoplasm. Several studies have shown that enolase 1 plays an...

Directtoconsumer Advertising

Merrell Dow was next, using DTC ads to inform the public that physicians had a new treatment to help smokers who wanted to stop smoking. When the company's new, nonsedating antihistamine became available, it used DTC ads to tell allergy sufferers that physicians now had a new treatment for allergies. The ads did not mention the name of the products rather, they asked patients with specific problems or symptoms to see their physician. To promote Nicorette, a NICOTINE-containing gum designed to help smokers stop smoking, Mer-rell Dow advertised it on television with the message that Nicorette was now available at phamacies but only by prescription and under a doctor's supervision. According to FDA rules at that time, Merrell Dow could not say that Nicorette was useful in helping smokers who wanted to stop smoking since it had included the name of the product in the commercial. When a company has the only or the major product in the market, this approach can be...

Socioemotional Well Being

African-American male adolescents are more likely than their European-American counterparts to be labeled conduct disordered or antisocial to be disciplined, suspended, or expelled from junior high and high school and to be arrested and incarcerated. Some of these differences appear to reflect racial bias resulting in more harsh treatment of African-American adolescents for comparable offenses. Generally, studies of self-reported delinquency find no race differences. For several decades, however, the rate of death from homicide has been higher for African-American male adolescents than European-American adolescents. In annual national surveys conducted since the early 1980s, African-American adolescents, compared to European-American and Hispanic adolescents, consistently reported the lowest level of marijuana use, the lowest prevalence of alcohol use and binge drinking, and the lowest level of cigarette smoking. School-based surveys probably underestimate drug use by African-American...

Understanding The Smoking Habit

Almost all smokers started before the age of 21 most before the age of 18 many before the age of 14. Young people who learn to inhale cigarette smoke and experience the mood-altering effects from the inhaled nicotine quickly become dependent on cigarettes to help them cope with the complexities of everyday life. Having developed a nicotine dependence, they find they must continue smoking to avoid the downside of nicotine withdrawal. The earlier they start to smoke, the more dependent they seem to become and the sooner they start to experience smoking-related health problems. Six years of research at the National Center on Addiction and Substance Abuse at Columbia University reveals that a child who reaches age 21 without smoking, using illegal drugs, or abusing alcohol is virtually certain never to do so. A survey conducted by the U.S. Department of Health and Human Services among high school students who smoked half a pack of cigarettes a day found that 53 percent had tried to quit...

Purpose Of Cigarette Advertising

To offset the effect of thousands of studies showing the adverse health effects of smoking and of the requested warning labels on cigarette packages, the tobacco industry has continued to claim that no one has yet ''proven'' that smoking ''causes'' health problems that these are just ''statistical associations.'' But, recently in Florida, a six-person jury decided, on April 7, 2000, that tobacco companies' cigarettes were a deadly, addictive, and defective product and caused cancer for three smokers who sued the industry in a class-action lawsuit. The companies must pay 12.7 million to the plaintiffs. The jury has yet to decide the punitive damages, which could be massive. The state of Florida, in order to protect its tobacco payments in the future, passed a law capping the amount of bond the companies would have to post in order to appeal such punitive damages at 100 million or 10 percent of the company's net worth, whichever is less. 2. To associate...

History Of Tobacco Advertising And Promotion

Tobacco advertising and promotional expenses have steadily increased. In 1997, the tobacco companies spent 5.66 billion to promote their products, up from 5.11 billion in 1996. The largest category of spending was for promotional allowances to wholesalers and retailers, 2.4 billion, more than double their spending in 1990. Next were expenditures for retail value added. At 970 million, this category includes non-cigarette items given away with cigarettes. Coupons and multiple STAT (Stop Teenage Addiction to Tobacco), at their 1991 STAT-91 Conference, addressed the problem of tobacco companies' efforts to encourage tobacco addiction in young people. It was learned that the RJR Nabisco cartoon camel was at the center of the most extensive advertising campaign ever created to influence the values and behavior of young people. Camel's share of the teenage market rose from almost nothing to almost 35 percent in just three years by ''this sleazy dromedary.''

Deficiency Signs And Symptoms

Low serum beta-carotene levels have been associated with male gender, younger age, lower non-HDL-cholesterol, greater ethanol consumption and higher BMI (Brady et al 1996), increased lipoprotein density and the presence of inflammation (Kritchevsky 1999), high C-reactive protein (Erlinger et al 2001), high blood glucose (Abahusain et al 1999), hypertension (Coudray et al 1997), exposure to environmental tobacco smoke (Farchi et al 2001), as well as all measures of obesity (Wallstrom et al 2001), including obesity in children (Strauss 1999).

Anticarcinogenic Activity

A review of carotenoid research by the International Agency for Research on Cancer suggests there is sufficient evidence that beta-carotene has cancer-preventive activity in experimental animals, based on models of skin carcinogenesis in mice and buccal pouch carcinogenesis in hamsters (Vainio & Rautalahti 1998), despite a review suggesting that beta-carotene does not protect against lung cancer in animals (De Luca & Ross 1996). None of these mechanisms has been conclusively found to contribute to preventing cancer in vivo and there is ongoing debate as to the role of beta-carotene in cancer prevention (Cooper et al 1999, Patrick 2000). This debate has been further fuelled by the findings of two large intervention studies, the Alpha-Tocopherol Beta-Carotene (ATBC) Cancer Prevention Study (the 'Finnish study' Heinonen et al 1994) and the Carotene and Retinol Efficacy Trial (CARET Omenn et al 1996a), which found a significantly increased risk of lung cancer in high-risk...

Environmental Factors

Additional variables have been associated with an increased risk of ovarian cancer. An example is saturated fat consumption (OR 1.20 for each 10 g day of intake 95 CI 1.03 to 1.40 P .008).35 Clinical and epidemiologic studies have conflicting views on an association between ovarian carcinoma and talcum powder use.36,37 Coffee and tobacco consumption has not been found to be associated with an increased risk.38 Obesity is a risk factor for several hormone-related cancers, but evidence of an effect on risk of epithelial ovarian cancer remains inconclusive. Some studies have shown a positive correlation between early adulthood obesity and ovarian cancer.39 Alcohol consumption has not been associated with increased risk.40,41 A history of pelvic inflammatory disease and endometriosis (endometrioid and clear cell histologies) has been associated with ovarian cancer.42,43

Bovine spongiform encephalopathy

Bronchitis Inflammation of the airways that connect the windpipe (trachea) to the lungs, resulting in persistent cough with quantities of phlegm or sputum. Attacks usually occur in the winter among smokers, babies, the elderly, and those with lung disease, although anyone can get bronchitis. Cigarette smoking is the primary cause of chronic bronchitis, because it stimulates the production of mucus in the lining of the bronchi and thickens the bronchi's muscular walls and those of smaller airways in the lungs, narrowing those passages. The passages then become more susceptible to infection, which cause further damage. Air pollution can have the same effect. The disease is most prevalent in industrial cities and in smokers, and more common in manual and unskilled workers.

Cardiovascular Disease

Epidemiological studies support the idea that a diet rich in high carotenoid containing foods is associated with a reduced risk of heart disease (Kritchevsky 1999). A review of observational and intervention studies on beta-carotene and the risk of coronary heart disease found that seven cohort studies (Gaziano et al 1995b, Gey et al 1993, Knekt etal 1994, Manson etal 1991, Morris et al 1994, Rimm et al 1993, Street et al 1994) reported relative risks between 0.27 and 0.78 for high serum beta-carotene levels or high dietary intake and that this was supported by case-control studies (Bobak et al 1998, Bolton-Smith et al 1992, Kardinaal et al 1993, Torun et al 1994, Tavani et al 1997) that reported odds ratios between 0.37 and 0.71, with a possible stronger protection for current smokers (Tavani & La Vecchia 1999). These results contrast with those of four more recent cohort studies (Knekt et al 1994, Kushi et al 1996, Pandey et al 1995, Todd et al 1995) and five large RCTs (Buring...

Macular Degeneration and Cataracts

However, the Linxian trial found no influence of vitamin supplementation on risk of cataract the ATBC trial found no reduction in the prevalence of cataracts with vitamin E, -carotene, or both among male smokers and the Health Physicians Study of more than 22 000 men showed no benefit from 12 years of supplementation with -carotene (50 mg on alternate days) on cataract incidence. In fact, current smokers at the beginning of this trial who received the supplement experienced an increased risk of cataract (by approximately 25 ) compared to the placebo group. The Vitamin E, Cataract and Age-Related Maculopathy Trial also reported no effect of supplementation with vitamin E for 4 years (500 IU day) on the incidence or progression of cataracts or AMD.

Overview Of Patterns Of Asbestos Use And Recognition Of Its Health Consequences

A number of adverse health outcomes are now causally associated with exposure to asbestos. An approximate timeline for recognition of the adverse consequences is provided in this section, as drawn from published sources. The first to be recognized was asbestosis, a pneumoconiosis characterized by fibrosis of the lung and reduction of lung function (Table 1.1), first reported as early as 1907 (Hamilton and Hardy 1974, as cited in Becklake 1976). Iron-coated fibers, called asbestos bodies, are typically found in the tissues of affected lungs. Mesothelioma, an uncommon tumor of the pleural and peritoneal mesothelium (tissues lining the thoracic and abdominal cavities and the organs in them), was linked to asbestos in the early 1960s in clinical case reports, and the increased risk was then further shown in cohort studies of asbestos workers. In the 1950s, epidemiologic studies documented the association of lung cancer with asbestos exposure, and the risk was found to be particularly...

Drug therapy or lifestyle modification

Many patients are unwilling, or unable, to live up to the high expectations of lifestyle modification. Also, there seems little reason to expose the vascular tree of a patient, and its target organs, to an elevated pressure for months before antihypertensive therapy is started. Importantly, there is no justification to deny antihypertensive therapy to patients who are unable to modify their alcohol intake to the desired two drinks a day, to overweight patients who are unable to shed the necessary pounds, or to smokers who are unable, or unwilling, to give up cigarettes. To the contrary, BP needs to be aggressively treated in such patients because they have comorbid factors that greatly accelerate the long-term repercussions of hypertensive cardiovascular disease.

Specific Hip Conditions

Legg-Calve-Perthes disease (LCP) results from softening of the head of the femur (the long bone of the leg), which gradually becomes distorted and may flatten or crumble (see Fig. 3-3). It is thought that this results from problems with the blood supply to the head of the femur, which may be caused by an injury or congenital abnormality. One report has suggested that LCP occurs far more frequently in the children of parents who smoke. However, problems with the environment or blood supply cannot be the whole answer, since LCP occurs four times more often in boys than in girls.

Dietary Sources and High Intakes

Vegetables deficiency is likely in people whose habitual intake of fruit and vegetables is very low. However, clinical signs of deficiency are rarely seen in developed countries. The range of intakes by healthy adults in Britain reflects fruit and vegetable consumption the 2.5 percentile intake is 19 mg per day (men) and 14 mg per day (women), while the 97.5 percentile intake from foods (excluding supplements) is 170 mg per day (men) and 160 mg per day (women). Smokers may be at increased risk of deficiency there is some evidence that the rate of ascorbate catabolism is 2-fold higher in smokers than in nonsmokers.

Degradation Turnover and Factors that Induce Increased Requirements for Vitamin C

It remains largely a mystery why some people succumb to classical scurvy after a short period of virtually zero intake, whereas others survive for much longer. It has been speculated that some people may be able to produce all of the enzymes of the vitamin C synthetic pathway, including gulo-nolactone oxidase, which is normally absent from humans. However, this now seems unlikely, and it is more probable that the retention and recycling mechanisms for the vitamin are more efficient in some people than in others. We now know, for example, that smokers have a higher turnover of endogenous vitamin C than non-smokers, presumably because of the free-radical oxidant species in cigarette smoke. People with infections also have increased vitamin C turnover, which is associated with the liberation of pro-oxidant substances (such as hypochlorous acid) that are used by the body to kill bacteria. Some people have isoforms of certain blood proteins such as haptoglobins that are associated with...

The Fourstage Intervention

The third intervention involves having the clients introduce themselves, their diagnoses, and give some medical information or update, and psychosocial history, almost every session. It is important to have clients state their diagnoses and some understanding of what is involved with that diagnosis, whether it is considered treatable or not. For many group members, this is the only place they can talk openly, without shame or blame (if they have HIV AIDS, or lung cancer),

General Approach To Evidence Review

The committee was charged with assessing the evidence concerning the causation of selected cancers, other than lung cancer and mesothelioma, by exposure to asbestos fibers. The charge required that the committee compile and review the available evidence, attempting to identify all relevant epidemiologic studies, and then evaluate whether the evidence was sufficient to infer the existence of a causal relationship. There are now well-established models for meeting the charge, dating as far back as the landmark 1964 report of the US surgeon general on smoking and health (HEW 1964), which reached the conclusion that smoking causes lung cancer and other diseases. That report assembled the full body of relevant scientific evidence and evaluated it according to formal guidelines. Abundant, comprehensive reviews of various other agents have since been conducted to gauge whether the sets of evidence associating them with particular health outcomes warrant causal conclusions. Effect...

Applications in Substance Abuse Research

Since all drugs of abuse are fundamentally organic (i.e., carbon containing) molecules, 11C radiochemistry makes PET uniquely suited to the study of their pharmacokinetics (i.e., since insertion of the radiolabel does not alter the native pharmacology of the parent drug). In fact, PET radiotracers currently exist for 11C cocaine, 11C heroin, 11C morphine, and 11C nicotine (Hartvig et al., 1984 Fowler et al., 1989 Halldin et al., 1992), and tracer doses of these compounds have been used to study the pharmacokinetics of each in vivo. Among the earliest applications is work by Fowler and colleagues (Fowler et al., 1989). Their pioneering work with 11C cocaine in humans demonstrated extremely high levels of brain uptake (8-10 of the injected dose) into basal ganglia (a brain region containing the highest concentrations of dopamine transporters) that occurred rapidly (peaking within 4-6 min) and cleared quickly (with an initial brain half-life of approx 20 min). These studies were...

Assembly of Literature Database

The biomedical literature concerning asbestos is vast (about 25,000 citations in the searchable reference databases MEDLINE and EMBASE), but much of it exclusively addresses asbestos's role in causing asbestosis, lung cancer, and mesothelioma. Given the committee's circumscribed task of answering the question of whether this known carcinogen plays a causal role in producing pharyngeal, laryngeal, esophageal, stomach, or colorectal cancer (selected cancers), the committee saw no need to revisit the entire body of information on asbestos's biologic activity or even to review the entire epidemiologic literature on asbestos exhaustively. The subset of epi-demiologic literature referring to the selected cancer sites, however, did need to be identified comprehensively, retrieved when possibly pertinent to the task, and thoroughly reviewed when found to be relevant. The secondary literature (e.g., ATSDR 2001 Becklake 1979 EPA 1986 IARC 1977, 1987 Kleinfeld 1973 Landrigan et al. 1999 Li et...

How can I improve my symptoms of GERD

Other lifestyle changes that may also be beneficial include stopping smoking, losing weight, and wearing loose clothing. Smoking hinders the protective factors against reflux, for example, decreasing saliva production. Wearing loose clothing and losing weight reduce the pressure on the stomach that can cause acidic fluid to be forced back into the esophagus.

Physical associations with fatigue

Perhaps surprisingly, very few studies have reported associations between site of primary disease and fatigue. One exception is an important study by Glaus (1998) who performed a cross-sectional study on 583 inpatients and outpatients attending a Swiss cancer centre. Lung cancer, melanoma, and ovarian cancer had the highest rates of fatigue, whereas tes-ticular cancer and breast cancer had the lowest. This may be due to the stage of disease lung cancer, for example, may present later than breast cancer. The same study found a strong association between stage of disease and fatigue, with patients in remission

Autocrine loops 2 receptor tyrosine kinases and downstream effectors

IGF-1R is another relevant RTK expressed in SCLC that mediates mitogenic and cellular differentiation signals. In addition, SCLC cell lines also secrete the ligands IGF-1 and IGF-2 171, 172 , being the former currently associated with lung cancer risk 173, 174 . The therapeutic relevance of IGF-1R has been emphasized by the development of an IGF-1R-blocking antibody and an IGF-1R inhibitor, that inhibit the growth of SCLC cell lines, unless they have constitutively high Akt activation 175, 176 .

Has she had any problems with past pregnancies or births

Find out if the baby was born early (it is normal for early babies to be small). If the baby came on time, ask the mother if she had anemia, high blood pressure, or pre-eclampsia . Also ask if she had enough to eat, or if she smoked cigarettes or used drugs . Any of these things could have made the baby small

Summary of Known Relations between Diet and Cancer

See also Alcohol Disease Risk and Beneficial Effects. Cancer Epidemiology of Gastrointestinal Cancers Other Than Colorectal Cancers Epidemiology of Lung Cancer Effects on Nutritional Status. Dietary Fiber Potential Role in Etiology of Disease. Dietary Surveys. Vegetarian Diets.

The Potential Therapeutic Role of Vitamins

Although vitamins in food, especially vegetables and fruits, have been shown to be beneficial in reducing the incidence of particular types of cancer when included in the diet, the beneficial effects have not always been shown with vitamin and mineral supplements. Some supplements may promote tumor growth, as was seen in a study using -car-otene supplementation in patients with lung cancer. Supplementation increased the rate of tumor recurrence in such patients. See also Cancer Epidemiology and Associations Between Diet and Cancer Epidemiology of Gastrointestinal Cancers Other Than Colorectal Cancers Epidemiology of Lung Cancer Effects on Nutritional Status. Cobalamins. Colon Nutritional Management of Disorders. Diarrheal Diseases. Eating Disorders Anorexia Nervosa. Folic Acid. Nutritional Support Adults, Enteral Adults, Parenteral Infants and Children, Parenteral. Supplementation Dietary Supplements. Vitamin B6. Vitamin D Physiology, Dietary Sources and Requirements. Vitamin E

Applications To Health Promotion And Disease Prevention

The significance of betel nut usage in health promotion and disease prevention is limited. It was one of the earliest psychoactive substances used in the world, mainly in the South Pacific islands, South-east Asia, and South Asia. It is the fourth most widely used addictive substance in the world, after caffeine, nicotine, and alcohol. Its use is also becoming increasingly frequent among youth, where it may serve as a gateway to tobacco use (Chandra & Mulla, 2007). People chew it for stress reduction, for a feeling of well-being, and for heightened awareness. It contains several psychoactive compounds. Arecoline, the principal alkaloid in betel nut, acts as a stimulant of the nervous system, and increases the levels of noradrenaline and acetylcholine. This leads to subjective effects of increased well-being, alertness, and stamina. Arecaidine,

The Role Tobacco Plays

Tobacco use is an important risk factor in periodontal disease. It is likely that tobacco suppresses certain components of the immune system. Impaired neutrophil (white blood cell) function, induced by the use of tobacco-containing products, appears to have an impact on the gums. In fact, smoking can irritate and stretch the gum tissue. Smoking also suppresses the immune system, leaving you open to frequent infections and gum problems. Tobacco also decreases the vitamin C level in the body, which is needed to build healthy gum tissue. Remedies Try to stop smoking. Seek professional advice if you feel you can't succeed in quitting on your own. Vitamin supplements, especially vitamin C, are helpful in reducing the incidence of gum problems. See your dentist or dental hygienist frequently and create a good oral hygiene regimen.

The risk factors paradigm

By attributing known risk factors, including behavioural, physiological, occupational and environmental ones, to the total number of deaths, or the burden of diseases (measured in DALYs - years of life lost due to premature mortality and disability), it is possible to estimate of how much the burden of diseases is attributable to these selected risk factors (Venkat et al. 2010 WHO, 2009). Based on such analysis, it was realised that more than one third of the world's deaths can be attributed to a small number of risk factors. The five top-ranked risks include high blood pressure, tobacco use, high blood glucose, physical inactivity and overweight obesity. They affect countries of all income groups high, middle and low (Figure 1) (WHO, 2009). When taking into account the fact that two leading world's causes of death include cardiovascular diseases and cancers, this is likely to suggest that avoiding tobacco and obesity, and using regular physical activity, can provide the greatest...

Hydrocarbon Carotenoid bCarotene

-Carotene is one of the most widely studied carot-enoids - for both its vitamin A activity and its abundance in fruits and vegetables. Epidemiological studies have often pointed to an abundance of carot-enoids in the diet being protective against many diseases. Diets rich in fruits and vegetables are recommended to reduce the risk of cardiovascular disease and some forms of cancer. However, when 3-carotene is removed from the plant matrix and administered as a supplement, these benefits sometimes disappear. For example, because lung cancer is Carotenoid Cardiovascular disease Cataract Macular degeneration Lung cancer Prostate cancer Carotenoid Cardiovascular disease Cataract Macular degeneration Lung cancer Prostate cancer the leading cause of cancer death in many developed countries, the fi-Carotene and Retinol Efficacy Trial (CARET) in the 1990s set out to test whether fi-carotene conferred protection against cancer. CARET was based on a number of observational studies that showed...

Xanthophyll bCryptoxanthin

3-Cryptoxanthin is one of the lesser known carote-noids that also has provitamin A activity and appears to have a protective health role. Several epidemiological studies suggest that dietary 3-cryptoxanthin is associated with lower rates of lung cancer and improved lung function in humans. A large prospective study on dietary intake and cancer, which included an interview on dietary habits and life style, identified -cryptoxanthin as protective against lung cancer after correcting for smoking. However, the beneficial effects for -cryptoxanthin suggested by these results could be merely an indicator for other antioxidants and or a measure of a healthy life style that are more common in people with high dietary intakes of -cryptoxanthin. In tissue culture, -cryptoxanthin has a direct stimulatory effect on bone formation and an inhibitory effect on bone resorption. Studies of these beneficial effects in humans have not been conducted.

Environmental pollution and industrial carcinogenes

The discovery of smoking tobacco as a factor being strongly associated with lung cancer (more than 85 of lung cancers occur among smokers), has further emphasized the definition of other external factors that could probable cause cancer (that are termed carcinogenes) (American Cancer Society, 2007, as cited in Majnaric-Trtica, 2009 Pearce, 1996, as cited in Majnaric-Trtica, 2009). Accordingly, at least 150 chemicals and other agents, including ionizing radiation, occupational (workplace) and environmental airborne particles, some drugs, as well as foods and other consumer products, have been listed so far by IARC, as potential carcinogens (American Cancer Society, 2007, as cited in Majnaric-Trtica, 2009 WHO, 2009). It is estimated, for example, that occupational exposure to microscopic airborne particles accounts for 8 of lung cancer, that is the most frequent form of occupational cancer (compared to 12 of deaths due to chronic obstructive pulmonary disease) (WHO, 2009). The...

Canada Drug And Alcohol

In 1996, 29 percent of adults were current smokers and another 29 percent were former smokers. Overall, the percentage of the population who smoke has been dropping since the 1970s. Practically all TOBACCO is consumed as cigarettes, with daily consumption per smoker estimated at 20.6 (more than one pack) in 1996.

Global cancer statistics and calls for action 51 Global cancer statistics

The most frequent cancer site diagnosed in females worldwide is breast cancer and it is also the leading cause of cancer death, comprising 23 of the total cancer cases and 14 of the cancer deaths. In general, the highest incidence rates are registered in the most developed regions, although 60 of the deaths occur in developing countries. Brest cancer is now the leading cause of cancer death among females in developing countries, a shift from cervical cancer which held this unfavorable position in the past decades. The second and the third most frequently diagnosed cancers in females are colorectal and lung cancers, the reverse order in cancer mortality (Table 1) (Jemal et al., 2011). In males, the most common cancer site and the leading cause of cancer death is lung cancer, comprising 17 of the cancer cases and 23 of the cancer death (Table 2). Colorectal and prostate cancers are at the second and the third positions in cancer incidence and follow the same order in cancer mortality,...

Effects On Microcirculation And Nitric Oxide

A double blind, dose-finding study found that flavanol-rich cocoa increased circulating NO species in the plasma of male smokers, with maximal effects seen with ingestion of 176-185 mg flavanols (Heiss et al 2005). Another double-blind trial found that ingestion of a high-flavanol cocoa drink, but not a low-flavanol one, enhanced NO bioactivity and increased plasma concentrations of nitroso compounds 2007 Elsevier Australia

Childrens Craniofacial Association CCA A

The act authorized the development of a national surveillance program designed to improve the understanding of maternal complications and mortality, authorized research into risk factors and prevention, and authorized public education campaigns to promote healthy pregnancies. Finally, it authorized funding for research initiatives and programs to prevent drug, alcohol, and tobacco use among pregnant women.

Bcl2 in SCLC prognosis

Bcl-2 is frequently expressed in SCLC cell lines 247 and tumors 248-251 , suggesting that it plays a role in the pathogenesis of the disease. Nevertheless, there is no correlation between Bcl-2 expression and resistance to therapy and or survival 252-256 . The relation to tumor stage is less clear, ranging from no relation to positive correlation, depending on the author 255, 257 . A correlation between Bcl-2 expression and decreased incidence of metastases, indicating attenuation or resistance to apoptosis, has also been reported 258 . Recently, in a series of 205 carcinomas, including lung cancer, Bcl-2 expression was associated with better overall survival. The risk of mortality was 2.3-fold higher in patients without Bcl-2 expression. Bcl-2 appeared to be the key biological factor influencing clinical behavior in the most common epithelial cancers 259 . Furthermore, despite higher Bcl-2 expression, SCLC cell lines present higher spontaneous apoptotic index than other lung cancer...

Economic Costs of Overweight and Obesity

Alarm about the increasing prevalence of overweight and obesity in the United States in recent years 54, 55 centers on the link between obesity and increased health risks, 42, 56 which translates into increased medical care and disability costs. 46,57 The total cost attributable to obesity amounted to 99.2 billion in 1995. Approximately 51.6 billion of these dollars were direct medical costs associated with diseases attributable to obesity. The direct costs also associated with obesity represent 5.7 percent of the national health expenditure within the United States. 58 The indirect costs attributable to obesity are 47.6 billion and are comparable to the economic costs of cigarette smoking. 58, 59 Indirect costs represent the value of lost output caused by morbidity and mortality, and may have a greater impact than direct costs at the personal and societal levels. 58

Cofactors in Biochemical Pathways

One sees that at least seven distinct B vitamin-derived coenzymes are needed to complete the transition. Nicotine adenine dinucleotide (NAD+), derived from niacin, is required for the oxidation of glucose to pyruvate and thiamine pyrophosphate (TPP) derived from the vitamin thiamine (sometimes written as thiamin), flavin adenine dinucleotide (FAD) from riboflavin, panthothenic acid from pan-tothene, and lipoic acid all take part in the oxidation of pyruvate to acetyl-coenzyme A in the middle stage. In addition, flavinmononucleotide (FMN) also from riboflavin and coenzyme Q from ubiqui-none take part in completing the oxidation to CO2 and H2O in the oxidative-phosphorylation pathway in the mitochondria. All told, some 20 organic cofactors engage enzymes in the various biochemical pathways of humans. Below is a brief description of each coenzyme cofactor. Table 2 summarizes the list of key enzymes known to be associated with each coenzyme.

Immune System In Cancer Treatment

The immune system's postulated role in preventing cancer by destroying cancer cells, along with other evidence, tells us it can also help destroy cells of established cancers. Its ability to do so, referred to as antitumor immunity, involves both the innate and adaptive immune systems. For example, recent evidence suggests the immune system may be capable of detecting the protein products of oncogenes on the cell surface immune responses to the HER-2 neu protein and mutated ras and p53 gene products have been re-ported.20,21 In addition, antibodies against the patient's own tumor have been identified in the sera of some patients with soft-tissue sarcoma, malignant melanoma, ovarian carcinoma, and lung cancer.22

Tea and Cancer Prevention

Cancer of the esophagus is decreased in animal models by tea (40), just as a lower risk is noted in parts of China of cancer of the esophagus in people who drink tea (41,42, reviewed also in Refs. 43,44). Similar results hold for oral cancer (45). There are more cigarette smokers in Japan than in the United States but the incidence of lung cancer in Japan is lower than in the United States, possibly because there are more tea drinkers in Japan, accounting for this protection. In parallel, mice and rats exposed to the tobacco-specific nitrosamines displayed a lower incidence of lung tumors when the animals were drinking tea (46). Even ''spontaneous lung tumors in mice were decreased by intake of black or green tea (47). The mechanism may depend on a reduction of oxidative stress (48). This inhibition by tea was due to lower

The Nutritional Transition and Its Health Effects

With people living longer, and with low birth weight at an all-time low, Asian health should be improving. But with increased Westernization of the Asian diet, elevated tobacco use (generally among Asian men), and lifestyle changes (such as decreased physical activity), there has been a marked rise in cardiovascular disease (CVD), diabetes mellitus, hypertension (high blood pressure), and certain cancers. obesity is also a growing health problem in Asia, and is strongly associated with hypertension (along with body mass index and age). Despite the low obesity levels in the Asia Pacific region, rates of obesity-related diseases such as diabetes and CVD are on the rise. High blood pressure is also a growing problem in Asia. In India, Indonesia, and Thailand alone, nearly 10 to 15 percent of adults have high

Historical And Institutional Factors

In the mid-to-late 1970s, the United States directed its international drug-control attention to eliminating the heroin and marijuana crossing our border at Mexico. As the U.S.-Mexican crackdown began to achieve positive results and the number of U.S. smokers of Mexican marijuana diminished, Colombian traffickers seized the opportunity to break into the lucrative U.S. drug market by smuggling large amounts of marijuana and small packages of cocaine. In the early 1980s, Florida became the destination of choice for smugglers because of its long coastlines, access to boats and planes, location in the Caribbean, and large Hispanic population by 1986, Colombia supplied an estimated 80 percent of the cocaine HCl.

Cytodiagnostic Tools for SCLC

Besides exfoliative cytology, transthoracic fine needle aspiration cytology 18, 19 , transbronchial needle aspiration 20 , endoscopic ultrasonography-guided fine needle aspiration biopsy 21 have been utilized for the diagnosis of lung cancer. In a study of 393 primary lung cancers, the diagnostic methods used by Okutan et al 3 were sputum cytology (27.3 ), transbronchial biopsy and lavage (38.6 ), thoracocentesis and pleural biopsy (15.8 ), transthoracic fine needle aspiration (13.6 ) and open lung biopsy (4.7 ). Transbronchial needle aspiration (TBNA) is a safe, easy to perform, and useful tool for the diagnosis and staging of pulmonary neoplasm, with a minimum of complications 22 . However, the frequency of satisfactory specimen by this tool varies widely, which is as low as 46 22 and as high as 93.4 18 . Khoo et al 23 observed that combining TBNA with the option for EUS-FNA immediately after unrevealing TBNA gave a yield approaching that

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