Health Alert

Stub That Butt Out

Pharmaceutical companies play up the use of anti-tobacco aids, which makes quitting smoking without help seem impossible……….. But it’s not, T.V. Jayan points out
Are the global efforts to kick the butt dimmed by distortion and deception? Perhaps, says tobacco control expert Simon Chapman.

A public health researcher at the University of Sydney, Chapman — who wrote more than a dozen tomes on tobacco control — has unearthed a disturbing trend in smoking cessation attempts. The pharmaceutical industry has been trying to create the false impression that attempting to quit smoking without medicines or nicotine replacement therapy (NRT) is futile, reveal Chapman and his colleague Ross McKenzie. Their article appeared in the journal PLoS Medicine last week.

With the industry proclaiming that “willpower alone is not enough to quit”, smokers may think it’s useless to try to kick the habit without any aid, they say.

“The aim should be to encourage attempts to quit smoking, and not constantly describe it as difficult. The process has become overly medicalised for many,” Chapman told KnowHOW.

Not surprisingly, nearly two-third to three-quarters of those who quit smoking did so without any professional or therapeutic help, he adds. This, even though anti-tobacco drugs — such as bupropion and varenicline — and NRT products like patches, gum and lozenges have been in the market for more than 25 years.

NRT, medicines and professional counselling or support may help many smokers, but are not necessary for quitting, asserts Chapman.

According to experts, the cold-turkey method — where you progressively reduce the number of cigarettes before stopping completely — is still the most preferred approach. And campaigners are pleased that in a growing number of countries, there are now more non-smokers than smokers.

Chapman and McKenzie, who analysed more than 660 papers on smoking cessation published in 2007 and 2008, found that the industry and many tobacco control researchers have conveniently neglected the power of unaided cessation. On the other hand, there has been an attempt to play up the benefits of pharmacological intervention.

The study also brought to light a bias in research on assisted cessation. While industry-supported research showed that quit-smoking medicines and NRT products have a 51 per cent efficiency, independent studies said the impact was just 22 per cent.

“Because of these attitudes, smoking cessation is becoming increasingly pathologised, a development that risks distorting public awareness of how most smokers quit, to the obvious benefit of the pharmaceutical companies,” say the researchers.

The study comes at a good time, when India is embarking on a major tobacco control campaign. In the last week of January, the Union cabinet approved a Rs 182-crore tobacco control programme. The project — which would cover 42 districts in 21 states — is expected to step up public awareness of the ill effects of tobacco use by setting up testing labs and conducting adult tobacco surveys over the next two years.

Sadly, India has one of the poorest rates of quitting: only about 2 per cent of the smoking population is able to kick the habit annually.

Chapman’s views are echoed by Prakash Chopra, a tobacco control expert and director of the Healis-Sekhsaria Institute of Public Health, Mumbai. Chopra strongly believes that there is a need to publicise the fact that most smokers quit without any aid.

“It isn’t enough for public health policymakers to simply stress this fact; they must also assist unassisted cessation,” he says. This can be done by allocating funds for initiating and enforcing policies in this direction, he suggests.

Chapman points out that most of the government money for tobacco control is spent in support of NRT or similar strategies rather than in aiding unassisted cessation. The criticism seems more than valid, as within a couple of days of publishing his paper many experts from all over the world came up with similar views.

Prabhat Jha, director of the Centre for Global Health Research in Canada, however, believes that pharmaceutical aids do help, though only for a brief while. “These aids double the effectiveness of smoking cessation attempts from a quit rate of about 3 per cent to up to 8 per cent in the following six months. It is true that a vast number of quitters quit cold turkey. But pharmaceutical drugs do help, and if they help more smokers to quit, it’s a good thing,” says Jha.

According to Jha, there is another way out of the haze — tobacco products should be taxed higher. In developing countries, a 10 per cent higher price, it has been found, results in about 3 to 4 per cent of smokers quitting, and another 3 to 4 per cent of individuals not taking up the habit, he says.

Higher prices and then drugs and therapy — why not use your willpower and save your health as well as money?

Source: The Telegraph (Kolkata) India

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Laser Therapy May Help Neck Pain

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So-called low-level laser therapy (LLLT) entails using a laser‘s light — but not its fiercely concentrated heat — to stimulate tissue repair and ease pain.
Doctors led by Roberta Chow of the Brain and Mind Research Institute at Australia‘s University of Sydney carried out an overview of 16 randomised trials that put this increasingly popular procedure to the test.

A total of 820 patients were enrolled in the trials, divided into groups that received either the therapy or a lookalike, dummy treatment. In five trials, patients given LLLT were around four times likelier to have reduced pain compared with a placebo, the paper found.

In the 11 other trials, for which there was a detailed analysis of pain symptoms, LLLT patients reported reductions of chronic pain by around 20 points on a scale of 100 points. The pain reduction continued for up to 22 weeks.

LLLT compares favourably with other drugs and other remedies for effectiveness and its side-effects are mild, says the study, which recommends that it be used in combination with an exercise programme.

Why LLLT works, though, is unclear. The authors suggest it could interfere with pathways of inflammation, muscle tiredness and the transmission of pain signals along nerves.

Between 10 and 24 percent of people suffer from chronic neck pain, inflicting a cost running into the hundreds of millions of dollars and highlighting the need for simple but effective treatent, the authors said.

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Source: The Times Of India

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Caffeine in Sunscreen May Cut Skin Cancer Risk

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Adding caffeine to sunscreens could boost protection against the most common form of skin cancer, claim scientists.

According to the study, conducted by a team from Harvard Medical School and Pfizer, caffeine has an effect on cells which can go on to cause non-melanoma skin cancers and found that the stimulant encourages the harmful cells to die.

The breakthrough study shows at caffeine helps eliminate human cells damaged by UV light, which can develop into cancer, by causing them to commit suicide, reports The Telegraph.

Writing in the Journal of Investigative Dermatology the authors said: “These data suggest topical application of caffeine…perhaps in a sunscreen or after-sun preparation could be investigated as an approach to minimise or reverse the effects of UV damage in human skin.”

Gavin Greenoak, Managing and Scientific Director of the Australian Photobiology Testing Facility (APTF) at the University of Sydney, Australia, said: “This research show the potential to improve protection from non-melanoma skin cancer by adding caffeine to topical sunscreens or through more specific drug synthesis.”

Sources: The Times Of India

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Healthy Tips

Simple Therapy for Back Pain

Paracetamol and keeping active are the best cures for back pain, according to Australian researchers who warn that other treatments do not work.

A Lancet study of 240 back pain sufferers found anti-inflammatory drugs and spinal manipulation did not make any difference to recovery time.

Yet currently, both treatments are recommended in several guidelines.

Experts said patients needed to be reassured that avoiding bed rest and taking paracetamol would work.

Researchers at the University of Sydney assigned patients to receive either an anti-inflammatory drug called diclofenac, a dummy drug, spinal manipulation or fake manipulation therapy.

They had already received simple treatment advice from their GP to keep active, avoid bed rest and take paracetamol for the pain.

The study found no difference in recovery times after 12 weeks in patients who also received diclofenac or spinal manipulation.

Almost all the patients had recovered by the end of the study no matter what treatment they had received.

Adverse effects

Study leader Mark Hancock said there was no clinical benefit from the additional treatments.

And both non-steroidal anti-inflammatory drugs (NSAIDs), such as diclofenac or ibuprofen, and spinal manipulation are associated with adverse effects, he added.

“GPs can manage patients confidently without exposing them to increased risks and costs associated with NSAIDs or spinal manipulative therapy,” he said.

Dr Bart Koes from the Department of General Practice at Erasmus University in the Netherlands, who wrote an accompanying article in The Lancet, said the results were probably applicable to other non-steroidal anti-inflammatory drugs, such as ibuprofen.

He told the BBC: “It is very likely that for many patients with acute low back pain currently treated with NSAIDs and/or spinal manipulation this would not have been needed if adequate first-line treatment with paracetamol and advice and reassurance was given.”

Dr Stuart Derbyshire, senior lecturer in the School of Psychology and expert in pain at the University of Birmingham, also agreed with the findings.

“For most people, providing simple care and advice should guide the patient through their acute phase of pain and allow them to return to normal life when that acute phase is over.”

Back pain is the largest single cause of sickness absence from work.

But Tony Metcalfe, president of the British Chiropractic Association warned the therapy in the study could not be compared with the treatment provided by chiropracters in the UK.

“Spinal manipulation is just part of a package of care offered by BCA chiropractors which also includes lifestyle and posture advice, rehabilitation and specific exercises.”

He added that spinal manipulation therapy is a safe treatment and none of the study participants reported serious adverse reactions.

Nia Taylor, chief executive of BackCare said the key message for people was to keep moving.

“We know that many GPs feel ill-equipped to help patients with low back pain and sometimes people are not given the right advice and reassurance when they first see a GP.”

She added: “In the UK a standard appointment of 10 minutes may not be long enough to give adequate advice and reassurance and convince the patient that a regime of paracetamol and keeping active is enough to ensure recovery.”

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>Exercises for Back Pain

Sources: BBC NEWS:Nov 9th. ’07

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