Another Choice for Smokers

   With Australia on the books and the UK likely to follow, smokers now have label options among their choices.  Actually, it is not going to be a choice but lets pretend that it is for my post.  When buying cigarettes smokers can choose from:

• reg(shorts) or 100s
• menthol or non-menthol
• mild or full flavored (aka light vs not light)
• graphic or Logo package

and now

• graphic or brand(logo) or plain package

   Why the fuss about a pack label?  Tobacco companies use them for branding.  If I asked you to name a cigarette brand - even if you have never smoked, I bet you could name at least two.  Some that come to mind for me are Camel, Kool, Pall Mall, Marlboro, Virginia Slims... etc.  There is an image tied to those brands.  Virginia Slims  associates w/ successful, thin, liberated women.  Marlboro is the rugged, tough, male.  People start smoking, it is suggested, to become that image or have what those people have.  Tobacco companies spend billions of dollars every year to make that so.  Probably they spend more on branding than ever before because the Master Tobacco Settlement of 1998 severely restricted their advertising options and prevent sponsorship of sporting events.
    Health experts use labels to dissuade people from smoking or to encourage them to quit.  Warning labels were expanded with the Family Smoking Prevention and Tobacco Control Act of 2008 (they had to take up more space on the labels), but graphic pictures are due in 2014.  Other countries have been using them for some time.  The USA used the evidence from Australia and the UK to make a case for graphic messages in the 2008 law.  The current CDC print and television ads are also graphic in nature.  
   Graphic labels are effective - but there are not  VERY effective.  
People who smoke have difficulty quitting due to the nature of nicotine addiction.  But why do people even start?  Why do thousands of adolescents try cigarettes every day and many become life long smokers.  Currently 18% of high school students smoke.  Read more statistics about youth smoking at the Tobacco Free Kids website here.
   People start smoking when they are young - usually under the age of 18.  Very few current smokers started after the age of 21.  (I started when I was 15 and smoked 17 years.  I have been quit 15)
   Who is most susceptible to the promise of glamor, sophistication, popularity, success??? Youth.  It is hoped that by making the cigarette packs plain there will be less of a branding effect.  This change may lead to a true reduction in the prevalence of smoking.
   We will have to wait a few years to test the effect of the Australia law - but it sure sounds reasonable in theory!
   

Understanding Triggers

I am 100% against tobacco in its current disease causing form. This includes cigarettes and much smokeless tobacco. There may be nicotine containing nontraditional tobacco products do not cause harm and I will keep a lookout for them. As it stands now, I am against smoking. I find the act and the emissions from it to be quite rebarbative. Smoking harms everyone who is exposed to it. It is bad for the environment and the individual.

I support all smoking bans and I want to tell you why. Other peoples' smoke is a significant trigger to light up or relapse to a nicotine addict. Even seeing tobacco products acts as a trigger to smoke. This trigger is something that manifests itself physically – it is NOT a controllable factor or an absence of willpower. It is a physiological response to access or availability. Let me provide a non-tobacco example so those of you who have never used tobacco can understand – really understand.

Imagine that you have to use the bathroom – to urinate. You have a subtle urge to go, maybe this feels like a 3 on a scale of 1-10. You say, “Well, I can wait a bit.” “I may even be able to wait an hour. Yes, I can wait an hour.” The first half hour the “urge” is steady at 3 or 4. The second hour, the “urge” is beginning to feel like pressure. Now you are at a 5 maybe a 6. (You should absolutely think about this the next time you have to go to the bathroom, so you really get what I am explaining). Okay time to find that bathroom – or that rest stop. You are getting physically closer to the bathroom and then you are there – you SEE the toilet – the “urge” is now an acute, pain in your bladder, at least an 8. You did not do anything, you did not THINK, you saw the toilet and your body, your mind, your neurotransmitters, reacted to it. That is what happens when someone is trying not to smoke and he or she sees cigarettes or people smoking. The smoker or quitter goes from not really thinking about a cigarette to “I must have one.”

Anything that we can do to make smoking harder, WILL make quitting easier.

All Smokeless Tobacco is NOT the Same

I received an email from a colleague with a link to an online magazine piece about re: evidence on the dangers of smokeless tobacco (ST). When I read the brief article I felt the need to see the actual published study. This is because one of the things said in the ScienceDaily press release was that the tobacco was commonly used in other parts of the world. I had to ask myself, “What does this scientific finding mean to us – the USA?” I expected that I would find that the tobacco analyzed, which did cause some cellular changes that could lead to cancer, was NOT a product used in this country. That has happened before, both with good and bad outcomes, and it is important as a health educator that I know what I am talking about- yes?

I was able to access the journal article in Chemical Research in Toxicology.
Well of course I was blown away by the technical nature of the study and it was somewhat (ok very much so) over my head. Very basically an enzyme abbreviated as CYP and its protein subtypes will break down (in phases) the cancer causing agents in tobacco and other products. Often in tobacco we are referring to tobacco specific nitrosamines or TSNAs. In this instance the metabolism of the TSNAs or the breakdown of them by the enzymes can affect the cells in such a way as to change DNA. When DNA is changed, cells can mutate and become cancerous. This study showed that there are several organ systems affected by this toxic metabolism and thus smokeless tobacco could lead to several types of cancer. This is not a study to say that ST causes cancer, only that the processes that were seen are the same that in other situations have created a cancerous condition.

Still, the type of tobacco used in the region of study, Southeast Asia and India, is not the common tobacco used in the USA or even Western Europe. The researchers studied the effects of the tobacco metabolites from a certain blend called gutkha which according to Wikipedia and other sources is a mixture of tobacco and crushed betel nut, catechu, lime and other flavorings. What is catechu you might ask? It is some type of palm plant that grows in India and similar areas.

The ScienceDaily article did not at all note the type of tobacco or more exactly, tobacco juice (tobacco mixed with saliva), that was studied. This gutkha is not Copenhagen, Skoal or Redman and it is known to be worse than the Swedish brand of snus – so the article is good and as someone concerned with global health it is relevant, but as a US tobacco educator I would be wise to make the distinction of which tobacco causes which harm in my presentations as the one thing I want to be sure of is that I, unlike Big Tobacco, tell the truth!

Orbs, Strips, Sticks and the CTP

How did that one grab you? Okay let us start with the end. CTP is the Center for Tobacco Products. This is a new department that was created after the FDA gained the right to regulate tobacco in the 2009 Family Smoking Prevention and Tobacco Control Act.

Orbs, Strips and Sticks are tobacco products being marketed by RJ Reynolds (parent company Reynolds American) that are smokeless. Also involved in this story are products called Ariva and Stonewall tablets. All of these deliver nicotine to the user without the use of a cigarette. They are likely safer than smoking and maybe even safer than snuff, chew or betel quid, but they are not without risk. Nicotine is a psychoactive drug. It alters one's mood and it is addictive.

So RJR and Star Scientific, which owns the two other products, have just received letters from this newly created CTP. The letters are requesting (demanding) information from both companies on these products, who is using them and what adverse effects have been found through the companies own research. The Center for Tobacco Products is concerned because these items are flavored and subtle and appear to be targeted to our youth. Of issue is that they may in and of themselves cause harm - and they may lead to a case of addiction which leads the user to seek out a product that delivers more nicotine more quickly, i.e. cigarettes.

Apparently, the CTP thinks that the idea that the product is meant for current adult smokers is hogwash. Current adult smokers are doing two things that make this somewhat unlikely. They are quitting smoking and/or they are dieing. It is also expected that if the companies ARE targeting these current smokers, they want them to continue to smoke while using the tic tac or tooth pick or breath strip like products in times and places where they cannot smoke.

I am glad the FDA/CTP and Office on Smoking and Health are being proactive. In reading this however, I recalled that Phillip Morris, parent company Altria, did NOT oppose the FDA regulation and RJR did. People who follow these types of things posited that the reason was PM did not want anyone else to get into the smokeless market. AHA. PM owns USST which makes Skoal or Copenhagen or both, I cannot remember, but that snuff has far far more market share then these products I mentioned today. If PM can keep the traditional smokeless tobacco, chew or dip, the choice of current and former smokers, and the other products don't make it to market, well, they make the money don't they!

PS, tobacco kills......

Diabetes and Smoking

Today I read an article that was part of a continuing education program. In other words, I read the article and then took a little test to earn credits to show others that I work to keep my knowledge up to date. The research result was not one that I was pleased to review, and though the study was large, it was not the gold standard type of study so many factors could work to against the findings.
The finding of the study was that smokers who quit smoking were more likely to develop diabetes in the three years following their quit, than non smokers or former smokers in that same time period. After about 12 years of quitting, however, the extra risk is about zero. The study did take into consideration many factors that might affect ones risk of getting the disease. The increase risk stood in light of some of those confounders and was associated with more years and more packs per day, but was mediated by consideration of systemic inflammation and weight. In other words, if the quitter gained weight in the years immediately following the quit, that could and did explain why the developed. Also, smoking leads to an inflammatory response and inflammation can lead to both heart disease and diabetes.

A couple of things to say here. The first is that while reading the current study, it was noted that smoking is a "well known" risk factor for new case diabetes II. Well, I had not believed that to be the case and according to our CDC and the Surgeon General reports, the evidence is not yet strong enough to make that conclusion. However, according to the article I am currently reading by Dr. Neal Benowitz of UC and also the Cancer Council of Australia's Tobacco in Australia, smoking most definitely is a risk for the disease as it appears to cause insulin resistance.

It is clear, and supported scientifically, that diabetics who use tobacco have much worse outcomes and significant risk for fatal heart disease.

But what of the current smoker and the quitting? Should they keep smoking? They do have a 50% chance of not developing any of the 30 or so diseases associated with tobacco use (though they have a 100% chance of smelling bad). Personally, I think 50-50 odds are ridiculous when the excess risk of these diseases could be zero. So the thing to do is watch the weight gain and to counsel the smoker about this risk.

Many people will tell you these two things and I stand fiercely against both. 1)
quitting smoking will lead to some weight gain and 2) the weight gain is not as bad as the continued smoking.

First, the only thing that causes weight gain is consuming more calories than your body needs. The caloric balance may shift when quitting, but that is not a guarantee of weight gain, it is a call to action. And well, the second part has been disproved by this research study.

Remember what I said the other day. You can choose neither. The option is NOT smoke or be overweight. Smoking is a negative coping skill and more positive ways for dealing with life exist. Eating too many calories is also often a negative coping skill. Increasing physical activity and utilizing some of the valuable tenets of both Volumetrics and Weight Watchers can offset that. (so can learning positive coping skills!)

Let the Head Scratching Cease

This is not another attempt on my part to leave you guessing - nor is it a blog about preventing or treating head lice. Nope. My goal for tonight's post is simple. I will explain what I was talking about yesterday!

The title was, You Can Choose NEITHER.
I then told you about recent reports on tobacco and obesity related health outcomes. Tobacco users, it is said, are more likely to die early. On average they die 14 years sooner than is expected and our life expectancy (USA) is around 77 these days.
Obese persons do not necessarily lose actual life years, but they lose quality life years. Obese persons often have debilitating conditions that limit functioning and require long term medication. It is said that obesity is more of a burden to our economy than tobacco has been.

And my point was... Instead of a dying young or dying slow - you can choose NEITHER! By maintaining a health promoting weight and not using tobacco you significantly increase your odds of living a long AND active life.

sigh - using tonight's post to explain last nights was inspired by my friend Paula.. who is no longer scratching her head!

You Can Choose NEITHER

Obesity had another day in the news. First a Heartwire release about a study that will be published in the American Journal of Preventative Medicine and later some insight from Michael Dietz, Director, Division of Nutrition, Physical Activity, and Obesity at the CDC and a spokesperson from the advocacy group Trust for America's Health. The two gentlemen spoke on NPR.

The research study involves data collected from both the Behavioral Risk Factor Surveillance System and the National Health Interview Survey - multi year multi method strategies for gathering data on the behavior and the disease outcomes of Americans. The study authors have found a difference in the way tobacco use and obesity alter our lives. Simply put, a smoker loses more years of life, period. They die much younger as a rule. Obese persons do not die younger but they spend many more years with disabling conditions. These conditions make them less active and less comfortable. Often they are on numerous medications as well. Thus, obesity costs the country much more money that tobacco. Also smoking rates continue to decline where as in the last fifteen years obesity, BMI over 30, has increased an astounding 85%.

Now on the radio show, it was noted that the ascent of obesity seems to have plateaued. Experts credit this to more awareness of obesity as a health issue and more acceptance of being active and watching the high fat or high calorie foods. Dr. Dietz spoke about public awareness campaigns and TFAH discussed the health reform bills which have provisions for including things such as calorie content on menus and mandated physical activity. Both men discussed the need for an environment that is conducive for the types of change people need to make.

That leads to my observation. It seems that we have made healthy lifestyles socially acceptable now we have to spend our dollars and efforts on making them socially possible.

Quitting Tobacco and Weight Gain

If the fear of gaining weight is keeping you from quitting, here is what you need to know:

-There may be a slight change in your metabolism (or energy burn) when you quit using tobacco. -You may feel hungry more often than when you used tobacco.
-Food is going to smell and taste better!
-You might want to eat to keep from smoking or dipping.
-Exercise can help keep your energy burn from slowing, including weight lifting.

But the most important thing you need to know:
Tobacco does NOT make you thin and quitting WILL NOT make you fat.

Eating more than you burn off will cause weight gain. So eat, but eat smart.

Change Your Plate!

-Eat several meals throughout the day.
-Drink plenty of water.
-Choose certain fruits and vegetables that are high in fiber, nutrients and water.
-Choose foods low in saturated fat.

American Institute for Cancer Research

-Choose foods low in sugar.
-Choose lean proteins like canned light tuna in water, chicken without skin, beef labeled loin or round, fish (broiled, not breaded or fried), peanut butter, tofu, beans… -Avoid butter, dips, sauces, full fat cheeses and oils as much as possible.
-Drink calorie free beverages like coffee, tea and water.
-Choose whole grains.
-Read your labels and watch out for fat, sodium, sugar and calories.

Check out this website for more on labels: http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/
Check out this book from the library:
The Volumetrics Eating Plan by Barbara J. Rolls Ph.D.
Watch healthy lifestyle videos on YouTube: “Deerunstoo” channel

New Zealand Nutrition Conference

I thought if I just wrote obesity conference as the title, you might skip this read due to obesity burnout. I will keep it short for you.

Tomorrow in New Zealand - Wellington to be exact, nutrition experts from across the country are meeting with tobacco control experts in an attempt to revitalize the campaign against obesity. The rates of overweight and obese are similar in New Zealand to USA and other western countries. About 33% of adults are overweight and 25% are obese. They may have more obese adults than the USA.

In a press release about the up coming conference the Cancer Society Health Promotion Manager, Dr. J. Pearson shared some of her thoughts or concerns and here I will share those that resonated with me.

She said that they (the country) needed to tackle this problem the way New Zealand and other countries have dealt with tobacco. Many countries have successfully reduced their national smoking rates, some, like the USA have cut them in half. You know how it was done - ongoing campaigns about the dangers, increase in cost, limited access and promotion, esp. to children, and medications or programs to assist in quitting.

When Dr. Pearson mentioned the advertising of unhealthy and fast foods I had a thought. Remember when tobacco ads were more prominent? Do you ever remember seeing a person who looked sick (or dry skinned and wrinkly) smoking a cigarette? No. Do you see many obese people doing commercials for Twinkies, Fritos, sodas and McDonald's?

I understand that eating is pleasureful but for some it is a pleasure substitute or a lack of understanding. Even if food makes you happy I am near certain that being overweight does not bring you contentment. When we first started to crack down on smoking people - addicts, became upset that the government was trying to control them and tell them what to do. That is mostly because the tobacco companies were minimizing the health effects and glamorizing smoking. Now that the majority of the population DOES believe that tobacco kills, having limited access to tobacco and being protected from tobacco smoke is seen as a GOOD thing.

So think of a person who is hearing that obesity, even moderate overweight(ness) , can lead to heart disease, diabetes, and arthritis but seeing healthy, slim, active people eating high fat high calorie foods? Or the person wants to eat the lower calorie plant based or Mediterranean diet but cannot find those foods or afford them?

As Dr. Pearson said, "It is like telling a smoker not to smoke, then putting them in a room full of smokers and handing them a cartoon of cigarettes!"

On a final note, there is also concern in New Zealand that many of the schools healthy lunch programs have lost funding and that the Government seems to think that increasing physical activity is going to solve the problem. As I have learned and Dr. Pearson notes "strong international evidence" is telling us that this problem cannot be solved if people do not start eating LESS calories. Physical Activity is a must for good health and disease prevention but it is NOT a first line weight loss strategy, calorie control, is.

Now stay tuned tomorrow for news on the problem of obesity in our PETS :)

Are We Smoking More or Less?

This is not the post I intended for today, but one I chose to reproduce from a work related email I sent out last week. I didn’t realize that the general public had also been exposed to some confusing information about the current rate of smoking in this country until my Mom mentioned something about it tonight. That being said, I will share with you the same email I sent to my peers. I will explain some of the abbreviations however!

The November 13 MMWR (Morbidity and Mortality Weekly Report – morbidity means disease) from the CDC (Centers for Disease Control) , of which there were two, give us different numbers in regards to tobacco use and cessation (quitting). This is confusing. One report uses the in person NHIS (National Health Information Survey) data with 62 % of 21,781 persons responding and the other is from the BRFSS (Behavior Risk Factor Surveillance System) telephone survey of 414,509 respondents. (notice the HUGE difference in numbers and that one is an in person survey and the other a telephone survey)
It is said that the findings are different as the NHIS data is meant to track trends towards the Healthy People 2010 objective of 12 % smoking rates, while the BRFSS gives us better state level measures.
That being said, Florida’s smoking prevalence rate HAS declined. (newspaper headlines are focusing on the first national prevalence increase in I believe 15 years. I do not want me or you to be disheartened because we ARE making a difference in Florida. ) According then, to the MMRW that focuses on state – level estimates, Florida is now at 17.5 % total adult smokers, 18.7 men and 16.4 women! That is BELOW the national average with which we were even last time.

In the MMWR with the NHIS data, we learn that the highest level of smoking is in persons who have a GED. Interestingly, in the data set, I see that all age groups have gone up in prevalence EXCEPT the 18-24 age group. Otherwise the age group prevalence was similar across the board until we get to age 65 which is significantly lower (death and quitting!) Also in this data set: of all persons who had smoked at least 100 cigarettes in their lifetime, 51% had quit.

And for tobacco treatment specialists and educators, this statement is worth sharing, “Evidence based programs known to be effective at reducing smoking should be intensified among groups with lower education, and health care providers should take education level into account when communicating about smoking hazards and cessation to these patients.”

Here is the CDC table listing state smoking rates.


TABLE 2. Estimated prevalence of current cigarette smoking among adults,* by sex and state/area --- Behavioral Risk Factor Surveillance System (BRFSS), United States, 2008


Much to my chagrin, I cannot paste the tables in here so that they are in any way readable. This is only the half of it, HOWEVER, it is the lower half! Please go to this CDC link . You will see a much better image of the nations smoking rates.

There is more that might interest you in the data.

You Heard it FIRST

Several weeks ago I blogged about a vaccine that is being tested for use in the prevention or treatment of nicotine dependence.
http://yourhealtheducator.blogspot.com/2009/10/drug-abuse.html
This same vaccine, known as NicVax, was discussed in an USA Today piece this morning. There was no new information in the article. It discussed how the vaccine worked and that the National Institutes of Health had granted 10 million dollars to the company that has made the vaccine. There were phase one and two trials, but now the drug will be used in very large phase three clinical trials. The ten million is for the clinical trials.

Before I saw the article in the paper, I had read on line that GlaxoSmithKline was working on a licensing agreement with the company that makes the vaccine. The company is Nabi Biopharmaceuticals. The agreement will give GSK exclusive rights to market and sell the drug should it be FDA approved for use. GSK is paying 40 million dollars up front for this and Nabi expects that with all "fees and regulatory, developmental and sales milestones" it could net 500 million. They will also benefit from royalty fees.

A reason GSK, who produces and sells the nicotine patch, gum and lozenge, could be forward thinking and hoping on this can be found in a statement from the USA Today article. The statement was comparing the nicotine vaccine and the similar cocaine vaccine. It is felt that the nicotine vaccine is going to have a lot more support from drug companies because it "would be much more profitable."

So as I said before, if anyone can beat Big T it is going to be Big P, and I AM right about this!

first, second or third

This post is not really inspired by all the research I do on tobacco, but by my leisure time activity last night.

In a way it is a two or three part post on my experience. It involves second and "third" hand smoke and triggers to use tobacco.

Firstly, I conduct or facilitate quit smoking classes and groups as part of my job. Many times smokers wonder about drinking without smoking. The two acts are entrenched for smokers, and it takes some time to separate them. Last week in one of my classes, we discussed what to do when newly quit and going out to drink. Our responses ranged from not drinking, to drinking at a restaurant, to using a cocktail straw, and lastly, having some nicotine gum on hand. Then someone asked me when I had quit, 1/2/97 and if I still had cravings. I do not have cravings in general and I do not have them when I am faced with old triggers.

Last night I was at a bar that allowed smoking. I didn't realize it at first. Because the doors were open, front side and back, the smoke didn't hit me hard. It usually does as I am very sensitive. Seeing a person here or there with a cigarette in their hand was just mind boggling for me. I paid attention though, and No, it did not make me want one. I did not feel like I needed to have a cigarette in one hand and a beer in the other. I was fine with just the beer!

When I left the bar (two beers in three hours) and sat in my car, then it hit me. I seriously thought, "what is that smell?" It took a minute, but yes, my hair and my clothing had the cigarette smell.

So let me explain the 1st. 2nd, 3rd of it.

First hand smoke is what the person smoking the cigarette inhales into their lungs only. It is a toxic mix of particulate matter that causes or exacerbates numerous disease states and also activates several neurotransmitters in the brain.

Second hand smoke is what they exhale as well as what is emitted from the lit cigarette. (we refer to this as mainstream and sidestream smoke) SHS is deadly and there is no safe level, only lower doses.

The particulate matter I mentioned doesn't just evaporate, it settles on anything in the room where the smoke was exhaled or emitted. That means it settles on YOU> It settles on clothing, furniture, walls, hair and skin. Particulate matter is microscopic. You can not see the chemical residue but it infiltrates lungs and is what we refer to , in total, as TAR.

We have surgeon generals' reports on smoking, smokeless tobacco and second hand smoke. I expect there will be one on the residue as well. Earlier this year, folks at MassGeneral Hospital for Children, in Boston, began calling this "stink" third hand smoke. I disagree with the name, but certainly get the concept.

So for myself, I say this. The night out was FUN. I did have a SHS headache for much of the morning and had to cleanse my skin and clothes of the smoke residue and so for this reason, I do support total public smoking bans.

Believe it or not, the less places a person can smoke, the less triggers they will have when they make their QUIT and the more successful their quitting will be.

Big Pharna Eats em Up

When you get a notion about something, you tend to stay on alert for any article that will support or debunk that notion. I have recently been expressing my thoughts on how Big Pharma is similar to Big Tobacco. Well, even I am surprised at how true my presumption appears to be. This was supported a few days ago by a headline regarding one big pharmaceutical company buying another. In fact, two companies have bought companies that were pretty big themselves and the profits for Big Pharma appear to be pretty consistent, just like tobacco.

Merck bought Schering- Plough and Pfizer bought Wyeth. That would put Merck against Pfizer and GlaxoSmithKline. Also this week, the FDA noted that the labels on many drugs were misleading and did not tell consumers the whole story.

Now I have cautioned you about commercials that tell you a drug or product or DIET PROGRAM was clinically tested, as that doesn't tell you anything, and I have also warned you about ads that say that people on a diet, for example, lost more weight than people not on it, because if it wasn't statistically significant, than it could be related to chance. But even pharmaceutical companies are guilty according to doctors speaking in the New England Journal of Medicine. One example they give is telling people that the drug is more effective than placebo. Ok, it is better than nothing. Is it better enough to change a disease outcome?

Why does this make me think of Big Tobacco?
Altria Group owns Philip Morris USA, maker of many top selling cigarettes, including Marlboro and Virginia Slims and US Smokeless Tobacco, AND John Middleton, which sells cigars and pipe tobacco. Philip Morris International sells some of the same brands of cigarettes abroad and has additional country specific brands, PLUS they just bought Swedish Match South Africa which sells smokeless tobacco and snus, Reynolds American owns RJ Reynolds which sells five of the top ten cigarette brands, including my old favorite, Winston as well as Conwood Co LLC which is the second largest smokeless tobacco company and sells roll your own tobacco and a company called Sante Fe which sells the American Spirit brand.

I don't think I need to tell you how fraudulent and unscrupulous their tobacco advertising has been.

So yeah, these are behemoths of companies with billions of dollars in revenue and people either desperate for the medication they sell to treat illnesses many times self perpetuated and people desperate for a product that they are addicted to and which is leading them down the road to having to rely on Big Pharma to get off the stuff or to stay alive or both.

Cynicism is on the menu tonight - sorry

Let the Comparison Begin

I am actually torn about tonight's post. Yesterday I received an article in the mail from a dear friend in Maine. I did not read it closely until just now.
Last night the first news stories were published about the cost of treating obesity (147 billion a year) and out of curiosity I looked up the cost per year that Tobacco Free Kids estimates is spent on tobacco related illnesses (96 billion a year). Obesity has indeed passed tobacco, I expected it would.
And this morning, I read an article about reducing hospital re admissions and got rather frustrated at a lack of personal responsibility in the patients. So all that is on my mind!

The article, ironically, compares Big Tobacco with Big Food and was written by Ellen Goodman. She notes a new film and a new book regarding the food industry's tactics to get us to eat more cheap, fast and harmful food and wonders if the mood of America isn't about to change and say, "Enough." She does note a concern that always frustrates me and that is the controversy over accepting ones weight or size and rallying against obesity. Well, the fact that it is considered a controversy is the problem. I actually had the thought today that maybe our Armageddon is going to be related to our total lack of responsibility in taking care of the body that the creator(s) gave us. Many times it seems a total disregard for health and wellness. An abuse of our very essence... we wouldn't treat our cars or motorcycles this way and expect them to keep running, would we?

I am not without empathy and I do feel that addictions exist and are not something that can be willed away.. however, one has the personal responsibility to adopt a treatment or follow a plan to change what is wrong. In the article I read this morning, a woman with chronic heart failure was dismissed from the hospital after an exacerbation of her illness. She was advised not to eat hot dogs, as the July 4th Holiday was approaching. The patient is quoted as saying that she went to the picnic and said, I am not supposed to have a hot dog, but give me one anyway. She further commented that if she was dead in the morning she would never know. Well, ha ha, isn't that funny. Instead, she was back in the ER and admitted to the hospital because she did NOT do what the doctor's said. Perhaps people need to understand that not taking care of themselves has a ripple effect. Her family would have been worried and strained by this readmission, doctors and nurses would have to care for her and somebody did not get a bed at that hospital because she was in it. Oh, and she is a Medicare patient so premiums for everyone can be effected.

I suppose everyone has a right to go to hell in a hand basket at their whim.. as my friend Tom Brown used to say.. but only if they can do so without wasting the rest of our valuable resources to get there.

So yes, I feel incensed by some of the recent news...